How to test for meningitis?

Written by Zhang Hui
Neurology
Updated on September 05, 2024
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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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Written by Zhang Hui
Neurology
1min 40sec home-news-image

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 Hu Bai Yu
Pulmonology
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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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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.)

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Written by Xie Wen
Neurology
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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.

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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.