Meningitis (Hindi) : Internal Medicine

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Meningitis

Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord. It can be caused by various infectious agents such as bacteria, viruses, fungi, and parasites, or by non-infectious factors like certain medications and autoimmune diseases. Bacterial meningitis is particularly severe and can be life-threatening if not treated promptly, whereas viral meningitis is generally less severe but still requires medical attention. The pathogenesis involves the invasion of pathogens into the central nervous system (CNS), either through the bloodstream crossing the blood-brain barrier or spreading from nearby infections like sinusitis or otitis media. Once in the CNS, these pathogens trigger an inflammatory response, causing swelling, increased intracranial pressure, and potential brain damage. Clinically, meningitis presents with early symptoms such as fever, headache, and neck stiffness, along with photophobia, nausea, and vomiting. Neurological symptoms may include altered mental status, seizures, and, in severe cases, coma. Specific signs like positive Kernig’s and Brudzinski’s signs indicate meningeal irritation. Diagnosis is confirmed through lumbar puncture, where cerebrospinal fluid (CSF) analysis typically reveals elevated white blood cell count, high protein levels, and low glucose levels in bacterial meningitis, while viral meningitis shows a mild increase in white blood cells with normal glucose levels. Additional diagnostics include blood cultures, imaging studies like CT or MRI, and PCR testing for specific pathogens. Management of bacterial meningitis involves immediate empirical antibiotic therapy with broad-spectrum antibiotics such as ceftriaxone or cefotaxime combined with vancomycin until specific pathogens are identified, along with corticosteroids to reduce inflammation. Viral meningitis treatment is generally supportive, including rest, hydration, and pain relief, while antifungal or antiparasitic treatments are used for fungal and parasitic causes, respectively. Early diagnosis and appropriate treatment are crucial to prevent severe complications and improve patient outcomes. 🌟🩺💊

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