Meningitis is inflammation of the meninges, the three protective membranes, the dura mater, arachnoid mater, and pia mater, that envelop the brain and spinal cord and contain the cerebrospinal fluid. It arises most often from infection but also from non-infectious causes such as autoimmune and granulomatous disease.…
Meningitis is inflammation of the meninges, the three protective membranes, the dura mater, arachnoid mater, and pia mater, that envelop the brain and spinal cord and contain the cerebrospinal fluid. It arises most often from infection but also from non-infectious causes such as autoimmune and granulomatous disease. Etiologic classification is fundamental to its management: bacterial meningitis, typically acute and life-threatening; viral or aseptic meningitis, generally more benign; tuberculous meningitis; and fungal forms, among which cryptococcal meningitis is prominent, particularly in immunocompromised hosts. The pathophysiology involves microbial entry into the subarachnoid space, an intense inflammatory response, disruption of the blood-brain barrier, raised intracranial pressure, and impaired cerebral perfusion. Cardinal clinical features include fever, headache, neck stiffness, photophobia, and altered consciousness, and the syndrome may be revealed by or complicate other conditions, including systemic infection and toxin-mediated disease. Diagnosis rests on examination of the cerebrospinal fluid obtained by lumbar puncture, with analysis of cell counts, protein and glucose, microscopy, culture, and specific biomarkers, supplemented by imaging when mass lesions or related intracranial pathology are suspected. Complications include seizures, hydrocephalus, cranial nerve deficits, cerebral infarction, and long-term neurological sequelae, making prompt recognition and pathogen-directed therapy essential to outcome.
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