Essentials in managing chronic meningitis.

The diagnosis is often elusive, but the high morbidity and mortality of unrecognized chronic meningitis make diagnosis and therapy imperative. The family physician is likely to be the first to encounter a patient with chronic meningitis. Meningeal signs, changes in mentation, seizures or cranial nerve palsies may occur. Cerebrospinal fluid protein is elevated and there is a lymphocytic pleocytosis. Tuberculous and fungal infections are the most common causes, but metastatic carcinoma is being seen with increasing frequency.