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Meningitis is an acute infection of the meninges presenting with:

• Pyrexia

• Headache

• Meningism


1. INFECTIVE -Bacterial,Viral Protozoal and fungal


Malignancy- CA Breast, CA Bronchus, Leukemia Inflammatory- SLE, Sarcoidosis


• Neonates–Gram Negative bacilli, Group B Streptococcus • Preschool- Haemophilus, menningococcus, Streptococcus pneumonae, TB

Older-meningococcus, S pneumonae, TB, Staph, Haemophilus

Viral – Polio, mumps, influenza, Herpes, Varicella

Protozoa Cysticercus, Amoebic

Fungi. Cryptococcus, candida


1. Can be direct spread from CSOM, Fracture skull, Sinus

2. Air borne infection close contacts, epidemics

• Commonest organism -H influenza, S pneumonae

• Pia Mater and Archnoid are congested and inflammatory cellsare present. Pus may form.

• Adhesions may lead to Hydrocephalus and Cranial nerve damage.

 • Cerebral infarcts may be present


• Severe Headache

• Drowsiness

• Fever

• Neck stiffness

• Coma

• Focal neurological deficits

• Rash


• Benign,self limiting, less serious • Severe headache, Meningism, high Pyrexia • No Focal neurological signs

• CSF shows lymphocytosis


• Shock

• Renal failure

• Pericarditis

• Intravascular coagulation


1.CSF – pressure is raised, cloudy appearance, increased proteins Low Glucose levels, Raised WBC(Neutrophils).

2.CSF for gram stain and culture

3. CT Scan

4. Blood culture

5.PCR on blood and CSF


• Caeseous focus in brain/meninges

• Exudate is greenish and gelatinous • Presence of Tubercles

• Clinical features:

Headache, low grade fever, vomiting, behavioural changes, meningism, altered consciousness, focal signs

• Investigations:

1. CSF- increased pressure, clear appearance, cobweb formation Increased WBC (lymphocytes), high proteins, very low Glucose levels 

2. CSF for Z N stain and culture

3. imaging- Hydrocephalus and tuberculoma

Dr .Lalit Choudhary
Hii everyone, I'm Dr Lalit Choudhary PT. Born and brought up in delhi. Practicing as a professional PHYSIOTHERAPIST. As a therapist I love to interact with others and and get myself updated regarding all the social issues which are leading my countrymen to distress themselves. Yes, I agree that Iam a workaholic but my work gives me immense pleasure but there are sometimes when I feel stressed up so to relax myself I travel to new places, meet new people and try to adopt their culture. Most of the time I like to travel hills as it helps me to relax and enjoy our nature beauty. For being a good therapist and to deal with all the difficulties I always prefer to be good listener and have good patience that is what my strength is. I also work as a social worker and the Founder of thesocialphysiofitnessclub and PHYSIO FIT INDIA. In last I just want to say that " I believe that physical therapy is not just a therapy but actually a remedy which not only make you physically fit but also adds happiness, joy and more days to your life." So don't just sit and thought now it's time to stand and work on yourself.

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