Abstract

Meningoencephalitis (; from Greek μῆνιγξ "meninx", "membrane", ἐγκέφαλος, "enképhalos" "brain", and the medical suffix "-itis", "inflammation") is a medical condition that simultaneously resembles both meningitis, which is an infection or inflammation of the meninges, and encephalitis, which is an infection or inflammation of the brain.

Causes

Causative organisms include protozoans, viral and bacterial pathogens.

Specific types include:

Causes | Protozoal

Ameobic pathogens exist as free-living protozoans. Nevertheless, these pathogens cause rare and uncommon CNS infections. N. fowleri produces primary amebic meningoencephalitis (PAM). The symptoms of PAM are indistinguishable from acute bacterial meningitis. Other amebae cause granulomatous amebic encephalitis (GAE), which is a more subacute and can even a non-symptomatic chronic infection. Ameobic meningoencephalitis can mimic a brain abscess, aseptic or chronic meningitis, or CNS malignancy.

Causes | Animal

Animal pathogens exist as facultative parasites. They are an exceptionally rare cause of meningoencephalitis.

clinical diagnosis include recurrent or recent herpes infection fever, headache, mental symptom, convulsion, disturbance of consciousness, focal signs.

CSF ,EEG, CT, MRI are responsive to specific antivirus agent.

Definite diagnosis – besides the above, the followings are needed

CSF: HSV－antigen,HSV－Antibody, brain biopsy or pathology: Cowdry in intranuclear

CSF: the DNA of the HSV(PCR)

cerebral tissue or specimen of the CSF:HSV

except other viral encephalitis

Treatment

Antiviral therapy: as early as possible

10~15mg/kg every 8 hours for 14~21d

5~10mg/kg every 12hours for 14~21d

immune therapy: interferon

symptomatic therapy

High fever: physical regulation of body temperature

Seizure: antiepileptic drugs

high intracranial pressure-20%mannitol

Infections: antibiotic drugs

Prognosis

The disease is associated with high rates of mortality and severe morbidity.

Notable cases

It was cause of death of the popular British TV presenter Christopher Price.

In May, 2009 former Premier of New South Wales (Australia) Morris Iemma was admitted to hospital with meningoencephalitis.

Recent medical research indicates that it was the cause of Mary Ingalls' (older sister of Laura Ingalls) blindness (not scarlet fever as the book indicates).

In popular culture

In the 2011 film Contagion, the pandemic disease kills when it causes meningoencephalitis in patients. The film's virus is named Meningoencephalitis Virus One (MEV-1).

In the 'House' episode Euphoria (Part 2), primary amoebic meningoencephalitis was the cause of Foreman's symptoms.