You are a medical research assistant. Using the medical library database tools (query_library_db and read_file), research the topic of MENINGITIS comprehensively from these key textbooks: - Harrison's Principles of Internal Medicine 22E (isbn: 9781265977061) - Goldman-Cecil Medicine (isbn: 9780323930345) - Adams and Victor's Principles of Neurology (isbn: 9781264264520) - Bradley and Daroff's Neurology in Clinical Practice (isbn: 9780323642613) - Medical Microbiology 9e (isbn: 9780323642613) — search this too Your focus areas are: 1. DEFINITION of meningitis (what it is, types: bacterial, viral, fungal, TB) 2. EPIDEMIOLOGY (incidence, prevalence, demographics, risk factors, worldwide and Malaysian/Southeast Asian data if available) 3. AETIOLOGY (causative organisms — bacterial: N. meningitidis, S. pneumoniae, L. monocytogenes, H. influenzae, Gram-negatives; viral: enteroviruses, HSV, EBV, HIV; fungal: Cryptococcus; TB meningitis; parasitic; non-infectious causes) 4. PATHOPHYSIOLOGY (how infection spreads to meninges, BBB disruption, inflammatory cascade, cerebral edema, raised ICP, complications at cellular/molecular level) 5. CLINICAL FEATURES (symptoms, signs — meningism: neck stiffness, Kernig's sign, Brudzinski's sign; photophobia, phonophobia; rash in meningococcal disease; altered consciousness; complications) 6. MENINGITIS as a cause of Pyrexia of Unknown Origin (PUO) — any relevant connections Search strategy: - First use headings_fts to find dedicated meningitis sections: SELECT title, book_title, '/textbooks/' || block_file_path AS file_path, line_number, para_line_ranges, para_count FROM headings_fts WHERE headings_fts MATCH 'meningitis' ORDER BY rank LIMIT 15 - Then use paragraphs_fts for specific topics: SELECT book_title, section_heading, '/textbooks/' || block_file_path AS file_path, line_start, line_end, snippet(paragraphs_fts, 0, '>>>', '<<<', '...', 40) as snippet FROM paragraphs_fts WHERE paragraphs_fts MATCH 'meningitis epidemiology incidence' ORDER BY rank LIMIT 10 - Read the most relevant file sections using read_file(path, offset=line_start-1, limit=100) to get full content - Make multiple targeted searches for each topic area Return a comprehensive, detailed, well-organized report with all findings clearly attributed to the source textbook. Include specific data points, organism names, pathophysiology mechanisms, and clinical signs. Be thorough — this is for a medical seminar.

You are a medical research assistant. Using the medical library database tools (query_library_db and read_file), research the topic of MENINGITIS comprehensively from these key textbooks: - Harrison's Principles of Internal Medicine 22E (isbn: 9781265977061) - Goldman-Cecil Medicine (isbn: 9780323930345) - The Washington Manual of Medical Therapeutics (isbn: 9781975190620) - Adams and Victor's Principles of Neurology (isbn: 9781264264520) Your focus areas are: 1. INVESTIGATIONS for meningitis: - Lumbar puncture / CSF analysis (opening pressure, appearance, WBC count/differential, protein, glucose, CSF:serum glucose ratio for bacterial vs viral vs TB vs fungal meningitis) - Blood tests (FBC, CRP, procalcitonin, blood cultures, coagulation) - Imaging (CT head indications before LP, MRI findings) - Microbiology (Gram stain, culture, sensitivity, PCR, antigen tests — latex agglutination, cryptococcal antigen) - Special tests for TB meningitis (ADA, AFB, culture) - CSF interpretation table comparing bacterial vs viral vs TB vs fungal 2. MANAGEMENT: - Empirical antibiotic therapy (by age group and risk factors): dexamethasone, ceftriaxone, ampicillin, acyclovir - Specific antibiotic therapy by organism (N. meningitidis, S. pneumoniae, L. monocytogenes, Gram-negatives) - Antiviral therapy (HSV meningitis/encephalitis: acyclovir dosing) - Antifungal therapy (Cryptococcal meningitis: amphotericin B + flucytosine induction, fluconazole consolidation/maintenance) - TB meningitis treatment (RHEZ regimen, steroids) - Supportive care (ICP management, fluids, seizure management) - Chemoprophylaxis (rifampicin, ciprofloxacin, ceftriaxone for close contacts of meningococcal disease) - Vaccination (meningococcal, pneumococcal, Hib vaccines) - Malaysian Clinical Practice Guidelines if any content mentions Malaysian or Asia-Pacific guidelines 3. PROGNOSIS/OUTCOMES: - Mortality rates by organism - Neurological sequelae (hearing loss, cognitive impairment, hydrocephalus) - Prognostic factors - Glasgow Outcome Scale 4. COMPLICATIONS: - Cerebral herniation - SIADH/hyponatremia - Septic shock/DIC - Subdural empyema - Seizures - Cranial nerve palsies Search strategy: - First use headings_fts: SELECT title, book_title, '/textbooks/' || block_file_path AS file_path, line_number, para_line_ranges, para_count FROM headings_fts WHERE headings_fts MATCH 'meningitis treatment management' ORDER BY rank LIMIT 15 - Then paragraphs_fts for specifics: SELECT book_title, section_heading, '/textbooks/' || block_file_path AS file_path, line_start, line_end, snippet(paragraphs_fts, 0, '>>>', '<<<', '...', 40) as snippet FROM paragraphs_fts WHERE paragraphs_fts MATCH 'meningitis CSF lumbar puncture' ORDER BY rank LIMIT 10 SELECT book_title, section_heading, '/textbooks/' || block_file_path AS file_path, line_start, line_end, snippet(paragraphs_fts, 0, '>>>', '<<<', '...', 40) as snippet FROM paragraphs_fts WHERE paragraphs_fts MATCH 'meningitis antibiotic ceftriaxone dexamethasone' ORDER BY rank LIMIT 10 - Read relevant file sections using read_file(path, offset=line_start-1, limit=100) for full content - Make multiple targeted searches to cover all sub-topics Return a comprehensive, detailed, well-organized report with all findings clearly attributed to the source textbook. Include specific drug doses, CSF values, and treatment algorithms. Be thorough — this is for a medical seminar.