Meningoencephalitis

Meningoencephalitis
Classification and external resources
Specialty	neurology
ICD-10	G04
ICD-9-CM	323.9
DiseasesDB	22354
MeSH	D888590

Meningoencephalitis (/mɪˌnɪŋɡoʊɛnˌsɛfəˈlaɪtᵻs, -ˌnɪndʒoʊ-, -ən-, -ˌkɛ-/;^[1][2] from Greek: meninges- membranes; enkephalos brain; and -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:

Bacterial

• Listeria monocytogenes
• Neisseria meningitidis
• Rickettsia prowazekii
• Mycoplasma pneumoniae
• Tuberculosis
• Borrelia (Lyme disease)
• Leptospirosis

Viral

• Tick-borne meningoencephalitis
• West Nile virus
• Measles
• Epstein-Barr virus
• Varicella-zoster virus
• Enterovirus
• Herpes simplex virus type 1
• Herpes simplex virus type 2
• Mumps, a relatively common cause of meningoencephalitis. However, most cases are mild, and mumps meningoencephalitis generally does not result in death or neurologic sequelae.^[3]
• HIV, a very small number of individuals exhibit meningoencephalitis at the primary stage of infection.^[4][5]

Other/multiple

• Granulomatous meningoencephalitis
• Antibodies targeting amyloid beta peptide proteins which have been used during research on Alzheimer's disease.^[6]
• The fungus, Cryptococcus neoformans, can be symptomatically manifested within the CNS as meningoencephalitis with hydrocephalus being a very characteristic finding due to the unique thick polysaccharide capsule of the organism.
• Anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies, which are also associated with seizures and a movement disorder
• Vasculitis

Protozoal

• Primary amoebic meningoencephalitis, e.g., Naegleria fowleri, Balamuthia mandrillaris, Sappinia diploidea
• Trypanosoma brucei
• Toxoplasma gondii (sporozoa)

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.^[7]

Animal

• Halicephalobus gingivalis

Animal pathogens exist as facultative parasites. They are an exceptionally rare cause of meningoencephalitis.^[8]

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.^[9]

In May, 2009 former Premier of New South Wales (Australia) Morris Iemma was admitted to hospital with meningoencephalitis.^[10]

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).^{[11][12][13][14]}

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.

See also

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

References

1. "Meningoencephalitis". Oxford Dictionaries. Oxford University Press. Retrieved 2016-01-21.
2. "Meningoencephalitis". Merriam-Webster Dictionary. Retrieved 2016-01-21.
3. Bruyn HB, Sexton HM, Brainerd HD (March 1957). "Mumps meningoencephalitis; a clinical review of 119 cases with one death". Calif Med. 86 (3): 153–60. PMC 1512024. PMID 13404512.
4. Newton, PJ; Newsholme, W; Brink, NS; Manji, H; Williams, IG; Miller, RF (2002). "Acute meningoencephalitis and meningitis due to primary HIV infection". BMJ (Clinical research ed.). 325 (7374): 1225–7. doi:10.1136/bmj.325.7374.1225. PMC 1124692. PMID 12446542.
5. Del Saz, SV; Sued, O; Falcó, V; Agüero, F; Crespo, M; Pumarola, T; Curran, A; Gatell, JM; et al. (2008). "Acute meningoencephalitis due to human immunodeficiency virus type 1 infection in 13 patients: clinical description and follow-up". Journal of neurovirology. 14 (6): 474–9. doi:10.1080/13550280802195367. PMID 19037815.
6. Orgogozo JM, Gilman S, Dartigues JF, et al. (2003-07-08). "Subacute meningoencephalitis in a subset of patients with AD after Aß42 immunization". Neurology. 61 (1): 46–54. doi:10.1212/01.WNL.0000073623.84147.A8. PMID 12847155. Retrieved 2008-05-01.
7. Amebic Meningoencephalitis at eMedicine
8. "Rare parasitic worm kills two kidney donor patients, inquest hears". The Guardian. 2014-11-18. Retrieved 2014-11-24.
9. "Presenter Killed by Rare Infection". BBC News. 2002-06-19. Retrieved 2008-05-01.
10. Silmalis, Linda (2009-06-28). "Paralysed Iemma fights to walk again". The Sunday Telegraph. Retrieved 2009-06-28.
11. Allexan, Sarah S.; Byington, Carrie L.; Finkelstein, Jerome I.; Tarini, Beth A. (2013). "Blindness in Walnut Grove: How Did Mary Ingalls Lose Her Sight?". Pediatrics. peds.2012-1438.
12. Dell'Antonia, KJ (2013-02-04). "Scarlet Fever Probably Didn't Blind Mary Ingalls". New York Times. Retrieved 2013-02-04.
13. Serena, Gordon (2013-02-04). "Mistaken Infection 'On The Prairie'?". U.S. News and World Report. Retrieved 2013-02-04.
14. "What really made Mary Ingalls go blind?". NBC News. 2013-02-04.