DISEASE
MANAGEMENT OF
MENINGITIS
Meningitis
Meningitis is an infection of the protective
membranes that surround the brain and spinal
cord (meninges).
It can affect anyone, but it is most common in
babies, young children, teenagers and young
adults.
Meningitis can be very serious if not treated
quickly.
It can cause life-threatening blood poisoning
(septicaemia) and result in permanent
damage to the brain or nerves.
Types of meningitis
Viral Meningitis
Bacterial Meningitis
Fungal Meningitis
Parasitic Meningitis
Non infectious Meningitis
Viral meningitis
It is the most common type of
meningitis.
Viral meningitis typically goes away
without treatment.
However, some cases do need to be
treated.
Bacterial meningitis
Bacterial meningitis is contagious and caused by infection from
certain bacteria.
It’s fatal if left untreated.
The most common types of bacteria that cause bacterial meningitis
are:
1. Streptococcus pneumoniae, which is typically found in the
respiratory tract, sinuses, and nasal cavity and can cause
“pneumococcal meningitis”
2. Neisseria meningitidis, which is spread through saliva and other
respiratory fluids and causes “meningococcal meningitis”
3. Haemophilus influenza, which can cause not only meningitis but
infection of the blood, inflammation of the windpipe, cellulitis,
and infectious arthritis.
4. Staphylococcus aureus, which is typically found on the skin and in
the respiratory tract, and causes “staphylococcal meningitis” “
Fungal meningitis
Fungal meningitis is a rare type of meningitis. It is caused by a
fungus that infects the body and then spreads from bloodstream
to brain or spinal cord.
People with a weakened immune system are more likely to
develop fungal meningitis. This includes people with cancer or
HIV.
The most common funguses related to fungal meningitis include:
1. Cryptococcus, which is inhaled from dirt or soil that is
contaminated with bird droppings.
2. Blastomyces, another type of fungus found in soil.
3. Histoplasma, which is found in environments that are heavily
contaminated with bat and bird droppings.
4. Coccidioides, which is found in soil.
Parasitic meningitis
This type of meningitis is less common than viral or bacterial
meningitis, and it’s caused by parasites that are found in
dirt, feces, and on some animals and food, like snails, raw
fish, poultry.
One very rare type of parasitic meningitis, amebic
meningitis, is a life-threatening type of infection. This type is
caused when one of several types of ameba enters the body
through the nose while you swim in contaminated lakes,
rivers, or ponds. The parasite can destroy brain tissue and
may eventually cause hallucinations, seizures, and other
serious symptoms.
The most commonly recognized species is Naegleria fowleri.
Non-infectious
meningitis
Non-infectious meningitis is not an infection.
Instead, it is a type of meningitis that’s caused
by other medical conditions or treatments.
These include:
Lupus
A head injury
Brain surgery
Cancer
Certain medications
Symptoms of meningitis
The symptoms of viral and bacterial meningitis can
be similar in the beginning. However, bacterial
meningitis symptoms are usually more severe. The
symptoms also vary depending on the age.
Viral meningitis symptoms
Viral meningitis in infants may cause:
Decreased appetite
Irritability
Sleepiness
Lethargy
Fever
In adults, viral meningitis may cause:
Headaches
Fever
Stiff neck
Seizures
Sensitivity to bright light
Sleepiness
Lethargy
Nausea and vomiting
Decreased appetite
Bacterial meningitis
symptoms
Bacterial meningitis symptoms develop suddenly.
They may include:
Altered mental status
Nausea
Vomiting
Sensitivity to light
Irritability
Headache
Fever
Chills
Stiff neck
Purple areas of skin that resemble
bruises
Sleepiness
Lethargy
Bacterial and viral meningitis can be
deadly.
Fungal meningitis
symptoms
Symptoms of fungal meningitis resemble the other
types of this infection. These may include:
Nausea
Vomiting
Sensitivity to light
Fever
Headache
Confusion or disorientation
Each type of meningitis has some distinguishing
symptoms.
Diagnosis
Diagnosing meningitis starts with a health history and physical exam.
Age, residence, and day care center attendance can be important
clues.
During the physical exam, the doctor will look for:
A fever
An increased heart rate
Neck stiffness
Reduced consciousness
Doctor will also order a lumbar puncture. This test is also called a
spinal tap.
It allows the doctor to look for increased pressure in the central
nervous system. It can also find inflammation or bacteria in the spinal
fluid.
This test can also determine the best antibiotic for treatment.
Other tests may also be ordered to diagnose meningitis.
Common tests include the following:
Blood cultures
A complete blood count. The count is usually elevated in
meningitis.
Chest X-rays can reveal the presence
of pneumonia, tuberculosis, or fungal infections. Meningitis can
occur after pneumonia.
A CT scan of the head may show problems like a brain
abscess or sinusitis. Bacteria can spread from the sinuses to the
meninges.
Doctor may also conduct a glass test. For this test, the doctor
will roll a glass over the meningitis rash. If the rash doesn’t fade
under the pressure, it’s likely meningitis rash. If it does fade, the
unusual spots on the skin may be the result of another condition.
Treatment
Meningitis treatment depends on whether the
meningitis is viral, bacterial, or fungal in origin.
Viral meningitis
Viral meningitis tends to resolve on its own with
adequate rest and fluids.
However, children with bacterial or fungal meningitis
or those at risk of developing severe illness need
close observation and treatment in a hospital setting.
Sometimes, a doctor may prescribe an antiviral for
children with a type of viral meningitis known
as herpes simplex meningitis. They may also provide
pain relief medication for headaches and
an antiemetic to reduce nausea and vomiting.
Bacterial meningitis
Doctors treat bacterial meningitis with antibiotics. The following
antibiotics are used to treat bacterial meningitis:
Cefotaxime
Ampicillin
Ceftriaxone
Gentamicin
Vancomycin
Chloramphenicol
The choice of antibiotic will depend on the type of bacteria causing
the disease, the child’s age, and the presence of complications, if
any. A doctor may prescribe other antibiotics instead of or in
addition to the above, depending on the causative organism. They
will recommend the best course of treatment while also cautioning
on its side effects.
Antibiotic therapy can last for 5–21 days or more depending on the
causative organism, the type of antibiotic used, and the severity of
Fungal meningitis
The treatment for fungal meningitis is a long course
of high-dose antifungal medicines.
A healthcare professional will usually administer
these directly into a vein in the hand through an IV,
but sometimes a person can take them orally.
Amphotericin B and fluconazole are the two
commonly prescribed antifungal drugs in children.
The duration of treatment depends on the type of
fungus causing the infection, the child’s symptoms,
and the overall health of their immune system.
