Meningitis and encephalitis
Framing
- Meningitis (meningeal inflammation) and encephalitis (brain parenchymal inflammation) frequently overlap clinically (meningoencephalitis) but are distinguished by the dominant clinical picture - meningism (neck stiffness, photophobia) versus altered consciousness/focal neurological deficit/seizures - which shapes the differential and urgency of specific antimicrobial cover (e.g. empirical aciclovir for possible HSV encephalitis)
- Lumbar puncture (once safe - after excluding raised intracranial pressure) is central to both diagnoses, with CSF findings (cell count, protein, glucose, specific PCR) discriminating bacterial, viral, and other causes
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