Note also the very congested blood vessels. Two days before death the patient became drowsy. When examined, her neck was stiff and any attempt to bend it produced pain. Lumbar puncture yielded turbid fluid and culture of the cerebrospinal fluid grew Streptococcus pneumoniae. She died in spite of vigorous antibiotic therapy.
Chronic meningitis occurs when low-grade infections affect the meninges.
Often these are basal and cause thickening and fibrosis of the leptomeninges. The haemorrhage is probably the result of neurosurgical exploration. Severe cryptococcal meningitis in a woman aged 66 with a thymoma and myasthenia gravis, who was treated with large doses of prednisone. Cryptococcal pneumonia was also present. Note characteristic opacification of meninges.