Cerebral meningitis, commonly referred to as meningitis, is an inflammation of the protective

membranes covering the brain and spinal cord, collectively known as the meninges. This condition can
be caused by various infectious agents, including bacteria, viruses, fungi, and parasites, as well as by
non-infectious factors such as certain medications, autoimmune diseases, and cancers.

The inflammation from meningitis can lead to severe complications, including brain damage, hearing
loss, and learning disabilities if not treated promptly. The most common and severe form is bacterial
meningitis, which can be life-threatening and requires immediate medical attention. Symptoms typically
include severe headache, fever, neck stiffness, sensitivity to light, confusion, and in some cases, seizures
and coma.

Diagnosis is usually confirmed through a lumbar puncture (spinal tap) to analyze cerebrospinal fluid
(CSF) for signs of infection and inflammation. Treatment varies depending on the cause but often
involves antibiotics or antiviral medications, supportive care, and sometimes corticosteroids to reduce
inflammation.

The clinical manifestations of cerebral meningitis can vary depending on the age of the patient, the
causative agent, and the severity of the condition. However, some common signs and symptoms
typically observed in patients with meningitis include:

### General Symptoms

1. **Fever**: Often high and persistent.

2. **Headache**: Severe and unrelenting.

3. **Neck Stiffness (Nuchal Rigidity)**: Pain and stiffness when trying to move the neck.

4. **Photophobia**: Sensitivity to light.

5. **Altered Mental Status**: Confusion, lethargy, irritability, or in severe cases, coma.

6. **Nausea and Vomiting**: Common due to increased intracranial pressure.

7. **Seizures**: Occur in some cases, particularly with severe or untreated meningitis.

8. **Rash**: In bacterial meningitis, particularly meningococcal meningitis, a petechial or purpuric rash

### Symptoms in Infants and Young Children

1. **Bulging Fontanelle**: In infants, the soft spot on the top of the head may bulge.

2. **Poor Feeding**: Difficulty eating or refusing to eat.

3. **Irritability**: Excessive crying, often inconsolable.

4. **Lethargy**: Unusual sleepiness or difficulty waking.

### Additional Symptoms

- **Joint Pain**: Particularly in bacterial meningitis.

- **Muscle Pain**: General body aches.

- **Tachycardia**: Increased heart rate.

- **Hypotension**: Low blood pressure, particularly in septicemia associated with bacterial meningitis.

### Complications

1. **Hearing Loss**: Partial or complete, due to inflammation or damage to the auditory nerves.

2. **Cognitive Impairments**: Learning difficulties, memory problems, or behavioral changes.

3. **Vision Problems**: Due to increased intracranial pressure or cranial nerve involvement.

4. **Hydrocephalus**: Accumulation of cerebrospinal fluid in the brain, causing increased pressure.

5. **Sepsis**: Severe bacterial infections can spread to the bloodstream, leading to septic shock.

### Meningitis by Causative Agents

- **Bacterial Meningitis**: Rapid onset of symptoms, high severity, risk of serious complications.

- **Viral Meningitis**: Often milder than bacterial, with flu-like symptoms, generally self-limiting.

- **Fungal Meningitis**: Gradual onset, more common in immunocompromised individuals.

- **Parasitic Meningitis**: Rare, usually occurs in specific regions or conditions, often severe.

### Diagnosis and Treatment

Prompt diagnosis and treatment are crucial. Diagnosis is often confirmed through lumbar puncture
(spinal tap) and analysis of cerebrospinal fluid (CSF). Treatment varies based on the cause: bacterial
meningitis requires urgent antibiotics, while viral meningitis may only need supportive care.

### Preventive Measures

Preventing meningitis involves both general health measures and specific interventions depending on
the causative agent. Here are key preventive strategies:

#### Vaccination

1. **Bacterial Meningitis**:

- **Haemophilus influenzae type b (Hib) Vaccine**: Routinely given to infants.

- **Meningococcal Vaccines**: Including MenACWY (for serogroups A, C, W, and Y) and MenB (for
serogroup B). Recommended for adolescents, people in high-risk environments (e.g., college
dormitories), and travelers to certain areas.

2. **Viral Meningitis**:

- **Measles, Mumps, and Rubella (MMR) Vaccine**: Reduces the risk of viral meningitis caused by
these viruses.

- **Varicella (Chickenpox) Vaccine**: Protects against chickenpox-related viral meningitis.

- **Influenza Vaccine**: Prevents flu-related complications, including viral meningitis.

#### General Hygiene and Health Practices

1. **Hand Hygiene**: Regular and thorough handwashing with soap and water.

2. **Respiratory Hygiene**: Covering mouth and nose when coughing or sneezing, using tissues, and
disposing of them properly.

3. **Avoiding Close Contact**: Especially with individuals known to have meningitis or respiratory
infections.

#### Preventive Antibiotics

- **Post-exposure Prophylaxis**: Close contacts of someone diagnosed with bacterial meningitis may be
given antibiotics to prevent infection.

#### Safe Practices

- **Food Safety**: Proper food handling and preparation to avoid infections like Listeria, which can
cause meningitis.

- **Avoiding Contaminated Water**: Particularly important in areas where certain parasitic meningitis is
a risk.

### Treatment

Treatment for meningitis depends on the causative agent and the severity of the disease. Early diagnosis
and treatment are crucial for the best outcomes.

#### Bacterial Meningitis

1. **Antibiotics**: Immediate administration of broad-spectrum antibiotics, later tailored to the specific

- Vancomycin

- Ampicillin (especially for Listeria monocytogenes)

2. **Corticosteroids**: Dexamethasone may be used to reduce inflammation and prevent neurological

3. **Supportive Care**: Includes fluid management, pain relief, and treatment of symptoms such as
fever and seizures.

#### Viral Meningitis

1. **Supportive Care**: Rest, hydration, and pain management (analgesics).

2. **Antiviral Medications**: In some cases, such as herpes simplex virus, antiviral drugs like acyclovir
may be used.

3. **Symptomatic Treatment**: Addressing fever, headache, and nausea.

#### Fungal Meningitis

1. **Antifungal Medications**: Amphotericin B, flucytosine, and fluconazole are commonly used.

2. **Long-term Therapy**: Fungal meningitis often requires prolonged treatment and close monitoring.

#### Parasitic Meningitis

1. **Antiparasitic Drugs**: Depending on the parasite, specific medications are used.

2. **Supportive Care**: Symptomatic relief and management of complications.

### Additional Measures

1. **Hospitalization**: Severe cases may require intensive care, especially for monitoring and managing
complications.

2. **Isolation**: Patients with bacterial meningitis may be isolated to prevent the spread of the disease.