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Difference Between Meningitis and Encephalitis
August 30, 2016 • by Embogama • 6 min read
Main Difference – Meningitis vs
Encephalitis
According to the National Institute of Neurological Disorders
and Stroke (NINDS), Meningitis and Encephalitis are defined
as two neurological conditions where the membranes
surrounding the brain and the spinal cord are more or less
inflamed. The main difference between Meningitis and
Encephalitis is that Encephalitis is an acute inflammation of
the brain parenchyma whereas Meningitis is the
inflammation of the protective layers of tissue, or
membranes, covering the brain. While the main cause can either be a viral or bacterial infection, the severity of both
conditions could vary from mild to fatal.
It is highly important to detect how these conditions differ from each other, mainly for the purpose of treatment and
followup, in order to prevent them from leading to irreversible and negative lifethreatening consequences.
Here, we will discuss,
1. What is Meningitis? – Definitions, Causes, Signs and Symptoms, Treatment
2. What is Encephalitis? – Definitions, Causes, Signs and Symptoms, Treatment
3. What is the difference between Meningitis and Encephalitis?
EXPLORE
What is Meningitis
Defined as an inflammation of the protective lining of the brain and spinal cord (Meninges), Meningitis is mainly
caused by a bacterial or viral infection. Viral and bacterial infections are contagious and could get transmitted through
sneezing, coughing or contact. Other minor causes may include tumors, radiation, chemical irritation, fungal
infections and drug allergies. Other major risk factors include immunecomprised states such as HIV, AIDS, Auto
immune diseases, etc.
Viral Meningitis
The commonest cause of viral meningitis (85%) is Coxsackievirus A, Coxsackievirus B, or Echoviruses. Other
possible viral infections may include Mumps, HIV, Measles, Influenza, and Herpes. Most Viral infections will resolve
spontaneously, even without treatment.
Bacterial Meningitis EXPLORE
Streptococcus pneumonia (pneumococcal meningitis), Neisseria meningitides (Meningococcal meningitis),
Haemophilus influenza, Listeria monocytogenes (foodborne) are among the main bacteria which give rise to this
condition, and untreated bacterial meningitis can be life threatening.
While being able to affect anyone at any age, this condition is mostly seen in babies, young children, teenagers and
young adults. Children below 5 years of age are at a high risk of contracting viral meningitis whereas infants are at
high risk of contracting bacterial meningitis.
A weak and illlooking patient brought to the hospital with signs and symptoms such as high temperature over 37.5°C,
severe headache, a blotchy rash that doesn’t fade off when a glass is rolled over it (not always), neck stiffness,
avoidance of bright light (photophobia), drowsiness and unresponsiveness and fits should be properly cared and
immediate interventions should be taken since meningitis tops the list of differential diagnoses. More importantly, the
above symptoms can manifest completely or may range in any order depending on the causative agent, fitness of the
patient and severity of the condition.
A full neurological examination will help to establish a proper diagnosis up to a certain extent. A lumbar puncture will
reveal inflammation (spinal tap), blood cultures will identify the causative organism and full blood count and CRP
levels will detect ongoing inflammation. Chest Xray (since pneumococcal meningitis can follow pneumonia) and CT
scan (exclude brain abscess or sinusitis which can be the focus of infection) will help to exclude other causes and
confirm the diagnosis.
Treatment for Meningitis mainly depends on the etiology whereas bacterial meningitis requires immediate
hospitalization and treatment with intravenous antibiotics based on the type of organism; fungal meningitis is treated
with antifungal agents. Viral meningitis isn’t usually treated and would resolve spontaneously, and the symptoms
would disappear within about two weeks.
Patients who don’t receive timely interventions are susceptible to develop complications such as seizures, impaired
hearing, brain damage, Hydrocephalus and subdural effusions (development of fluid between the brain and skull).
Additionally, vaccinations against Haemophilus influenza type B (Hib) vaccine, Pneumococcal conjugate vaccine, and
Meningococcal vaccine can be given as prophylactic measures in order to prevent from Meningitis.
