{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:45:08Z","timestamp":1787168708920,"version":"build-2736575974"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"unspecified","delay-in-days":283,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Subacute and chronic meningitis (SCM) presents significant diagnostic challenges, with numerous infectious and non-infectious inflammatory causes. This study examined patients aged 16 and older with SCM admitted to referral centers for neuroinfections and neuroinflammations in Mashhad, Iran, between March 2015 and October 2022. Among 183 episodes, tuberculous meningitis was the most common infectious cause (46.5%), followed by Brucella meningitis (24.6%). The cause of SCM was definitively proven in 40.4%, presumptive in 35.0%, and unknown in 24.6% of cases. In-hospital mortality was 14.4%, and 30.5% of survivors experienced unfavorable outcomes (Glasgow Outcome Scale 2\u20134). Patients with unknown causes had a significantly higher risk of death compared to those with presumptive or proven diagnoses (risk ratio 4.18). This study emphasizes the diagnostic difficulties of SCM, with one-quarter of cases remaining undiagnosed and over one-third having only a presumptive diagnosis. Improving diagnostic methods could potentially enhance prognosis and reduce mortality.<\/jats:p>","DOI":"10.1017\/s0950268824001225","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T08:10:20Z","timestamp":1728547820000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["The challenge of etiologic diagnosis of subacute and chronic meningitis: an analysis of 183 patients"],"prefix":"10.1017","volume":"152","author":[{"given":"Mahboubeh","family":"Haddad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-4286","authenticated-orcid":false,"given":"Fereshte","family":"Sheybani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matin","family":"Shirazinia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Khoroushi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Baghestani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"S0950268824001225_r6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-003-1101-5"},{"key":"S0950268824001225_r2","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-996-0024-6"},{"key":"S0950268824001225_r8","first-page":"590","article-title":"Piepgras DG: Chronic meningitis: The role of meningeal or cortical biopsy","volume":"34","author":"Cheng","year":"1994","journal-title":"Neurosurgery"},{"key":"S0950268824001225_r9","doi-asserted-by":"publisher","DOI":"10.1177\/1941874418773924"},{"key":"S0950268824001225_r12","first-page":"185","article-title":"Chronic meningitis: A study on epidemiological and clinical findings, treatment results and prognosis of 97 patients","volume":"39","author":"Ahmadinejad","year":"2001","journal-title":"Acta Medica 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Neurology"},{"key":"S0950268824001225_r22","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328322ffac"},{"key":"S0950268824001225_r23","first-page":"43","article-title":"Chronic meningitis in immunocompromised adult Ethiopians visiting Tikur Anbessa Teaching Hospital and Ye\u2019huleshet Clinic from 2003\u20132004","author":"Mihret","year":"2014","journal-title":"Ethiopian Medical Journal"},{"key":"S0950268824001225_r20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2032996"},{"key":"S0950268824001225_r7","first-page":"1298","article-title":"Wilson MR: Chronic meningitis","volume":"24","author":"Thakur","year":"2018","journal-title":"CONTINUUM: Lifelong Learning in Neurology"},{"key":"S0950268824001225_r25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1995.tb02857.x"},{"key":"S0950268824001225_r18","first-page":"e1084","article-title":"Neurosarcoidosis: Pathophysiology, diagnosis, and 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