Recurrent meningitis revealing a Behçet’s disease

Abstract

The aim of the present study was to describe a case of Behçet's disease revealed by a recurrent meningitis and to review literature on these two conditions. We describe the case of a 25-year-old man who presented four episodes of recurrent meningitis without any locoregional cause and developed oral and genital ulcerations few months later. Behçet's disease is a chronic, multisystemic disorder with variable prevalence in different geographical areas. Its neurological manifestations are well recognized. Both central and peripheral nervous systems can be involved. Recurrent meningitis in Behçet's disease is exceptional. To our knowledge, only two cases reported recurrent meningitis as initial manifestation of Behçet's disease. This case report underscores another facet of neurological manifestations of Behçet's disease.

Neuro-Behçet’s Disease Presenting as Hypertrophic Pachymeningitis

“…It can be categorized into three main groups: parenchymal central nervous system (CNS) involvement, which includes brainstem, cerebral, spinal cord and optic neuropathy; nonparenchymal CNS involvement which includes cerebral venous thrombosis, intracranial hypertension syndrome, and acute meningeal syndrome; and peripheral nervous system involvement [ 1 4 ]. Although isolated meningeal presentation in NBD is quite rare, several cases have been reported as acute meningitis, and recurrent meningitis [ 2 7 ]. We suggest that if NBD affects the meninges, the meningeal chronic inflammation by NBD could be progressed to HP.…”

“…Parenchymal and non-parenchymal involvements are the most frequent types of NBD, while isolated meningeal involvement is rare. Several studies have reported cases with meningeal involvement, such as meningitis [ 2 3 ]. Hypertrophic pachymeningitis (HP) is a rare chronic inflammatory meningeal disorder associated with many conditions and characterized by a diffuse or localized thickening of the dura mater.…”

Meningitis recurrente en el adulto: un reto diagnóstico y terapéutico

“…Esta inflamación también se puede deber a tumores primarios o metastásicos, hipersensibilidad a medicamentos y enfermedades autoinmunes como la de Behçet, vasculitis y lupus eritematoso sistémico. 17,18 Lo anterior indica que si un paciente regresa a la institución con síntomas meníngeos sugestivos de MR se lo debe estudiar y tratar interdisciplinariamente para hacer el diagnóstico y, sobre todo, aplicar oportunamente un tratamiento adecuado de forma que se prevengan las secuelas.…”