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Meningitis

more about Meningitis


  • Meningitis is a serious condition that affects the membranes (meninges) that enclose and protect the brain and spinal cord from outside invasion.  The meninges can become damaged and, when they do, infectious agents can penetrate them and invade the brain, the spinal cord, and the spinal fluid.  Meningitis refers to the irritation or inflammation of the meninges due to invasion by such agents.  Meningitis can be divided into aseptic meningitis, which is non-bacterial meningitis, and bacterial meningitis.

  • Fever
  • Headache, diffuse and severe
  • Stiff neck
  • Vomiting
  • Sensitivity to light
  • Confusion
  • Drowsiness
  • Rash or tiny areas of bleeding under the skin are present in more serious types of meningitis.
  • Seizure
  • Skin rash, Diarrhea, or Lung Infection may be present, depending on the causes.
  • Coma and death can occur if meningitis is untreated or spreads to the brain.

  • Aseptic meningitis:
    1. Viruses are the most common cause of aseptic meningitis.  More than 50 viruses, such as Herpes, Influenza, HIV, and Measles virus, can cause meningitis, but enteroviruses are the most common cause.
    2. Fungi, parasites, and chemicals are less common causes of aseptic meningitis.
  • Bacterial meningitis: Some bacteria that cause meningitis normally live in the nose, mouth, or intestines.  Bacterial infections in other parts of the body, such as the sinuses or middle ear, can spread via the bloodstream or via direct extension, and cause meningitis.
  • The most common bacterial causes are:
    1. Group B Streptococcus (most common in < 1 month old)
    2. Neisseria meningitidis (most common in 2-18 years old)
    3. Streptococcus pneumoniae (most common in ages 19-59 and > 60 years old)
    4. Haemophilus Influenzae (more common after 1 month old)
    5. Listeria monocytogenes can cause disease in all ages.

  • History of exposure to others with meningitis
  • Physical exam by a physician
  • Examination of the spinal fluid via a spinal tap (needle is inserted between the vertebrae of the spine and fluid withdrawn and sent to laboratory) is the gold standard.
  • Blood, urine, and, occasionally, phlegm or other secretions are analyzed to look for the infectious agent and its source.
  • X-Rays, such as of the chest and CT scan of the brain, may be necessary.

  • Exposure to others with bacterial or viral Infections
  • Blood infection (bacterial or non-bacterial)
  • Infection of other parts of the body, such as sinuses
  • Skull fracture or other trauma to the meninges
  • Presence of other illnesses such as AIDS or cancer
  • Treatments that weaken the immune system such as chemotherapy
  • Intravenous drug abuse and sharing dirty needles in addicts

  • Hospitalization
  • Intravenous antibiotics
  • Antiviral or antifungal therapy
  • Treatment of vomiting, fever, headache, and Seizures
  • Evaluation by a specialist (e.g., neurologist)

  • Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
  • Brain abscess, subdural effusion
  • Disseminated intravascular coagulation (DIC)
  • Hydrocephalus
  • Ventriculitis

  • Meningitis can cause permanent brain damage and even death.
  • Prognosis is good for most cases, if treated early.
  • Some cases may permanently damage the body (e.g., hearing loss as seen in Mumps meningitis).
  • Some forms of aseptic meningitis can become chronic (i.e., last for months or years).

  • Meningitis is a true emergency and must be treated immediately.
  • Some forms of aseptic meningitis can become chronic (i.e., last for months or years), so report all persistent symptoms to your physician.

  • Vaccination can prevent some bacterial or viral infections.

  • These conditions may have some features, or a few features, in-common with meningitis:
    1. Migraine
    2. Stroke
    3. Severe Infections that have not spread to the meninges
    4. Brain hemorrhage




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