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Abstract: A 50-year-old aunt Wang had headache, fever, vomiting, along with loss of appetite and poor mental health, and the presence of cervical tonicity signs, which was initially diagnosed as viral meningitis after seeking medical attention. Since the viral infection was self-limiting, treatment was provided only for the symptoms. After treatment with medication, the symptoms basically improved and all tests returned to normal, and the prognosis was good.
Basic information】Female, 50 years old
Type of disease】Viral meningitis
Hospital】Beijing Anzhen Hospital, Capital Medical University
Date of consultation】May 2021
Treatment plan】Oral medication (ibuprofen extended-release capsule, ribavirin granules) + intravenous injection (mannitol injection)
Treatment period】2 weeks of hospitalization and regular follow-ups
Treatment effect] The discomfort symptoms were relieved after treatment, and the prognosis is good
I. Initial consultation
When we first saw Auntie Wang, she was in a poor mental state and reported that she had headache symptoms 10 days ago, but no other discomfort was associated with it. Auntie Wang had no history of headache, and her physical examination showed a temperature of 37.9℃, a heart rate of 76 beats/min, and no abdominal pressure pain or percussion pain.
II. Treatment process
The results of liver and kidney functions and electrolytes showed no abnormalities, while the results of routine blood tests indicated that the percentage of neutrophils was 31.8%, lymphocytes was 40.6% and monocytes was 16.8%, suggesting a viral infection. After communicating with Auntie Wang, a lumbar puncture was performed for Auntie Wang with signed informed consent. The results indicated that the cerebrospinal fluid pressure was high, the total cell count in the routine cerebrospinal fluid was mildly elevated, mainly mononuclear cells, and protein and cerebrospinal fluid sugar and chloride were in the normal range. For Auntie Wang’s headache symptoms, she was given ibuprofen extended-release capsules to reduce fever and relieve pain, together with drip mannitol injection to lower cranial pressure and oral ribavirin capsules for antiviral treatment, and a lumbar puncture was repeated after 2 weeks of medication treatment.
III. Treatment effect
After inpatient treatment, Auntie Wang’s headache symptoms were significantly improved. After 1 week of drug treatment, headache symptoms were significantly reduced, fever and vomiting disappeared, and her mental state was still acceptable. After 2 weeks of medication, the headache symptoms disappeared and her mental state was good. The results of lumbar puncture indicated that there was no abnormality, which meant that the disease was clinically cured and she could be discharged.
IV. Notes
We are glad that Auntie Wang is gradually recovering, but we need to remind her to take enough rest in life, avoid strenuous exercise, take walks, play tai chi, etc., and pay attention to the combination of work and rest to strengthen the body’s ability to resist disease. At the same time, it is recommended to follow the doctor’s prescription for regular medication to avoid aggravating the headache symptoms. Choose a softer pillow.
V. Personal insight
Auntie Wang, aged 50, did not pay attention to her headache symptoms when they first appeared, which led to the aggravation of the symptoms later. Seek medical attention promptly to identify the specific cause and follow medical advice for appropriate treatment. In the case of viral meningitis, if not treated actively, it may lead to serious diseases such as encephalitis and acute disseminated encephalomyelitis, which may even be life-threatening, so timely medical consultation is recommended.