What is meningitis?

Written by Han Shun Li
Pulmonology
Updated on September 04, 2024
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Meningitis is predominantly an inflammation that occurs in the meninges and can extend to the brain parenchyma. It is generally caused by pathogenic microorganisms, including common pathogens such as bacteria, fungi, viruses, tuberculosis bacteria, etc. The most common symptoms include fever, headache, nausea, vomiting, stiff neck, etc. More severe cases can present with convulsions, disturbances of consciousness, or even coma. The condition can be mild or severe, and if not treated promptly, it can be fatal in serious cases.

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Does meningitis cause fever?

Generally, patients with meningitis exhibit symptoms of fever, along with headaches, nausea, vomiting, or some cognitive impairments and confusion. It is advised that everyone should be cautious and distinguish the symptoms of meningitis from those of common colds, and perhaps visit the department of neurology at a hospital for proper diagnosis and targeted treatment. Under the circumstance of meningitis, it is crucial to follow the doctor's guidance and actively cooperate with the treatment. Typically, a regimen involving anti-infection and antiviral medications is necessary for about two to three weeks, and most patients have a favorable prognosis. Additionally, it is important to maintain a relaxed mood, avoid excessive stress, and drink adequate water to promote excretion.

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Causes of Meningitis

The main causes of meningitis are bacteria, viruses, fungi, rickettsiae, or other pathogens, which invade the pia mater, spinal cord, and theca mater, causing infection. Clinically, bacterial meningitis is more severe. If it is not treated promptly or if the treatment is ineffective or misdiagnosed, it may lead to death within a few hours or even cause permanent brain damage, resulting in sequelae. Meningitis can affect the dura mater, arachnoid mater, and pia mater. It may also lead to secondary intracranial infections. It is important to choose antibacterial drugs and medications that nourish brain cells and alleviate cerebral edema for symptomatic treatment promptly.

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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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Is meningitis scary?

Meningitis is a relatively common infectious disease of the central nervous system in clinical practice. The common types of meningitis seen clinically include viral meningitis, tuberculous meningitis, and purulent meningitis. The main clinical symptoms of meningitis include headache, nausea, vomiting, fever, and signs of meningeal irritation; some may present with focal neurological deficits in symptoms and signs. If meningitis is not treated promptly or the treatment is ineffective, it often leads to significant sequelae, and can even endanger the patient's life. Therefore, meningitis is considered a serious disease of the central nervous system. If diagnosed with meningitis, timely treatment is essential, underscoring the seriousness of the disease.

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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.