Meningitis

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Meningitis, inflammation of the meninges, the membranes that surround the brain and spinal cord. Meningitis may be caused by a physical injury, a reaction to certain drugs, or more commonly, infection by certain viruses, bacteria, fungi, or parasites. This article focuses on meningitis caused by viral or bacterial infection.

The most common causes of viral meningitis are coxsackie viruses and echoviruses, although herpesviruses, the mumps virus, and many other viruses can also cause the disease. Viral meningitis is rarely fatal, and most patients recover from the disease completely.

Most cases of bacterial meningitis are caused by one of three species of bacteria—Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis. Many other bacteria, including Escherichia coli and the bacteria that are responsible for tuberculosis and syphilis, can also cause the disease. Bacterial meningitis can be fatal if not treated promptly. Some children who survive the infection are left with permanent neurological impairments, such as hearing loss or learning disabilities.

SYMPTOMS AND DIAGNOSIS

No matter what the cause, the symptoms of meningitis are always similar and usually develop rapidly, often over the course of a few hours. Nearly all patients with meningitis experience vomiting, high fever, and a stiff neck. Meningitis may also cause severe headache, back pain, muscle aches, sensitivity of the eyes to light, drowsiness, confusion, and even loss of consciousness. Some children have convulsions. In infants, the symptoms of meningitis are often more difficult to detect and may include irritability, lethargy, and loss of appetite. Most patients with meningococcal meningitis develop a rash of red, pinprick spots on the skin. The spots do not turn white when pressed, and they quickly grow to look like purple bruises.

Meningitis is diagnosed by a lumbar puncture, or spinal tap, in which a doctor inserts a needle into the lower back to obtain a sample of CSF. The fluid is then tested for the presence of bacteria and other cells, as well as certain chemical changes that are characteristic of meningitis.

TREATMENT AND PREVENTION

It is imperative to seek immediate medical attention if the symptoms of meningitis develop in order to determine whether the meningitis is viral or bacterial. Any delays in treating bacterial meningitis can lead to stroke, severe brain damage, and even death. Patients with bacterial meningitis are usually hospitalized and given large doses of intravenous antibiotics. The specific antibiotic used depends on the bacterium responsible for the infection. Antibiotic therapy is very effective, and if treatment begins in time, the risk of dying from bacterial meningitis today is less than 15 percent.

No specific treatment is available for viral meningitis. With bed rest, plenty of fluids, and medicine to reduce fever and control headache, most patients recover from viral meningitis within a week or two and suffer no lasting effects.

Good hygiene to prevent the spread of viruses is the only method of preventing viral meningitis. To help prevent the spread of bacterial meningitis, antibiotics are sometimes given to family members and other people who have had close contact with patients who develop the disease. Vaccines are also available against some of the bacteria that can cause meningitis. A vaccine against one strain of Haemophilus influenzae, once the most common cause of bacterial meningitis, was introduced during the 1980s and has been a part of routine childhood immunization.

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