Chronic and Subacute Meningitis: Differentiating Neoplastic From Non-Neoplastic Etiologies

• Published in: Neurohospitalist Vol. 8; no. 4; pp. 177 - 182
• Main Authors: Marrodan, Mariano, Bensi, Catalina, Alessandro, Lucas, Muggeri, Alejandro D., Farez, Mauricio F.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2018
• Subjects: Original; leptomeningitis; pachymeningitis; neoplastic meningitis; chronic meningitis; subacute meningitis
• ISSN: 1941-8744; 1941-8752
• DOI: 10.1177/1941874418773924

Background and Purpose:
Although incidence rates vary, infectious, autoimmune, and neoplastic diseases can all cause chronic and subacute meningitis (CSM). We report a Latin-American, single center, CSM case series, analyzing the main clinical characteristics as well as ancillary diagnostic methods differentiating neoplastic from non-neoplastic etiologies.
Methods:
Retrospective review of CSM cases from a single center in Buenos Aires, Argentina.
Results:
Seventy patients with CSM diagnosis were identified, 49 with neoplastic and 21 with non-neoplastic meningitis. A history of previous cancer was significantly higher in neoplastic cases, whereas prevalence of autoimmune disease and fever was more common in non-neoplastic meningitis. C-reactive protein values were higher in non-neoplastic CSM, as was pleocytosis in cerebrospinal fluid analysis. The most frequent etiologies were breast and lung cancer for neoplastic meningitis cases; and idiopathic, tuberculous, and fungal infection for non-neoplastic cases.
Conclusions:
Chronic and subacute meningitis diagnosis is challenging in daily neurological practice. The results we report contribute information from Latin America regarding etiologies of CSM, which can be identified after a comprehensive evaluation in a majority of cases.