Meningitis: Symptoms, Causes, Treatment and Prevention

Meningitis is the inflammation of the meninges. The meninges is the membrane that surrounds the brain and the spinal cord. There are 3 meninges (layers): Dura mater, Arachnoid mater, and Pia mater.

The meninges and the cerebrospinal fluid come together to protect the central nervous system (which is the brain and spinal cord). 

What is the first sign of meningitis?

The early symptoms of meningitis may include:

  • Headache.
  • High fever.
  • Neck stiffness.
  • Confusion.
  • Vomiting.
  • Photophobia (inability to tolerate light)
  • Phonophobia (the fear of loud sounds or one’s own voice)
  • Drowsiness.
  • Irritability.
  • Leg pain.
  • Cold extremities.
  • Numerous small, irregular purplish or reddish Petechiae rashes on the lower extremities, conjunctiva, mucous membrane and palms of hands or soles of feet
  • Seizures.

Symptoms of meningitis in infants can include:

  • Constant high-pitched cry
  • Poor feeding and decreased appetite
  • Sleepiness
  • Breathe quickly
  • High fever 
  • Bulging fontanelle (soft spot on the infant head)

How do people get meningitis?

Meningitis is majorly caused by viruses but can be caused by fungal, parasites, or bacterial infection as well. Viral causes do not generally require treatments because patients usually get better without treatments. 

In very few cases where patients still have specific symptoms, those symptoms are managed appropriately. According to the CDC, It is essential to know the precise cause of meningitis because the treatment depends on the cause.

Viral Causes of Meningitis:

  • Coxsackievirus A.
  • Coxsackievirus B.
  • Echoviruses.
  • Mumps.
  • Influenza.
  • HIV
  • Measles.
  • Varicella-zoster virus (responsible for causing chickenpox and shingles)
  • Herpes simplex virus type 2
  • Influenza

Bacterial Causes of Meningitis :

  • Streptococcus pneumoniae
  • Neisseria meningiditis
  • Listeria monocytogenes
  • Haemophilus influenza
  • Staphylococcus aureus.
  • Escherichia coli.
  • Streptococcus agalactiae (also known as group B streptococcus)
  • Pseudomonas.
  • Mycobacterium tuberculosis (tuberculosis meningitis)

Fungal Causes of Meningitis:

  • Cryptococcus neoformans (Cryptococcus meningitis)
  • Coccidioides immitis
  • Histoplasma capsulatum
  •  Candida
  • Blastomyces dermatitidis

Parasitic Causes of Meningitis:

  • Schistosoma.
  • Toxocariasis (visceral larva migrants)
  • Gnathostoma spinigerum
  • Angiostrongylus cantonensis

What happens if meningitis is left untreated?

Meningitis left untreated can cause serious complications may include:

  • Epilepsy.
  • Deafness.
  • Cognitive deficits.
  • Hydrocephalus.
  • Sepsis.
  • Systemic inflammatory response syndrome
  • Disseminated intravascular coagulopathy

Diagnosis of Meningitis:

Doctor diagnose meningitis with the following process: 

Physical examinations:

  • Positive kernig’s sign: is the presence of pain in the knee on the extension when the thigh is flexed at the hip and knee at 90° angles
  • Positive brudzinski sign: is when pressure is a place on the cheeks, and this pressure triggers a reflex action of, twitching the area close to the eye or upper lip or pressure place on upper arm triggers flexion of the forearm
  • Presence of nuchal rigidity

Lumbar puncture 

For an accurate diagnosis, it is necessary to perform the following: 

  • Involves the examination of cerebrospinal fluid for the presence of white blood cells, the types of white blood cells, the presence of red blood cell, protein content and glucose levels
  • Polymerase chain reaction (take a small trace of bacteria or viral DNA and amplify it in order to detect their full presence in CSF)
  • Cloudy Cerebrospinal fluid (CSF) is an indication of a bacterial etiology.

Other diagnose process of meningitis include: 

  • Full blood count to check for inflammatory/infectious signs such as elevated C-reactive protein.
  • Biochemical investigation to check blood electrolytes levels.
  • Blood culture.
  • Computed tomography scan (CT scan)
  • Magnetic resonance imaging (MRI)

Treatment of meningitis

Meningitis is treated with the following medication: 

  • Antibiotics: Benzylpenicillin, ceftriaxone, vancomycin, chloramphenicol, and ampicillin.
  • In the presence of shock or low blood pressure, Intravenous fluids are the next best thing.
  • Hydrocephalus: mannitol and cerebral shunt.
  • Seizures: Paraldehyde, Diazepam.
  • Corticosteroids: dexamethasone.
  • Fungal meningitis: amphotericin B.

Preventions of meningitis

Always wash your hands and practice good proper hygiene. Vaccination is the most reliable way to protect yourself and your children from meningitis.

There are vaccinations for certain etiology of meningitis such as:

  • Meningococcal vaccine
  • Pneumococcal vaccine
  • Mumps vaccine 
  • Haemophilus influenza type B vaccine.

NOTE:

  • Bacteria and viral meningitis are contagious
  • Meningitis affects all age groups
  • Meningitis equally affects men and women, and there are no differences in gender either
  • Viral and bacterial infections are the common frequent causes of meningitis

Finally, this is an informative article about Pelvic inflammatory disease. If you experience PID symptoms, be sure to consult a doctor.