Which of the following pathologic processes is often associated with aseptic meningitis?
A. Ischemic infarction of cerebral tissue.
B. Childhood diseases of viral causation such as mumps.
C. Brain abscesses caused by a variety of pyogenic organisms.
D. Cerebral ventricular irritation from a traumatic brain injury.
Correct Answer: B. Childhood diseases of viral causation such as mumps.
Aseptic meningitis is caused principally by viruses and is often associated with other diseases such as measles, mumps, herpes, and leukemia. Aseptic meningitis is a term used to define inflammation of the brain meninges due to various etiologies with negative cerebrospinal fluid (CSF) bacterial cultures. It is one of the most common, usually benign, inflammatory disorders of the meninges. Viruses are a common etiology, however, there are many other infective and non-infective causes. Therefore, the terms aseptic meningitis and viral meningitis are not interchangeable.
Option A: Ischemic infarction of cerebral tissue can occur with tubercular meningitis. In tuberculous meningitis, the meninges are seeded by MTB and form sub-ependymal collections called Rich foci. These foci can rupture into the subarachnoid space and cause an intense inflammatory response that causes the symptoms of meningitis.
Option C: Incidences of brain abscess are high in bacterial meningitis. Several possible risk factors for bacterial meningitis have been identified. Patients with an abnormal communication between the nasopharynx and subarachnoid space are thought to be at increased risk. This abnormal communication can be due to a congenital abnormality or a result of trauma. Patients who have undergone neurosurgery, sustained skull fractures, or have cochlear implants are also at increased risk.
Option D: Traumatic brain injury could lead to bacterial (not viral) meningitis. Nosocomial bacterial meningitis is the result of the manipulation of the meninges during neurosurgical procedures. Invasion of bacteria into the subarachnoid space results in inflammation of the meninges.
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