EXPLORE
What is Encephalitis
Encephalitis is a rare yet serious condition defined as the
acute inflammation of the brain parenchyma. Signs and
symptoms of Encephalitis are so similar to those of the flu,
so it is quite difficult to differentiate which is which.
However, the features would last from 23 weeks where
mild forms can recover fully whereas some types can be
lifethreatening. Patients will mainly complain of difficulty
in speech or hearing, double vision, hallucinations,
personality changes, loss of consciousness, loss of
sensation (some parts of the body), weakness of muscles,
partial paralysis of arms and legs, sudden severe dementia,
fits and memory loss.
Mostly caused by Enteroviruses, herpes simplex virus types 1 and 2, rabies virus or Arboviruses (West Nile virus,
which are transmitted from infected animals to humans via bites from infected ticks, mosquitos, or other blood
sucking insects), people with an immunecompromised state are at a high risk of getting susceptible to the primary
infection, which is similar to meningitis.
Being contagious, the infection can spread through close contact with saliva, nasal discharge, feces or throat
secretions.
EXPLORE
In addition to a complete history and neurological examination, encephalitis is diagnosed by techniques similar to
those done for meningitis, and CT scan or MRI will show inflammation of the brain instead of inflamed meninges.
Moreover, Electroencephalography (EEG) can be carried out to reveal abnormal brain waves by monitoring electrical
activity in the brain through the skull.
Management – Based on the Causative Organism
Antiviral drugs – Acyclovir and Ganciclovir
Anticonvulsants to stop or prevent seizures
Corticosteroids to reduce brain swelling
Artificial respiration
Immunosuppressant drugs for autoimmune causes
Screening for tumors in suspected cases
A comprehensive rehabilitation
Cognitive rehabilitation
Physical, speech and occupational therapy once the acute illness is controlled
Coronal T2weighted MR image
Difference Between Meningitis and Encephalitis
Definition:
The main difference between Meningitis and Encephalitis lies in the definition itself.
Meningitis is defined as the inflammation of the protective layers of tissue, or membranes covering the brain known
as Meninges.
EXPLORE
Encephalitis is defined as an acute inflammation of the brain parenchyma.
Causes:
Meningitis can be caused by bacteria, viruses, and fungi.
Encephalitis is commonly caused by viral agents.
Types:
Meningitis can exist only as a single form.
Encephalitis can occur as primary (infective organism directly enters the brain) or secondary types (infectious
organism enters an organ before entering the brain).
Distinguishing Signs:
Both these conditions share very similar features which make it difficult to diagnosis the exact type and unfortunately
there are patients who get affected by both the diseases at once, leading to a complicated situation giving rise to a need
for complex modalities of treatment. However, the main distinguishing factor is the skin discoloration or rash which is
only seen in Meningitis.
The other hallmark signs of Meningitis are sudden fever, severe headache, nausea, vomiting, double vision,
drowsiness, photophobia and stiff neck.
Encephalitis is characterized by moderatesevere fever, seizures, behavioral changes, confusion, disorientation and
related neurological signs depending on which part of the brain is affected by the encephalitic process (locally
centered or global).
Diagnosis:
Meningitis is mostly diagnosed by routine blood examinations along with cultures to isolate the responsible organism.
Encephalitis might need neuroimaging techniques in addition to those.
Management:
Ampicillin is the gold standard antibiotic for meningitis (mostly bacterial) which will be given combined with
aminoglycoside or cephalosporin (cefotaxime).
Encephalitis (mostly viral) will be treated with intravenous Acyclovir for 10 days while being hospitalized.
Image Courtesy:
“Symptoms of Meningitis” By Mikael Häggström (Public Domain) via Commons Wikimedia
“Hsv encephalitis” By Dr Laughlin Dawes (CC BY 3.0) via Commons Wikimedia EXPLORE
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About the Author: Embogama
Embogama is a passionate freelance writer for several years. Her areas of interest include general
medicine, clinical medicine, health and fitness, Ayurveda medicine, psychology, counseling and
piano music
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