What is recurrent meningitis?

Question

Hello doctor,

My brother is 19 years old and had meningitis last year. He has been doing fine since then, but now he is complaining of really bad headaches and some neck stiffness. Could it be the same thing happening again? Last time, we were told it was a pneumococcal infection, and it was really scary. Is there a chance that it has come back? He has not had any vaccines or treatments since then. Should he go for a check-up or get some tests done? I am really worried because we do not want to go through the same thing again. What symptoms should we watch for to know if it is meningitis or something else serious? Also, is there any way to prevent this in the future? Please let us know what we should do right away to make sure he stays healthy.

Kindly guide us.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

The term recurrent meningitis encompasses a variety of conditions, some of which are life-threatening, some spontaneously remitting, and others representing exacerbations of chronic infections or complications of drug therapy. Recurrent meningitis may involve repeated episodes of bacterial meningitis, recurrent episodes due to nonbacterial microorganisms, chemical meningitis caused by the rupture of dermoid or parasitic cysts, or drug-induced meningitis in response to nonsteroidal drugs or other agents.

In some instances, such as protracted cases of meningitis due to Cryptococcus neoformans, what appears to be recurrent meningitis may actually represent periodic exacerbations of a chronic, ongoing infectious process. In this article, the author reviews the pathogenesis, clinical features, diagnosis, and treatment of this group of disorders.

Episodes of recurrent meningitis fall into two groups: recurrent bacterial meningitis and recurrent episodes of nonpurulent meningitis. The symptomatology and cerebrospinal fluid changes in recurrent bacterial meningitis are typical of bacterial meningitis in general. Symptoms in recurrent nonpurulent meningitis are much more variable, and cerebrospinal fluid may contain lymphocytes, neutrophils, or a mixed pleocytosis.

Recurrent bacterial meningitis did not exist as a clinical entity before the advent of antibiotics, as a single episode of meningitis was almost invariably fatal. In modern times, between one to nine percent of patients surviving acute bacterial meningitis may go on to have further episodes.

For management, I suggest you consult a multidisciplinary team (MDT) including the following specialists:

A consultant neurologist.
A consultant histopathologist.
A consultant anesthetist.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.