Multidisciplinary approach in the investigation and treatment of chronic meningitis: A systematic review of the literature and current guidelines

Abstract

This study presents a systematic review on chronic meningitis, an inflammatory condition of the membranes surrounding the brain and spinal cord, with potential for severe neurological complications and risk of fatality if not properly treated. We employed a rigorous methodology, including a comprehensive review of the literature in reputable databases such as PubMed, Scopus, Web of Science, Cochrane Library, and Embase. Inclusion and exclusion criteria were stringent to ensure the selection of relevant and high-quality studies. The analysis of selected studies revealed several underlying causes of chronic meningitis, ranging from infections to malignant neoplasms, autoimmune disorders, chemical meningitis, and parameningeal infections. Clinical manifestations are diverse and may include persistent headache, hydrocephalus, cranial nerve damage, spinal nerve damage, and cognitive alterations. Accurate diagnosis is crucial and is based on cerebrospinal fluid (CSF) analysis, involving a series of laboratory and microbiological tests. The importance of a multidisciplinary approach in the management of chronic meningitis is emphasized, which should involve clinicians, neurologists, microbiologists, and pathologists. Early identification of the specific cause and implementation of appropriate treatment are fundamental to improving clinical outcomes. Empirical therapy may be necessary in cases of uncertain diagnosis, but adjustments should be made based on clinical evolution and test results. We conclude that interdisciplinary collaboration and continuous updating of clinical practice are essential for the effective management of chronic meningitis. Future research should focus on the development of faster and more accurate diagnostic techniques, as well as more effective therapeutic strategies, aiming to significantly improve the quality of life of patients affected by this debilitating condition.

DOI:https://doi.org/10.56238/sevened2024.012-026