Major Infectious Causes of Subacute or Chronic Meningitis
Organisms | Circumstances |
|---|---|
Bacteria | |
Mycobacteria: (Mycobacterium tuberculosis, rarely other mycobacteria) | — |
Spirochetes: Lyme disease, syphilis, rarely leptospirosis | For Lyme disease, East Coast, upper Midwest, California, Oregon |
Brucella species | Associated with livestock Unusual in the United States or other high-resource countries |
Ehrlichia species | Tick bites |
Leptospira species | Associated with exposure to urine of rats, mice, and other animals Unusual in Western countries |
Fungi | |
Cryptococcus neoformans | Most common among immunocompromised patients, particularly those with HIV infection |
C. gattii | Predominantly northern Pacific coast Appears to have a widespread distribution |
Coccidioides immitis | Southwestern United States |
Histoplasma capsulatum | Central and Eastern United States |
Blastomyces species | Predominantly Central and Eastern United States |
Sporothrix species (unusual) | No geographic distribution, but infection associated with rose thorns or brush |
Parasites | |
Toxoplasma gondii | Cat feces, contaminated meat |
Viruses | |
Retroviruses: HIV; human T-lymphotropic virus, type 1 | In patients with known HIV or risk factors |
Enteroviruses | In patients with a congenital immunodeficiency syndrome |