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Meningitis

What is Meningitis ?

In meningitis, the brain and the spinal cord meninges become inflamed. Such inflammation may involve all three meningeal membranes: the dura mater, arachnoid membrane, and pia mater.

For most patients, meningitis follows the onset of respiratory symptoms: In about 50% of patients, it develops over 1 to 7 days; in about 20% of patients, over 1 to 3 weeks. In about 25% of patients, meningitis is unheralded by respiratory symptoms; it has a sudden onset, causing serious illness within 24 hours.

Types of Meningitis

  • Viral meningitis
  • Bacterial meningitis
  • Fungal meningitis
  • Parasitic meningitis
  • Noninfectious meningitis

Causes of Meningitis

Meningitis can be caused by bacteria, viruses, protozoa, or fungi. It most commonly results from bacterial infection, usually due to Neisseria meningitides, Haemophilus influenzae, Streptococcus pneumoniae, or Escherichia coli. Sometimes, no causative organism can be found.

In most patients, the infection that causes meningitis is secondary to another bacterial infection, such as bacteremia (especially from pneumonia. empyema, osteomyelitis, and endocarditis), sinusitis, otitis media, encephalitis, myelitis, or brain abscess. Meningitis can also follow a skull fracture, a penetrating head wound, lumbar puncture, or ventricular shunting procedures.

Meningitis caused by a virus is called aseptic viral meningitis.

Signs & Symptoms of Meningitis

Usually, someone with meningitis is very sick. Symptoms may include:

  • A very bad headache that won't go away
  • Back stiffness
  • Eye pain or irritation when exposed to light
  • Nausea and vomiting
  • Body aches
  • Rapid breathing
  • Fever or chills
  • Feeling very sleepy or unable to fully wake up
  • Stiff neck (meningismus)

Symptoms of meningitis can come on very quickly or take a couple of days to appear. Anyone who is ill with symptoms of meningitis needs to seek medical care right away.

Diagnostic Tests

Your doctor is the only person who can make a diagnosis to determine if meningitis is viral or bacterial. Meningitis is sometimes difficult to diagnose. Your doctor may order several tests or seek specialist advice. The diagnosis may include:

  • Taking a detailed history of signs and symptoms
  • Clinical examination
  • Chest X-rays
  • Computed tomography scanning
  • White blood cell count
  • A lumbar puncture, which may be done in hospital. (Spinal fluid is removed using a needle and examined for bacteria).

Treatment

Medical management of meningitis includes appropriate antibiotic therapy and vigorous supportive care.

Usually, I.V. antibiotics are given for at least 2 weeks, followed by oral antibiotics. Such antibiol include penicillin G, ampicillin, or nafcillin. If the patient is allergic to penicillin, anti-infective therapy includes tetracycline, chloramphenicol, or kanamycin.

Other drugs include a cardiac glycoside such as digoxin to control arrhythmias, mannitol to decrease cerebral edema, an anticonvulsant (usually given I.V.) or a sedative to reduce restlessness, and aspirin or aceraminophen to relieve headache and fever.

Supportive measures consist of bed rest, hypothermia, and fluid therapy to prevent dehydration.Isolation is necessary if nasal cultures are positive. Treatment includes appropriate therapy for any coexisting conditions such as endocarditis or pneumonia.

Look closely for signs of meningitis in individuals who are at risk, such as after ventricular shunting procedures, skull fracture, or penetrating head wounds.
Prevention Tips
  • Medications such as rifampin (Rifadin®), ceftriaxone (Duricef®), and ciprofloxacin (Cipro®) may be used to prevent the development of bacterial meningitis in people exposed to the disease.
  • Wash up regularly with warm, soapy water - especially before eating, after using the bathroom, and whenever your hands are dirty.
  • In addition, boost your immune system by getting enough rest, exercising regularly, and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.
  • Taking vaccines like Haemophilus influenzae type b, Streptococcus pneumoniae, Varicella (chickenpox) is the most effective way to prevent meningitis.


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