Meningitis differential diagnosis
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- Brain abcess - Brain abcess is a focal infection of the brain parenchyma commonly caused by bacteria, fungal and parasitic pathogens. Imaging and neurosurgical aspiration is required for is differentiation in addition to CSF profile.
- Encepahlitis - Encephatlitis is the inflammation of brain. Meningitis can itself cause encephalitis and is called meningoencephalitis. The symptoms appear gradually in encephalitis but occur abruptly in meningitis.
- Delirium tremens - Delirium tremens and alcohol withdrawal should be differentiated from meningitis especially when present with confusion and fever. Both the conditions can coexist.
- Brain tumour - Brain tumours can simulate purulent meningitis with symptoms fever, signs of meningeal irritation and marked CSF pleocytosis. Irritation of leptomeninges by tumour and its breakdown products causes these symptoms[1]. Determination of creatine kinase BB and carcinoembryonic antigenhelps in differentiating.[2]
- Subarachnoid hemorrhage - Subarachnoid hemorrhage also presents with severe headache, neck stiffness, nausea and vomiting like meningitis. It is a medical emergency. Imaging studies help in differentiating. Tubercular meningitis should ]be considered in the differential diagnosis in cases of nonaneurysmal subarachnoid hemorrhage.[3]
References
- ↑ Soffer D (1976) Brain tumors simulating purulent meningitis. Eur Neurol 14 (3):192-7. PMID: 1278192
- ↑ Terheggen HG (1985) [CNS tumors with the clinical picture of meningitis.] Monatsschr Kinderheilkd 133 (1):13-9. PMID: 3883130
- ↑ Yeh ST, Lee WJ, Lin HJ, Chen CY, Te AL, Lin HJ (2003) Nonaneurysmal subarachnoid hemorrhage secondary to tuberculous meningitis: report of two cases. J Emerg Med 25 (3):265-70. PMID: 14585453