Meningitis

Meningitis was known as a ravaging disease that took the lives of thousands of people around the globe until its destructive phase was stopped by the discovery of the vaccination against it in the year 1978 AD. A European Physician, Professor A. Weichselbaum, first discovered the cause of deadly meningitis in the year 1887 AD.

About Meningitis

When the membranes surrounding the brain and spinal cord are inflamed due to spread of infection, it leads to a condition known as meningitis.

Meningitis can be caused by bacterial, viral, and fungal infection. Meningitis can lead to a life threatening situation if it is not treated in time.

Meningitis may be due to infection caused by bacteria, virus, fungi, or certain cancers, lupus( inflammatory disease) and drug allergies. However, the most serious and life-threatening meningitis is caused by bacteria which passes through the blood stream and lodges itself in the brain and spinal cord causing swelling of the meninges (covering membranes of brain and spinal cord) leading to meningitis.

A fracture of the skull or infection of the sinus can cause the bacteria to enter and affect the meninges of the brain. The bacteria that cause meningitis include Streptococcus pneumonia, Haemophillus influenza, Neisseria meningitides and Listeria monocytogenes.

The mild form of meningitis occurs due to virus which gets cured in two weeks time. In the United States, 30% of viral meningitis is reportedly caused by a viral group known as enteroviruses. The other viruses that can cause viral meningitis include La Crosse virus, West Nile virus and Herpes simplex virus.

Fungal meningitis is not a common type of meningitis. In patients with low immunity and who have conditions like AIDS, a fungal meningitis known as Cryptococcal meningitis occurs. If treatment is not given in time, it could lead to a life threatening condition.

Risk factors

People at higher risk of getting meningitis include:

  • Children living in hostels

  • Personnel on military bases

  • Students living in dormitories

  • Infection by listeria bacteria in pregnancy

  • Working closely with domestic animals

  • In conditions with low immunity like AIDS, use of immunosuppressant drugs, diabetes and removal of spleen

Diagnosis

The doctor may conduct a blood culture in which blood is drawn from the vein and sent to the lab to check if the meningitis causing bacteria are growing in the blood.

Imaging tests like x-rays and Computerized tomography scan (3D images of internal structures are taken) of the sinuses, head and neck is done to check for any swelling.

A spinal tap or lumbar puncture is a sure way of diagnosing meningitis in which the cerebrospinal fluid is taken from the spine and analyzed in the lab.

If the Cerebrospinal fluid shows increased white blood cells, low blood sugar and increased protein content, then it is positive for meningitis. To diagnose viral meningitis, a DNA based test known as polymerase chain reaction amplification is done which gives the result in less than four hours time.

Signs and symptoms of meningitis take about few hours to a day or two to manifest. The person affected has the following symptoms. They are:

  • High fever

  • Severe headache

  • Nausea

  • Vomiting

  • Stiffness of the neck

  • Disinterest in normal activities like drinking and eating

  • State of confusion

  • Lack of concentration

  • No eye contact

  • Seizures

  • Sensitivity to light

  • Drowsiness

  • Difficulty in waking up

  • Skin rash can also occur in meningococcal or viral meningitis

In case of newborn babies, the symptoms include:

  • High fever

  • Irritability

  • Excessive sleep

  • Crying continuously

  • Bulge on the baby’s fontanelles (soft spot on front of baby’s skull or top)

  • Seizures

  • Irritability

  • Jaundice ( yellowish color to the skin and eyes due to bile)

  • Stiffness in the baby’s neck and body

  • Inactivity

  • Loss of appetite

If not treated on time meningitis can lead to;

  • Blindness

  • Memory loss

  • Hearing loss

  • Behavior problems

  • Speech loss

  • Brain damage

  • Paralysis

  • Learning disabilities

  • Adrenal gland failure

  • Kidney failure

  • Shock

  • Death

The treatment for bacterial meningitis includes giving the patient intravenous antibiotics specific for the bacteria causing the meningitis and cortisone medications.

The treatment will also be aimed at other complications that may occur like convulsions, dehydration and shock.

If there is infected fluid accumulation between the membranes surrounding brain and skull, it needs to be surgically drained.

Antibiotics cannot cure viral meningitis. The patient is recommended to take ample rest and fluids to prevent dehydration. Over the counter medications to relieve fever and body pain is advised.

For fungal meningitis intravenous anti fungal medications are given. For meningitis caused due to immunity deficient diseases and allergies, cortisones are given.

Meningitis is contagious and spreads through the following mentioned points:

  • Sharing the same utensils with an affected person

  • Sneezing

  • Coughing

  • Kissing

  • Sharing a toothbrush or a cigarette

  • It is necessary that one must wash hands thoroughly with an antiseptic soap after using the toilet

  • After petting animals

  • Before and after eating

  • Eating healthy foods like fresh vegetables, fruits, whole grains

  • Exercising regularly is important to improve the immune system

Pregnant women must take special care to eat only well cooked meat and avoid dairy products made from unpasteurized milk

Immunizations are important to protect children from meningitis. The vaccinations available include;

  • Haemophilus influenza type b (Hib) vaccine (given starting at 2 months of age)

  • Pneumococcal polysaccharide vaccine (PPSV)(for older children and adults)

  • Pneumococcal conjugate vaccine (PCV7)( for children between 2 to 5 years)

  • Meningococcal conjugate vaccine (MCV4)(11 years to 18 years).