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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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
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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.

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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 Bian Jun Li
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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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Written by Han Shun Li
Pulmonology
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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.)