meningoencephalitis

Signs of meningoencephalitis include unusual behavior, personality changes, nausea, and thinking problems.{{cite web |last1=Shelat |first1=Amit |last2=Ziegler |first2=Olivia |title=Herpes Meningoencephalitis |url=https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=27 |website=University of Rochester Medical Center - Health Encyclopedia |publisher=University of Rochester Medical Center Rochester, NY |access-date=26 January 2019}}

Symptoms may include headache, fever, pain in neck movement, light sensitivity, and seizure.

The organisms which cause meningoencephalitis include bacterial pathogens, protozoans, and viruses.{{citation needed|date=July 2021}}

Veterinarians have observed meningoencephalitis in animals infected with listeriosis, caused by the pathogenic bacteria L. monocytogenes. Meningitis and encephalitis already present in the brain or spinal cord of an animal may form simultaneously into meningeoencephalitis.{{cite web |last1=Long |first1=Maureen |title=Overview of Meningitis, Encephalitis, and Encephalomyelitis |url=https://www.merckvetmanual.com/nervous-system/meningitis,-encephalitis,-and-encephalomyelitis/overview-of-meningitis,-encephalitis,-and-encephalomyelitis |website=Merck Manual: Veterinary Manual |publisher=Merck Sharp & Dohme Corp. |access-date=28 January 2019}} The bacteria commonly targets the sensitive structures of the brain stem. L. monocytogenes meningoencephalitis has been documented to significantly increase the number of cytokines, such as interleukin-1beta (IL-1β), IL-12, and IL-15, leading to toxic effects on the brain.{{cite journal |last1=Deckert |first1=Martina |last2=Soltek |first2=Sabine |last3=Geginat |first3=Gernot |last4=Lütjen |first4=Sonja |last5=Montesinos-Rongen |first5=Manuel |last6=Hof |first6=Herbert |last7=Schlüter |first7=Durk |title=Endogenous Interleukin-10 Is Required for Prevention of a Hyperinflammatory Intracerebral Immune Response in Listeria monocytogenes Meningoencephalitis |journal=Infect. Immun. |volume=69 |issue=7 |pages=4561–4571 |date=July 2001 |doi=10.1128/IAI.69.7.4561-4571.2001 |pmid=11402000 |pmc=98533 }}

Meningoencephalitis may be one of the severe complications of diseases originating from several Rickettsia species, such as Rickettsia rickettsii (causes Rocky Mountain spotted fever [RMSF]), Rickettsia conorii, Rickettsia prowazekii (causes epidemic louse-borne typhus), and Rickettsia africae. It can impair the cranial nerves, paralysis to the eyes, and sudden hearing loss.{{cite journal |last1=Biggs |first1=Holly |title=Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States |journal= MMWR. Recommendations and Reports |volume=65 |issue=2 |pages=1–44 |publisher=U.S. Department of Health & Human Services |doi=10.15585/mmwr.rr6502a1 |pmid=27172113 |year=2016 |doi-access=free }}{{cite journal |last1=Ryan |first1=Edward |last2=Durand |first2=Marlene |title=CHAPTER 135 - Ocular Disease |journal=Tropical Infectious Diseases: Principles, Pathogens and Practice (Third Edition) |date=2011 |volume=III |pages=991–1016 |doi=10.1016/B978-0-7020-3935-5.00135-X |isbn=9780702039355 }} Meningoencephalitis is a rare, late-stage manifestation of tick-borne ricksettial diseases, such as RMSF and human monocytotropic ehrlichiosis (HME), caused by Ehrlichia chaffeensis (a species of rickettsiales bacteria).{{cite journal |last1=Huntzinger |first1=Amber |title=Guidelines for the Diagnosis and Treatment of Tick-Borne Rickettsial Diseases |issue=1 |pages=137 |url=https://www.aafp.org/afp/2007/0701/p137.html |journal=American Family Physician |volume=76 |publisher=American Academy of Family Physicians |access-date=30 January 2019|date=July 2007 }}

Other bacteria that can cause meningoencephalitis are Mycoplasma pneumoniae, Tuberculosis, Borrelia (Lyme disease), and Leptospirosis.

The viral organisms which cause meningoencephalitis include:

