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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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.

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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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Neurology
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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.

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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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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.