How to rule out meningitis.

Written by Zhang Hui
Neurology
Updated on September 01, 2024
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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.

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Written by Han Shun Li
Pulmonology
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Is meningitis serious?

Meningitis is a common infectious disease of the central nervous system. Patients with meningitis often experience symptoms such as fever, headache, nausea, vomiting, and neck stiffness. As the disease progresses, they may also experience seizures, motor disorders, disturbed consciousness, coma, and other conditions, with severe cases posing a risk to life. Many patients can still have sequelae after recovery, such as speech impairments, hemiplegia, and decreased intelligence. Therefore, meningitis is a very serious disease, and patients should actively cooperate with doctors for treatment after becoming ill.

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Written by Zhang Hui
Neurology
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Early symptoms of meningitis

Meningitis is primarily a clinical display caused by various factors leading to inflammatory lesions and inflammatory exudation in the meninges. It can be triggered by viral infections, as well as bacterial, tuberculous, or fungal infections. Different pathogens can lead to different symptoms. The initial symptoms of meningitis mainly include the following aspects: First, patients generally experience significant fever, which can range from mild to high and persistent, closely related to the specific pathogen involved. Second, patients will have obvious headaches, as the meninges are irritated, and pain is certain. Third, it usually leads to symptoms of increased intracranial pressure such as nausea and vomiting. Fourth, patients may also experience discomfort and pain in the neck, and upon examination, positive signs of meningeal irritation can be observed.

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Written by Zhang Hui
Neurology
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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 Han Shun Li
Pulmonology
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Does meningitis cause headaches?

Meningitis is an inflammation of the meninges caused by pathogenic microorganisms, such as bacteria, tuberculosis bacteria, viruses, fungi, etc., which can all cause meningitis. Common symptoms of meningitis include fever, headache, nausea, vomiting, etc., thus patients with meningitis do experience headaches. Moreover, headache is one of the most common symptoms in patients with meningitis. Often, patients suffering from headaches will experience symptoms of nausea and vomiting, which is frequently projectile, and in many cases, the headache can be alleviated after vomiting.

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Written by Li Jian Wu
Pulmonology
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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.