• Tick-borne encephalitis
• West Nile virus
• Measles
• Epstein–Barr virus
• Varicella-zoster virus
• Enterovirus
• Herpes simplex virus type 1
• Herpes simplex virus type 2
• Rabies virus
• Adenovirus
• Meningoencephalitis is almost solely seen in heavily immunocompromised patients.{{Cite journal|url=https://doi.org/10.1016/S0002-9343(97)00015-6|doi=10.1016/S0002-9343(97)00015-6|title=Adenovirus Infections in Immunocompromised Patients|year=1997|last1=Carrigan|first1=Phd|journal=The American Journal of Medicine|volume=102|issue=3|pages=71–74|pmid=10868146|url-access=subscription}}
• Mumps
• A relatively common cause of meningoencephalitis. However, most cases are mild, and mumps meningoencephalitis generally does not result in death or neurologic sequelae.{{cite journal |vauthors=Bruyn HB, Sexton HM, Brainerd HD |title=Mumps meningoencephalitis; a clinical review of 119 cases with one death |journal=Calif Med |volume=86 |issue=3 |pages=153–60 |date=March 1957 |pmid=13404512 |pmc=1512024 }}
• HIV
• A very small number of individuals exhibit meningoencephalitis at the primary stage of infection.{{cite journal | last1 = Newton | first1 = PJ | last2 = Newsholme | first2 = W | last3 = Brink | first3 = NS | last4 = Manji | first4 = H | last5 = Williams | first5 = IG | last6 = Miller | first6 = RF | title = Acute meningoencephalitis and meningitis due to primary HIV infection | journal = BMJ (Clinical Research Ed.) | volume = 325 | issue = 7374 | pages = 1225–7 | year = 2002 | pmid = 12446542 | pmc = 1124692 | doi = 10.1136/bmj.325.7374.1225}}{{cite journal | last1=Del Saz | first1=SV | last2=Sued | first2=O | last3=Falcó | first3=V | last4=Agüero | first4=F | last5=Crespo | first5=M | last6=Pumarola | first6=T | last7=Curran | first7=A | last8=Gatell | first8=JM | last9=Pahissa | first9=A | last10=Miró | first10=Jm | last11=Ribera | first11=E | title=Acute meningoencephalitis due to human immunodeficiency virus type 1 infection in 13 patients: clinical description and follow-up | journal=Journal of NeuroVirology | volume=14 | issue=6 | pages=474–9 | year=2008 | pmid=19037815 | doi=10.1080/13550280802195367| s2cid=9473244 | display-authors=8 }}

• Antibodies targeting amyloid beta peptide proteins have been used during research on Alzheimer's disease.{{cite journal |doi=10.1212/01.WNL.0000073623.84147.A8 |vauthors=Orgogozo JM, Gilman S, Dartigues JF, etal |title=Subacute meningoencephalitis in a subset of patients with AD after Aß42 immunization |journal=Neurology |volume=61 |issue=1 |pages=46–54 |date=2003-07-08 |url=http://www.neurology.org/cgi/content/abstract/61/1/46 |pmid=12847155 |s2cid=22582966 |url-access=subscription }}
• Anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies, which are also associated with seizures and a movement disorder, are related to anti-NMDA receptor encephalitis.
• Nonvasculitic autoimmune inflammatory meningoencephalitis (NAIM) can be divided into glial fibrillary acidic protein negative (GFAP-) and GFAP positive (GFAP+) cases.Keith A Josephs, Frank A Rubino, Dennis W Dickson, Nonvasculitic autoimmune inflammatory meningoencephalitis, Neuropathology 24(2):149-52 · July 2004, DOI: 10.1111/j.1440-1789.2004.00542.x The second is related to the autoimmune GFAP astrocytopathy.

The protozoal organisms which cause meningoencephalitis include:

• Naegleria fowleri (percolozoa)
• Trypanosoma brucei (euglenozoa)
• Toxoplasma gondii (apicomplexa)

The nematode Halicephalobus gingivalis is an exceptionally rare cause of meningoencephalitis.{{cite news |title=Rare parasitic worm kills two kidney donor patients, inquest hears | work=The Guardian | date =2014-11-18 |url=https://www.theguardian.com/society/2014/nov/18/rare-parasitic-worm-killed-two-kidney-donor-patients-inquest-hears |access-date=2014-11-24}}

Other causes of meningoencephalitis include granulomatous meningoencephalitis and vasculitis. The fungus, Cryptococcus neoformans, can symptomatically manifest within the central nervous system (CNS) as meningoencephalitis, with hydrocephalus being a very characteristic finding due to the unique thick polysaccharide capsule of the organism.{{citation needed|date=July 2021}}

Clinical diagnosis includes evaluation for the presence of recurrent or recent herpes infection, fever, headache, altered mental status, convulsions, disturbance of consciousness, and focal signs. Testing of cerebrospinal fluid is usually performed.{{citation needed|date=May 2021}}

{{More citations needed|section|date=April 2019}}

Meningoencephalitis caused by bacteria can be treated with antibiotic drugs.{{citation needed|date=July 2021}} Antiviral therapy, such as acyclovir and ganciclovir, work best when given to the individual as early as possible. Individuals may also be treated with interferon as immune therapy. Symptomatic therapy can be applied as needed. A high fever can be treated by physical regulation of body temperature. Seizures can be treated with antiepileptic drugs. High intracranial pressure can be treated with drugs such as mannitol.

• Meningitis
• Meningism
• Primary amoebic meningoencephalitis
• Encephalitis
• Naegleria fowleri

{{Reflist}}

{{wiktionary}}

{{Medical resources

| DiseasesDB = 22354

| ICD10 = {{ICD10|G|04||g|00}}

| ICD9 = {{ICD9|323.9}}

| ICDO =

| OMIM =

| MedlinePlus =

| eMedicineSubj =

| eMedicineTopic =

| MeshID = D888590

}}

{{Inflammation}}

{{Diseases of meninges}}

{{CNS diseases of the nervous system}}

{{Authority control}}

Category:Encephalitis

Category:Meningitis

Category:Central nervous system disorders

Category:Herpes simplex virus–associated diseases