OVERVIEW

What is subacute or chronic meningitis?

When acute meningitis persists for several days or weeks, it becomes subacute meningitis. If the condition persists for more than 4 weeks, it is considered chronic meningitis.

SYMPTOMS

What are the symptoms and manifestations of subacute or chronic meningitis?

Cases of subacute or chronic meningitis are very rare, with diverse causes and varying clinical symptoms.

However, most cases still present symptoms similar to acute meningitis, such as fever, headache, and vomiting, but the progression of the illness is slower or fluctuates repeatedly.

CAUSES

What are the causes of subacute or chronic meningitis?

There are many possible causes, including microbial infections (such as enteroviruses, HIV, fungi, Mycobacterium tuberculosis, Rickettsia, spirochetes, Toxoplasma gondii), autoimmune rheumatic diseases (such as systemic lupus erythematosus, rheumatoid arthritis), or cancer.

Is subacute or chronic meningitis hereditary?

No.

Is subacute or chronic meningitis contagious?

It may be contagious if caused by a microbial infection.

DIAGNOSIS

What tests are needed to diagnose subacute or chronic meningitis?

The tests required for subacute or chronic meningitis are similar to those for acute meningitis, but repeated lumbar punctures may be necessary to determine the cause.

• Blood test: This involves drawing blood to check indicators such as white blood cell count to determine if there is an infection.

• Lumbar puncture: A needle is inserted into the lower back to extract cerebrospinal fluid for testing. This can identify the specific bacterial infection and also relieve symptoms like headaches and vomiting. This test is crucial for diagnosing the nature of meningitis but is invasive, requiring consent from the patient and family. The patient must remain still during the procedure, and family members may need to provide comfort. After the puncture, the patient should lie flat without a pillow for a period of time.

• Brain MRI: This helps assess brain swelling.

• Meningeal or brain biopsy: A small portion of brain tissue or meninges is surgically removed for laboratory testing. However, current reports indicate that a biopsy does not always provide a definitive diagnosis.

TREATMENT

Which department should I visit for subacute or chronic meningitis?

Neurology.

Is it necessary to seek medical attention for subacute or chronic meningitis?

Yes.

How is subacute or chronic meningitis treated?

If the cause can be identified, treatment is tailored accordingly—for example, antibiotics for bacterial infections or antiviral drugs for viral infections.

For chronic meningitis of unknown cause, empirical treatments such as anti-tuberculosis therapy or glucocorticoids may be used.

Does subacute or chronic meningitis require hospitalization?

Yes.

Can subacute or chronic meningitis be cured?

Due to limited data, it is uncertain. Many patients remain undiagnosed, making targeted treatment impossible. However, some patients, even without a confirmed diagnosis, remain stable for 1–3 years after onset.

DIET & LIFESTYLE

Does subacute or chronic meningitis affect fertility?

It does not affect fertility after recovery.

PREVENTION

Can subacute or chronic meningitis be prevented?

Due to numerous causes and unclear research, there are currently no known effective prevention methods.