Chronic Meningitis - Benign and Malignant Forms

Our plain-English summary of Chronic Meningitis - Benign and Malignant Forms, by G.W. Zeluff, T.W. Williams, D. Jackson (1980).

The study

• Authors: G.W. Zeluff, T.W. Williams, D. Jackson
• Published: Heart and Lung, Volume 9 No3. May-June 1980
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article is not about asbestos. It is a published hospital grand rounds discussion on chronic meningitis from The Methodist Hospital in Houston, Texas, and it reports no asbestos exposure or findings. Two patients were presented. The first was a Bolivian woman with recurrent headaches and abnormal cerebrospinal fluid. She had repeated episodes of meningitis with no cause found. A neurologist on the panel said her attacks fulfilled the criteria for Mollaret's meningitis, a benign recurrent form that is diagnosed only after other causes are excluded. The second was an 84-year-old man from Arkansas with progressive dementia who had cryptococcal meningitis. An India ink preparation of his spinal fluid was strongly positive, and Cryptococcus neoformans grew on culture. He was given amphotericin B but died of cardiopulmonary arrest, and autopsy showed cryptococcal meningitis. An infectious disease discussant reviewed diagnosis and treatment. The discussant stated that of 100 patients with proven cryptococcal meningitis, 80 will have a positive India ink preparation when a large volume of spinal fluid is used. The discussant recommended sending at least 30 cc of spinal fluid to the laboratory when chronic fungal meningitis is suspected.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Grand rounds conference discussion with two case presentations and a general review of chronic meningitis by the participating physicians
• Who was studied: Two patients at The Methodist Hospital, Houston: a Bolivian woman (age unreadable in the scan) with recurrent meningitis, and an 84-year-old man from Arkansas transferred in February 1979
• Exposure: No asbestos exposure is discussed; the article concerns infectious and other causes of chronic meningitis
• Main results:
  • First patient: her repeated episodes of meningitis had no established cause, and the neurology discussant judged that her attacks met the criteria for Mollaret's meningitis
  • Second patient: India ink preparation of the cerebrospinal fluid was strongly positive and Cryptococcus neoformans grew on culture
  • Second patient died of cardiopulmonary arrest; autopsy showed cryptococcal meningitis and cryptococcal infiltrates in the lungs
  • The discussant stated that of 100 patients with proven cryptococcal meningitis, 80 will have a positive India ink preparation using a large volume of spinal fluid. This is the discussant's general statement, not a result from these patients.
  • Asked how much cerebrospinal fluid to send to the laboratory in a patient suspected of chronic fungal meningitis, the discussant recommended a minimum of 30 cc
• The authors' conclusion: The discussant emphasized culturing large volumes of spinal fluid to diagnose fungal meningitis

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Autopsy.

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