Meningitis
What is Meningitis?
The brain and the spinal cord are covered by a thin layer called meninges. Meningitis is an infection of the meninges and is caused by a virus or bacterium. Bacterial meningitis (caused by bacteria), can be quite severe and may result in brain damage, hearing loss, or learning disability.
What are the causes?
Bacterial meningitis is of two types – acute and severe (called pyogenic) or sub-acute chronic. The common causes of the latter are tuberculosis, syphilis or fungus. The severe form occurs in a community when: Bacterium H. Influenza, which is common in children reaches the meninges via the blood stream. Pneumococcus, which comes form the blood after pneumonia or a chest infection, enters the brain. The organisms are in the throat and often persist for months and then when a new infection with a different form of the micro-organism occurs, it may enter the brain and cause meningitis.Thus, the organisms enter the brain either through the blood or other infections of the ear, sinus, wounds of the scalp or the face. Another cause of the disease is due to a neurosurgical operation.
What are the symptoms?
Patients with meningitis suddenly develop fever, headache, and stiffness of the neck. There may also be nausea and vomiting, and the patients may become confused or are difficult to awaken. In severe meningitis, the meningeal infection may subsequently involve the blood vessels which may get blocked. This leads to damage to the part of the brain supplied by those blood vessels and can cause paralysis, fits and symptoms like that. Similarly meningitis can involve the nerves coming out of the brain, resulting in squint, visual failure and face paralysis.
How is the diagnosis made?
It is very important to determine the cause of meningitis. While children with viral meningitis usually get better without special treatment, bacterial meningitis can be life-threatening. For diagnosis, a lumbar puncture may be required. In this procedure a thin needle is inserted into the spine in the lower back to withdraw a small amount of spinal fluid. This procedure is very safe. By examining the fluid, it can be determined if the meningitis is viral or bacterial. The bacteria can then be cultured and the antibiotics can be modified accordingly.
What is the treatment?
Patients with bacterial meningitis need to be admitted to the hospital. The disease can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment should reduce the risk of death to below 15%, although the risk is higher among the elderly. Usually more than one antibiotic is needed, and these are administered through injections into the veins (intravenous). The antibiotics are required for 7-21 days depending on the bacterium that causes it. For chronic (long term) meningitis, the treatment is much longer, for example, tuberculosis meningitis requires treatment for 9 months or longer. Besides antibiotics, proper nursing care is very important.
What are the prevention?
There are vaccines against certain bacteria which are safe and highly effective. A meningitis cases should be reported to state or local health departments to assure follow-up of close contacts and recognise outbreaks.