{"id":"4eadd3be-193f-439b-b367-6afcf80f5c39","slug":"before-diagnosing-postoperative-chemical-meningitis-all-infectious-causes-must-be-thoroughly-ruled-out-2","title":"Before diagnosing postoperative chemical meningitis, all infectious causes must be thoroughly ruled out","authors":["Josef Finsterer","Fulvio Scorza"],"abstract":"Background: The article discusses a case of a 33-year-old female who developed aseptic meningitis after undergoing redo-resection for a fourth ventricular epidermoid cyst. The patient's postoperative course was complicated by recurrent fever, sub-occipital pseudomeningocele, hydrocephalus, and other neurological symptoms, leading to repeated treatments with steroids and antibiotics despite negative cerebrospinal fluid (CSF) cultures. Summary: The authors of the letter raise concerns regarding the thoroughness of the diagnostic workup in the original case report. They emphasize the need to rule out all infectious causes, including SARS-CoV-2 and other viral infections, as well as to conduct comprehensive CSF analyses for fungi and mycobacterium tuberculosis. The letter also highlights the importance of consistent terminology in describing the type of meningitis. Conclusion: The authors advocate for a re-evaluation of the original study's conclusions by addressing the limitations in the diagnostic approach and clarifying the terminology used. They stress that a definitive diagnosis of aseptic meningitis necessitates the exclusion of all possible infectious causes. Keywords: aseptic meningitis, chemical meningitis, diagnosis, CSF analysis, SARS-CoV-2, infectious causes, neurological symptoms","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/general-neurosurgery.png","publishDate":"2023-04-21T00:00:00.000Z","doi":null,"categories":["General Neurosurgery","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2023/04/12266/SNI-14-148.pdf"}