Mortality rates and morbidity vary by etiology of meningitis. Higher mortality rates correlate with poor mental status, high CSF opening pressure at presentation, positive India ink test, extra-CNS manifestations, and higher fungal burdens. In general, symptoms and signs typically associated with meningitis are less likely to occur in HIV-seropositive individuals than in the general population. This probably reflects the different organisms involved and the differences in immune responses. Less common are confusion, somnolence, and personality changes.
Exam can show nuchal rigidity, fever, and cranial neuropathies.
Rarely, the patient is somnolent or confused. High CSF opening pressure is present in about two thirds of patients and is a poor prognostic sign. CSF may have a clear or turbid appearance. Protein and glucose may be high or normal. Ependymal enhancement is seen with CMV encephaloventriculitis.