How to test for meningitis?

Written by Li Jian Wu

Pulmonology

Updated on September 18, 2024

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The main methods for meningitis examination are lumbar puncture and cerebrospinal fluid testing. Cerebrospinal fluid examination may show increased pressure, turbid appearance, and purulent changes, containing a large number of white blood cells and neutrophils. Routine blood tests may also show a white blood cell count significantly higher than normal, predominantly composed of immature neutrophils. Additionally, it is possible to check electrolytes and use auxiliary diagnostic tools such as X-rays, CT scans, and MRI to confirm the diagnosis, facilitating early detection and treatment.

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Written by Zhang Hui

Neurology

1min 40sec

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Differences between Viral Meningitis and Tuberculous Meningitis

Virial meningitis and tuberculous meningitis sometimes require additional differentiation in clinical practice because their treatment plans are significantly different. Virial meningitis has a relatively abrupt onset and is caused by a viral infection, generally having a good prognosis. Patients with tuberculous meningitis usually exhibit symptoms of tuberculosis toxicity such as low fever, night sweats, and fatigue before the onset of the disease. Commonly, other forms of tuberculosis can be identified, such as pulmonary tuberculosis or intestinal tuberculosis. An important diagnostic tool for differentiation is the lumbar puncture. In viral meningitis, the lumbar puncture pressure is generally not particularly high, whereas in tuberculous meningitis, the lumbar puncture pressure is very high, reaching over 400 mm of water column. Additionally, the cerebrospinal fluid (CSF) in tuberculous meningitis is yellowish, and its protein levels are significantly elevated, as are its white blood cell counts, typically ranging from 50 to 500 × 10^6/L. In tuberculous meningitis, the levels of glucose and chloride in the cerebrospinal fluid are significantly decreased, especially chloride, which is a prominent indicator for diagnosing tuberculous meningitis. In contrast, such clear changes are not observed in the lumbar puncture for viral meningitis. Another aspect to consider is the treatment response; if antiviral treatment is ineffective, the possibility of tuberculous meningitis should be considered.

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Written by Zhang Hui

Neurology

1min 8sec

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How to test for meningitis?

Meningitis is a very common disease in neurology, and the most common causes are infections, including viral infections, common bacterial infections, tuberculosis infections, and fungal infections. The main methods of examination for meningitis are as follows: First, physical examination. A physical examination can reveal neck stiffness in the patient, and positive meningeal irritation signs. These examinations are non-invasive and very safe. Second, a lumbar puncture can also be performed. A lumbar puncture can be used to observe whether the fluid pressure is high, and also to collect cerebrospinal fluid to examine its color, perform cytological and biochemical analyses, and culture the cerebrospinal fluid. This is very important to definitively determine the presence of meningitis and to identify the type of infectious agent involved. Additionally, enhanced magnetic resonance imaging can also be performed to see if there is significant enhancement of the meninges.

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Written by Li Jian Wu

Pulmonology

40sec

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How to test for meningitis?

The main methods for meningitis examination are lumbar puncture and cerebrospinal fluid testing. Cerebrospinal fluid examination may show increased pressure, turbid appearance, and purulent changes, containing a large number of white blood cells and neutrophils. Routine blood tests may also show a white blood cell count significantly higher than normal, predominantly composed of immature neutrophils. Additionally, it is possible to check electrolytes and use auxiliary diagnostic tools such as X-rays, CT scans, and MRI to confirm the diagnosis, facilitating early detection and treatment.

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Written by Han Shun Li

Pulmonology

57sec

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How is meningitis treated?

The treatment of meningitis is comprehensive. Firstly, medication should be based on the cause of the disease. For example, if it is caused by bacteria, sensitive antibiotics should be chosen for treatment; if caused by tuberculosis bacilli, standard anti-tuberculosis treatment should be applied; if caused by fungi, appropriate antifungal drugs should be used, and so forth. Additionally, symptomatic treatment is necessary, such as timely decompression treatment for increased intracranial pressure; fever reduction, especially for patients with high fever; and controlling seizures in patients with anticonvulsants. Moreover, it is important to maintain nutritional and electrolyte balance and ensure that the respiratory tract remains clear, among other things. If there are complications, they should be actively treated. (Specific medications should be administered under the guidance of a physician.)

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Written by Zhang Hui

Neurology

1min 1sec

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How to rule out meningitis.

Patients with meningitis usually show clinical symptoms such as fever, headache, nausea, and vomiting. To rule out meningitis, the following points should be considered. The first point is to check if the patient has a relevant medical history. If the patient's symptoms are very normal, without fever or headache, the possibility of meningitis is generally not very high. The second point is to pay attention to the physical examination, to see if there is any sign of meningeal irritation. If there is no meningeal irritation, it also does not support the presence of meningitis. The third point involves performing a lumbar puncture to examine the cerebrospinal fluid, checking if the pressure of the cerebrospinal fluid is high, and whether the cellular and biochemical properties within the fluid are normal. If completely normal, the likelihood of meningitis is also very small. Additionally, if necessary, an enhanced MRI scan of the brain should be performed, as meningitis usually shows enhancement.