Meningitis

Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord, usually due to the spread of an infection. The swelling associated with meningitis often triggers the “hallmark” signs and symptoms of this condition, including headache, fever and a stiff neck in anyone over the age of 2.

Most cases of meningitis are caused by a viral infection, but bacterial and fungal infections also can lead to meningitis. Depending on the cause of the infection, meningitis can resolve on its own in a couple of weeks — or it can be a life-threatening emergency. College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at increased risk of meningococcal meningitis, probably because the bacterium is spread by the respiratory route and tends to spread quickly wherever large groups of susceptible teenagers or young adults congregate.If you suspect that you or someone in your family has meningitis, seek medical care right away. Early treatment can prevent serious complications.

A number of strains of bacteria can cause acute bacterial meningitis. The most common include:

  • Streptococcus pneumoniae (pneumococcus). This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the United States. It more commonly causes pneumonia or ear or sinus infections.
  • Neisseria meningitidis (meningococcus). This bacterium is another leading cause of bacterial meningitis. Meningococcal meningitis commonly occurs when bacteria from an upper respiratory infection enter your bloodstream. This infection is highly contagious. It affects mainly teenagers and young adults, and may cause local epidemics in college dormitories, boarding schools and military bases.
  • Haemophilus influenzae (haemophilus). Before the 1990s, Haemophilus influenzae type b (Hib) bacterium was the leading cause of bacterial meningitis in children. But new Hib vaccines — available as part of the routine childhood immunization schedule in the United States — have greatly reduced the number of cases of this type of meningitis. When it occurs, it tends to follow an upper respiratory infection, ear infection (otitis media) or sinusitis.
  • Listeria monocytogenes (listeria). These bacteria can be found almost anywhere — in soil, in dust and in foods that have become contaminated. Contaminated foods have included soft cheeses, hot dogs and luncheon meats. Many wild and domestic animals also carry the bacteria. Fortunately, most healthy people exposed to listeria don’t become ill, although pregnant women, newborns and older adults tend to be more susceptible. Listeria can cross the placental barrier, and infections in late pregnancy may cause a baby to be stillborn or die shortly after birth. People with weakened immune systems, due to disease or medication effect, are most vulnerable.

Symptoms

It’s easy to mistake the early signs and symptoms of meningitis for the flu (influenza). Meningitis signs and symptoms may develop over several hours or over one or two days and, in anyone over the age of 2, typically include:

  • High fever
  • Severe headache that isn’t easily confused with other types of headache
  • Stiff neck
  • Vomiting or nausea with headache
  • Confusion or difficulty concentrating — in the very young, this may appear as inability to maintain eye contact
  • Seizures
  • Sleepiness or difficulty waking up
  • Sensitivity to light
  • Lack of interest in drinking and eating
  • Skin rash in some cases, such as in viral or meningococcal meningitis

When to see a doctor
Seek medical care right away if you or someone in your family has signs or symptoms of meningitis, such as:

  • Fever
  • Severe, unrelenting headache
  • Confusion
  • Vomiting
  • Stiff neck

There’s no way to know what kind of meningitis you or your child has without seeing your doctor and undergoing spinal fluid testing.

  • Viral meningitis may improve without treatment in a few days.
  • Bacterial meningitis is serious, can come on very quickly and requires prompt antibiotic treatment to improve the chances of a recovery without serious complications. Delaying treatment for bacterial meningitis increases the risk of permanent brain damage or death. In addition, bacterial meningitis can prove fatal in a matter of days.

Also talk to your doctor if a family member or someone you work with has meningitis. You may need to take medications to prevent getting sick.

Treatments

The treatment depends on the type of meningitis you have.

Bacterial meningitis
Acute bacterial meningitis requires prompt treatment with intravenous antibiotics and, more recently, cortisonelike medications, to ensure recovery and reduce the risk of complications. The antibiotic or combination of antibiotics that your doctor may choose depends on the type of bacteria causing the infection. Your doctor may recommend a broad-spectrum antibiotic until he or she can determine the exact cause of the meningitis.

If you or your child has bacterial meningitis, your doctor may also recommend treatments for:

  • Brain swelling
  • Shock
  • Convulsions
  • Dehydration

Infected sinuses or mastoids — the bones behind the outer ear that connect to the middle ear — may need to be drained. Infected fluid that has accumulated between the skull and the membranes that surround the brain also may need to be drained surgically.

Viral meningitis
Antibiotics can’t cure viral meningitis, and most cases improve on their own in a week or two without therapy. Treatment of mild cases of viral meningitis usually includes:

  • Bed rest
  • Plenty of fluids
  • Over-the-counter pain medications to help reduce fever and relieve body aches

If the cause of your meningitis is a herpes virus, there’s an antiviral medication available.

Other types of meningitis
If the cause of your meningitis is unclear, your doctor may start antiviral and antibiotic treatment while a cause is being determined.

Fungal meningitis treatments are associated with harmful side effects, so treatment is often deferred until a laboratory can confirm the cause is fungal.

Non-infectious meningitis due to allergic reaction or autoimmune disease may be treated with cortisonelike medications. In some cases, no treatment may be required, because the condition can resolve on its own. Cancer related meningitis requires therapy for the individual cancer.

 

Taken from: http://www.mayoclinic.com/health/meningitis/DS00118

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