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Meningitis
Meningitis is inflammation of the sheaths and membranes (meninges)
covering the brain and the spinal cord. Although the most common
causes are infection (either bacterial or viral), chemical agents and
even tumor cells may cause meningitis. Encephalitis and brain abscess
can complicate infective meningitis.
Meningitis is usually caused by the infectious disorders of the
neighboring structures (sinuses, mastoid cells of ear etc.).
Major bacteria that cause meningitis are
Streptococcus pneumoniae,
Haemophilus influenzae,
staphylococcus and
meningococcus.
Symptoms and diagnosis
The classical symptoms of meningitis are headache, neck stiffness and
photophobia (the trio are called "meningism"). An altered level of
consciousness or other neurological deficits may be present depending
on the severity of the disease. A lumbar puncture to obtain
cerebrospinal fluid is usually indicated to determine the cause and
direct appropriate treatment.
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Treatment
Meningitis is a medical emergency with high levels of fatality and the
cause is usually a bacteria strain that is highly treatable by
antibiotics, patients with suspected meningitis should immediately
undergo a lumbar puncture procedure after a CT scan (which will
eliminate a possible brain swelling that may cause a brain herniation
during lumbar puncture) and broad spectrum antibiotics should be
urgently started before the culture studies are completed. If lumbar
puncture can not be performed because of brain swelling or a possible
concomitant brain abscess, a broad spectrum intravenous antibiotic is
started anyway and later it can be replaced with a more specific
antibiotic depending on the results of blood culture studies.
Diagnostic tests should be run to find and treat these possible
sources of infection, as well. Convulsions are frequently encountered
during the course of meningitis and are treated with appropriate
anti-seizure drugs like phenytoin.
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