Subscribe
Meningitis
Is vomiting frequent in meningitis?
Is vomiting frequent in meningitis? There are generally two situations for frequent vomiting in meningitis. The first situation occurs when pathogens infect the meninges or brain tissue, leading to an inflammatory response in the brain tissue, which then causes brain edema and subsequently leads to increased intracranial pressure. When intracranial pressure increases, it can cause vomiting, and this type of vomiting becomes projectile. Therefore, when vomiting is frequent and projectile, accompanied by severe headaches, fever, or even changes in condition, it is necessary to be vigilant about the increase in intracranial pressure leading to the formation of brain herniation, a situation that must be urgently addressed. The second reason is that after the pathogen enters the blood, it invades the gastrointestinal tract. An infection of the gastrointestinal tract itself can also cause frequent vomiting, accompanied by diarrhea, or even gastrointestinal bleeding, etc.
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.
Meningitis examination methods
The examination methods for meningitis mainly include several types. The first is the lumbar puncture examination, which is a very important diagnostic tool. Through lumbar puncture, one can observe the cerebrospinal fluid (CSF) pressure, its color, and perform laboratory tests on the CSF to examine biochemical properties and cell count changes. Additionally, it is possible to culture pathogens from the cerebrospinal fluid, which is of great auxiliary value in the diagnosis and differential diagnosis of meningitis. Secondly, patients with meningitis also need to undergo physical examinations. If signs of meningeal irritation are found during the physical examination, it also indicates meningitis. Thirdly, patients may need to undergo enhanced Magnetic Resonance Imaging (MRI) of the brain. If the meningitis lesions are severe, meningeal enhancement can be seen.
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.
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.)
How is meningitis transmitted?
Meningitis, a disease primarily transmitted through close contact, airborne droplets, and poor dietary habits, is mainly caused by bacterial infections leading to purulent meningitis in clinical settings. Some cases are due to tuberculosis bacillus causing tuberculous meningitis. Additionally, there are viral forms of meningitis, most commonly from enteroviruses or Echo viruses. A minority of patients may also develop cryptococcal meningitis. Treatment should involve the use of appropriate antimicrobial drugs based on clinical symptoms and the infecting pathogen, coupled with measures to decrease intracranial pressure and relieve brain edema, ensuring early detection and treatment to prevent complications.
sequelae of meningitis
Firstly, it may cause meningitis adhesions leading to hydrocephalus. Once hydrocephalus occurs, it may leave cognitive impairments as sequela, such as slow response, memory decline, and reduced executive functions. Secondly, tuberculous meningitis might also damage cranial nerves, resulting in symptoms such as diplopia, difficulty swallowing with choking on water, and dysarthria. If it affects the facial nerve, peripheral facial paralysis and other sequelae might occur. Thirdly, it could also lead to arteritis. The occurrence of arteritis can cause arterial occlusion, leading to the formation of cerebral infarction.
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.
What is meningitis?
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.
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.