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Basics About Meningitis by Shelby Honeycutt

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Meningitis is the medical term used to explain inflammation of the protective coverings surrounding the brain and spinal cord. The condition requires immediate evaluation and observation by a physician. If left untreated meningitis may result in hearing loss, neurological impairment, brain damage, or death. Infants and children are most susceptible, followed by adolescents and young adults or adults with suppressed immune systems. As infants and children may not always be able to convey the severity of their sickness, it is paramount that parents and caregivers are educated on the symptoms of meningitis to ensure a positive prognosis for children presenting with the disease.

Symptoms of meningitis include fever, nausea, vomiting, neck stiffness, headache sensitivity to light and sound, and in more critical cases diminished mental capacity. Infant caregivers should also be wary of inconsolable cries, poor eating or decreased nursing, extreme tiredness, and difficulty in waking the infant. In young infants especially parents and caregivers should take note of the fontanel, more commonly known as a baby’s “soft spot”, if this area appears raised or bulging it is indicative of meningitis.  Symptoms may appear rapidly or over several days, depending on the severity, and necessitate emergency medical care.

If a physician suspects this potentially life-threatening disease he or she may order blood tests, x-rays, or a CT scan that may reveal swelling in the brain or spinal cord. A definitive diagnosis requires a spinal tap, or lumbar puncture, to provide a small sample of the cerebrospinal fluid. The fluid surrounds the membranes that protect the brain and spinal column. The constant contact with these membranes is reflected in the fluid’s composition. When the composition is high in protein, tests positive for bacteria, or shows elevated white blood cell count meningitis is indicated.

The direction of treatment is dictated by the cause of the inflammation. In most cases meningitis is viral, and treatment is supportive. Viral meningitis is rarely life-threatening and often resolves with rest at home within 7 to 10 days. In contrast, meningitis caused by bacteria is a life-threatening situation requiring hospitalization. If the cerebral spinal fluid contains bacteria immediate care is critical to recovery. Treatment calls for antibiotics administered intravenously to subdue the infection. Recently more consideration has been given to co-administering steroids intravenously alongside antibiotics. As the antibiotics work to reign in the infection, the steroids act to reduce inflammation. Often this combination of treatment seems to result in a better prognosis and increased rate of recovery.

Meningitis can also result from noninfectious mediums, although this is exceedingly rare it is noteworthy. Fungal meningitis is the result of an escalating lung infection caused by the spores of certain funguses and typically only affects individuals with suppressed immune systems. Treatment requires high-dose antifungal medications delivered intravenously. Another very rare type of meningitis is caused by parasites, the Naegleria fowleri ameba to be specific. The ameba lives in hot fresh water and causes infection by entering the cerebrospinal fluid via nasal entry. In developed nations, this form of meningitis is so rare that only 32 cases have been documented over the last ten years, the majority of which resulted in fatalities. Noninfectious meningitis may also result from cancers, certain drugs, brain surgery, or Lupus. Presenting with classical meningitis symptoms, treatment for these types of meningitis must be tailored to the patient’s case.

Thankfully meningitis is fairly uncommon due to routine vaccinations that all children two and under receive within the United States.  These vaccines inoculate for the infectious agents that are most often responsible for causing bacterial meningitis.  Additionally, good hygiene practices in home, community, and healthcare settings reduce infection overall and in turn lower the occurrence of meningitis. Finally, informing parents and caregivers of infants and children of the specific symptoms of meningitis and the need to complete their children’s vaccine schedules is crucial in reducing meningitis cases.

 

References 

Centers for Disease Control and Prevention. (2012). Meningitis. Retrieved May 21, 2013, from http://www.cdc.gov/meningitis/index.html

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Mayo Clinic. (2013). Meningitis. Retrieved May 21, 2013, from http://www.mayoclinic.com/health/meningitis/DS00118

Spencer, David C. & Karceski, Steven. (2012). Treating Meningitis. American Academy of Neurology. Retrieved from http://www.neurology.org/content/79/22/e190.full.pdf

 

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