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A Plea to Reconsider the Diagnosis

Journal of Hospital Medicine 15(2). 2020 February;:111-115. Published online first December 18, 2019 | 10.12788/jhm.3348
December 18, 2019|Journal of Hospital Medicine
Joseph A McBride, MD;Bryce Binstadt, MD, PhD;Raheel Ahmed, MD, PhD;Mustafa K Baskaya, MD;Andrew PJ Olson, MD;Ellen Wald, MD
Author and Disclosure Information

1Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin;2Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; 3Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; 4Department of Neurosurgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; 5Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

Disclosures

The authors have no financial conflicts of interest or disclosures.

© 2019 Society of Hospital Medicine

KEY LEARNING POINTS

  • The CSF cell count and differential should be used in conjunction with CSF chemistries (glucose and protein) to raise or lower suspicion of bacterial meningitis.
  • Aseptic meningitis is a syndrome and not a specific diagnosis. Clinicians should be alert to key aspects of the history and physical examination, which prompt consideration of noninfectious etiologies.
  • Aseptic chemical meningitis secondary to discharging CNS tumors, including RCCs, should be considered in episodes of recurrent culture-negative meningitis.

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