脑炎与脑膜炎
脑膜炎和脑炎有相似的原因d symptoms. There is a certain degree of brain inflammation in meningitis and a certain degree of meningeal inflammation in encephalitis. However, they are two different conditions. This article will talk about both encephalitis and meningitis in detail, highlighting their clinical features, symptoms, causes, investigation and diagnosis, prognosis, and also the course of treatment they require and the differences between encephalitis and meningitis.
脑膜炎
脑膜炎是inflammationof the meninges caused by bacteria, viruses,fungi或者寄生虫. Bacterial meningitis is a killer, and it kills quickly. Organisms like E coli, beta hemolytic streptococci, Listeria moncytogenes, Heamophilus, Nisseria meningitidis, pneumococcus, cause meningitis. Meningitis presents with headache which worsens when exposed to light, stiff neck, Kernig’s sign (pain and resistance on passive knee extension with hips fully flexed), Brudzinski sign (hips flex on bending head forward) and opisthotonus. These are known as脑膜功能. Meningitis increases pressure inside the skull. This is characterized by headache, irritability, drowsiness, vomiting, fits, papilledema, reduced level of consciousness, irregular respiration, low pulse rate and high blood pressure. (Read脉搏率和血压之间的差异.）当生物体进入血液时，脓毒症会症状，例如感染，关节肿胀，关节疼痛，奇怪的行为，皮疹，弥漫性血管内凝血，快速呼吸，快速脉搏和低血压。
Treatment to meningitis should not be delayed until test results arrive. If meningitis is suspected, nothing should delay intravenous antibiotics. Airway, breathing, and circulation should be maintained. High flow oxygen therapy via a face mask is good. Treatment protocol differs according to the presentation. If septic signs predominate, lumbar puncture should not be attempted. If the patient is in shock, volume resuscitation is indicated. If meningitic features predominate at presentation, lumbar puncture should be attempted if no features of increased intracranial pressure are present. Intravenous antibiotics should be given. If there is any indication of respiratory failure, intubation should not be delayed.
脑膜炎的并发症是脑水肿，cranial nervelesions, deafness, and cerebral venous sinus thrombosis. Lumbar puncture is critical to diagnosis. If there are no features of increased intra cranial pressure, lumbar puncture should be done. If there are features of increased pressure inside the skull,CTshould precede lumbar puncture. 3 bottles of cerebrospinal fluid should be sent for gram stain, Zheil neilson stain,cytology, virology, glucose, protein, and culture. Cerbrospinal fluid analysis may be normal early on. If indicated lumbar puncture should be repeated. Other tests like blood culture, blood glucose, full blood count, urea, electrolytes, chest x-ray, urine culture, nasal swab and stools for virology may be indicated.
Risk factors for meningitis are overcrowding, head injury, infective focus, very young, very old, complement deficiency, antibody deficiency,cancers, sickle cell disease, and CSF shunts. Acute bacterial meningitis has a mortality 70 to 100% untreated; Neisseria meningitides has an overall mortality of 15%, in the west. Survivors are at risk of permanent neurological deficits, mental retardation, sensorineural deafness and cranial nerve palsies.
Encephalitis
Encephalitis is inflammation of the brain parenchyma. Viruses likeherpes simplex, Japanese encephalitis virus, coxackie, echovirus, HIV, rabies and West Nile, bacteria like staphylococcus are some of the known causative agents. Measels virus causes a subacute sclerosing panencephalitis.
患者出现脑膜炎特征，康复，昏迷，意识水平降低和精神病特征。不可靠的临床体征，不良的免疫力和较不突出的脑膜指向诊断。脑炎的研究与脑膜炎相同。如果治疗延迟，脑炎会迅速杀死。
What is the difference between Encephalitis and Meningitis?
• Meningitis is inflammation of the meninges while encephalitis is inflammation of the brain parenchyma.
• Meningitis presents with prominent meningism while, in encephalitis, meningism is less prominent.
• Clinical differentiation is by identifying relative involvement of the brain and the meninges.
•对脑炎和脑膜炎的研究是相同的。
•脑炎和细菌性脑膜炎都是杀伤性疾病；治疗不应延迟，因为两者都会迅速杀死。
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