Noninfectious meningitis

[Tracie Lynn]

Meningitis is occasionally caused by noninfectious conditions (eg, noninfectious disorders, drugs, vaccines). Many cases of noninfectious meningitis are subacute or chronic.
(See also Overview of Meningitis.)
Symptoms of noninfectious meningitis are similar to those caused by other kinds of meningitis (eg, headache, fever, nuchal rigidity). Severity and acuity can vary, but noninfectious meningitis tends to be less severe than acute bacterial meningitis.
Diagnosis of noninfectious meningitis is based on analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (preceded by neuroimaging if increased intracranial pressure or an intracranial mass effect is suspected). CSF findings may include

Lymphocytic or neutrophilic pleocytosis
Elevated protein
Usually normal glucose

Treatment of noninfectious meningitis involves treating causative disorders and stopping causative drugs. Otherwise, treatment is supportive.
If patients appear seriously ill, appropriate antibiotics and corticosteroids are started immediately (without waiting for tests results) and continued until acute bacterial meningitis is ruled out (ie, CSF is shown to be sterile).