Clinical Features
Meningococcal Meningitis
- Acute onset
- Headache
- Photophobia
- Temperature
- Often rigors
- Muscle aches and pains
- Conjunctivitis
- Convulsions
- Confusion and drowsiness
- Irritability
- Neck rigidity
- A petechial rash
- May be large ecchymoses (bleeding in the skin) and gangrenous skin lesions in fulminant meningococcal septicaemia
Acute Pyogenic Meningitis
Signs of meningitis are present and associated with signs of a local septic focus, but there is no rash, and other pyaemic signs (arising from organisms that produce pus) are rarer than in meningococcal infection. Bacteriological examination of the cerebrospinal fluid via lumbar puncture establishes the diagnosis and should be performed without delay.
Tuberculous Meningitis
- In children the onset of tuberculous meningitis is is so insidious that it may be two weeks before the parents realise that the illness is serious.
- Initial symptoms include lassitude, anorexia and constipation.
- Headache gradually worsens.
- In adults symptoms progress more quickly.
- Vomiting and pyrexia (fever) worsen and without intervention other neurological symptoms quickly develop, including cranial nerve and limb paresis, drowsiness, and coma.
As the ill effects of delayed treatment are so serious, it is important to diagnose Tuberculous Meningitis early. It should be considered in any patient known to have tuberculosis, who develops a persistent headache, perhaps with a slight headache, and lumbar puncture performed to confirm the diagnosis.
Viral Meningitis
Viral meningitis is usually considered to be benign, and is a fairly common complication of other viral illnesses.
Benign Lymphocytic Meningitis
The onset is acute and evidence of meningeal irritation develops rapidly. There are not usually any focal neurological signs. There may be a high temperature, which gradually drops to normal in five to seven days. The cerebrospinal fluid is usually clear. There is no specific treatment for the condition.
