Meningitis is an inflammation of the meninges which are protective coverings of the brain and spinal cord. It is a notifiable disease in many countries but the exact incidence rate is not known. It is considered as a medical emergency because of the close proximity of the inflammation to the brain and spinal cord. But, how do you catch meningitis?
Causes of Meningitis
There are three possible causes of meningitis which are:
The type of bacteria that causes meningitis depends on the age of the person. In premature babies and newborns, group B streptococci is the main cause of meningitis while Neisseria meningitides for older children and adults. Viruses that cause meningitis are:
- Varicella zoster virus.
- Mumps virus
- Herpes simplex virus type 2.
Parasites that can cause meningitis are:
- Gnathostoma spinigerum
- Angiostrongylus cantonensis.
Symptoms of Meningitis
Symptoms associated with meningitis are:
- Stiff neck
- Altered level of consciousness
- Photophobia or inability to tolerate light
- Phonophobia or inability to tolerate loud noises
Diagnosis of Meningitis
Meningitis is diagnosed by performing a lumbar puncture. In this procedure, the person is position in a fetal position or shrimp position and then a needle is inserted on the spinal canal to collect samples of cerebrospinal fluid. The fluid is then brought to the laboratory for examination. If ac causative agent of meningitis is found on the sample, then the diagnosis of meningitis is established and treatment is started immediately.
Meningitis can be transmitted through the saliva and respiratory discharges of those infected with the disease. Sneezing, kissing, coughing and even sharing of eating utensils can transmit the infection from one person to the other. The incubation period of meningitis is about 2 to 10 days with an average of 3-4 days.
Treatment of Meningitis
The treatment of meningitis depends on the type of causative agent. A bacterial cause is treated with antibiotics such as cephalosporin, cefotaxime, vancomycin, benzylpenicillin. The choice of antibiotics depends on the country because some natives are found to be non reactive to certain antibiotics.
Empiric antibiotics are started even without the result of lumbar puncture yet because it would normally take some time before the result would come out. As the result of the lumbar puncture comes out, antibiotics can be shifted where the causative agent reacts most.
Viral meningitis needs supportive therapy because viruses are self limiting. If there is respiratory failure, mechanical ventilation can help retain normal breathing.
Fungal meningitis is treated with high dose of antifungals such as amphotericin B and flucytosine. Steroids are also given as adjuvant theraphy to decrease the severity of the inflammation.