Syndromes

Meningitis is the most common cause of meningism; however, meningism can occur in the absence of meningitis It may accompany upper lobe pneumonia, urinary tract infection and other febrile conditions. Cerebrospinal fluid examination is normal in these conditions. Bacterial meningitis is a medical emergency. The clinical presentation depends on the age of the patient and the infecting organism. In the neonate, the presentation is non-specific, with features of bacteraemia. Tuberculous meningitis is a manifestation of primary tuberculosis, which occurs mainly in children and young adults. It has an insidious onset; meningism is usually mild and other features (except fever) are often absent. Rubella infection in pregnancy can be prevented both directly, by vaccination of susceptible women of childbearing age, and indirectly, by universal childhood immunisation (which reduces circulation of wild virus and thus prevents exposure).