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Bacterial Meningitis



Bacterial Meningitis Definition


Meningitis is an inflammation of the meninges – the protective membranes wrapping the central nervous system. This condition may develop as a result of viruses, bacteria and a number of infectious agents. However, it may also occur in people who recently experience physical injury, those with cancer and others who have a history of drug abuse. Most cases of meningitis resolve without treatment. However, this condition can become severe because the inflammation can damage the spinal cord and the brain, which are both in close proximity to the areas affected by meningitis. Since severe meningitis could cause serious neurological damage or death, immediate medical attention and diagnosis is needed. The most common type of meningitis – infectious meningitis – can be treated with antibiotics alone, but requires continues observation. Other types of meningitis can be prevented through scheduled immunization.


Bacterial Meningitis Diagnosis


When a person suspects meningitis, the number of symptoms present and the findings of several physical exams confirm the disease. Once confirmed, antibiotics should be administered immediately since the condition may worsen quickly. Physical exams include an x-ray of the chest and blood tests to determine kidney and liver function, electrolytes, complete blood count and inflammatory markers. However, the most important exam that confirms or rules out meningitis is the analysis of the fluid that surrounds the spinal cord and the brain known as “cerebrospinal fluid”. This is determined through lumbar puncture.


Bacterial Meningitis Symptoms and Signs


The most common meningitis symptom is headache. Over 85% of people suspected with meningitis experience severe headaches. Around 80% of meningitis patients experience neck stiffness or “nuchal rigidity”. Three common diagnostic signs of meningitis, which exist in 40% of patients with infectious meningitis, are fever, altered mental status and neck rigidity or being unable to move the neck forward. Neck rigidity is usually associated with patients lying supine, both knees and hips flexed. If pain is educed when knees are extended passively, this is a sign of neck (or “nuchal”) rigidity. Other symptoms associated with this disease include inability to bear bright lights (photophobia), inability to withstand loud noises (phonophobia), seizures and irritability. In small children with meningitis, delirium occurs. For infants age 0 to 6 months, swelling of soft spots may occur. With meningococcal meningitis, which is caused by the Neisseria meningitidis bacteria, a common symptom is a rapidly spreading rash that is preceded by a plethora of other symptoms.


Bacterial Meningitis Treatment


Treatment for meningitis depends largely on the type of meningitis – bacterial, viral and fungal meningitis. In cases of bacterial meningitis, immediate medical attention is needed regardless of how mild the condition may be. This type of meningitis has a high mortality rate when untreated, so empiric antibiotics are usually administered immediately after hospital confinement. Antibiotics depend on where patients are located; UK uses cephalosporin, U.S. administers carbapenem or vancomycin, Africa uses ceftriaxone or chloramphenicol. For viral meningitis patients, hospital admission is not required. However, some cases need close observation for several days. Generally, viral meningitis is less severe compared to bacterial meningitis. However, unlike bacteria, antibiotics cannot kill viruses. Fungal meningitis rarely occurs to healthy people. It is usually present in people who have AIDS or other forms of health conditions related to the immune system, such as immune system malfunction or immunodeficiency.


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