Meningitis
Meningitis is an acute or chronic inflammation of the fluid and membranes (meninges) enclosing the spinal cord and the brain. The inflammation is due to infection of the cerebrospinal fluid (CSF) encircling the brain and spinal cord. The meninges consist of three membrane layers that enclose the brain and spinal cord. The three membranes of meninges are known as the dura mater, arachnoid mater and pia mater. Meningitis can attack any age group but is mostly seen in babies, children, and young adolescents. It is a serious disease and should be treated quickly without wasting any time. If not treated on time it can result in blood poisoning (septicaemia) or result in lasting damage to the brain or nerves. Meningitis vaccine (meningococcal vaccine) is available that provides protection against meningitis infection.
Types of Meningitis
Viral meningitis
It is caused by a virus and is more common as compared to bacterial meningitis. Viral meningitis is caused by different types of viruses and transmitted between people by coughing or sneezing, or through poor hygiene habits. In rare cases, few insects, like mosquitoes and ticks, are capable to spread these viruses.
Bacterial meningitis
It is caused by a bacterial micro-organism. It rarely occurs, but can be severe. Bacterial infection is contagious and is transmitted through respiratory and throat secretions, like as sneezing, coughing and kissing.
Many bacterial species can lead to meningitis. There are 4 types:
- Neisseria meningitis (meningococcus)
- Streptococcus pneumoniae (pneumococcus)
- Haemophilus influenzae type b
- Listeria monocytogenes.
Symptoms
Meningitis symptoms are as follows - Early meningitis symptoms may seem like the flu (influenza). Meningitis symptoms may develop over several hours or over a few days. The symptoms are as follows
- Meningitis rash
- Neck pain/stiffness (Nuchal rigidity)
- Sudden high fever
- Severe headache
- Headache accompanied by nausea or vomiting
- Photophobia
- Dizziness
- Delirium
- Irritability
- Difficult to concentrate
- Confusion
- Seizures
- Sleepiness
- Difficulty waking
- No appetite or thirst
Signs of increased intracranial pressure during meningitis are neurologic deficits, disturbed mental status, and seizures. It has a poor prognosis. In adults, the examination of the symptoms is centred on recognizing focal neurologic deficits, and meningeal irritation, for example, Brudzinski and Kernig signs. In meningococcal meningitis, typical skin lesions like petechiae and purpura and cranial nerve abnormalities are observed.
Meningitis signs and symptoms are less noticeable in neonates and infants. The symptoms can appear with and without fever or hypothermia, reduced oral intake, change in mental status, irritability, and bulging fontanelle. It is necessary to monitor a full perinatal history and vaccine records. A meningococcal vaccine can prevent some causes of meningitis. One of the visually visible signs of meningitis diseases is Brudzinski's sign. Severe neck stiffness (Nuchal rigidity) makes a patient's hips and knees to flex when the neck is bent. Brudzinski's sign is used to diagnose meningitis infection. One of the clinical signs of meningitis disease is kernig's sign. Severe hamstrings stiffness results in an inability to straighten the leg when the hip is flexed to 90 degrees.
When to see a doctor?
Visit your doctor immediately if you or anyone has meningitis signs or symptoms. Bacterial meningitis can be fatal and need quick antibiotic treatment. Delayed meningitis treatment increases the risk of permanent brain damage or death.
Meningitis Causes
Viral meningitis infections are the primary cause of meningitis disease, next comes bacterial meningitis and, in a few cases, fungal and parasitic infections. Bacterial meningitis infections can be serious, and their diagnosis is essential.
Viral meningitis
It is a common type of meningitis disease. It is not life-threatening, but few cases are exceptional. Viral meningitis can occur due to different viral infections and is transmitted through coughing, sneezing droplets, kissing, or poor hygiene. Certain insects such as mosquitoes and ticks can spread these viruses.
The viruses that can cause meningitis are
- Non-polio enteroviruses
- Mumps virus
- Herpesviruses, such as Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus
- Measles virus
- Influenza virus
- Arboviruses, such as West Nile virus
- Lymphocytic choriomeningitis virus
Bacterial meningitis
Neisseria meningitides (meningococcus)
It is a common cause of bacterial meningitis disease in children 2 to 18 years of age. It leads to an upper respiratory infection and results in meningococcal meningitis when they are introduced into the blood circulation. This is a very contagious infection that is found in teenagers and adolescents.
Streptococcus pneumoniae (pneumococcus)
Pneumococcal disease is the most common and fatal kind of bacterial meningitis. Individuals with weak immunity are most at risk. When these bacteria invade the coverings of the brain, it results in meningitis. This type of meningitis occurs mainly in children less than 2 years old and adults 65 years or older
Haemophilus influenzae type b or Hib
It is passed on through respiratory secretions. Infected people spread the bacterial infection by coughing, sneezing or close contact. Other individuals can fall ill if they breathe in those droplets. Asymptomatic people can spread the infection if they have bacteria in their noses and throat. This type of meningitis occurs mainly in kids less than 5 years old and adults 65 years or older.
Listeria monocytogenes
Eating contaminated food with L. monocytogenes, gives rise to a disease called listeriosis. Elderly people, pregnant women, newborns, and people with weak immunity are most prone to this infection. Listeria is capable of crossing the placental barrier and be fatal to the unborn baby.
Risk factors
Risk factors for meningitis disease are:
Skipping vaccinations
Not taking the meningococcal vaccine puts you at high risk of contracting meningitis infection
Age
Children and elderly people are more susceptible to the meningitis infection.
Living in a close set-up
Individuals staying together like in hostels, military camps or schools are at greater risk of meningococcal meningitis.
Pregnancy
An infection caused by listeria bacteria may also result in meningitis. It increases the risk of pregnancy-related complications.
A weak immune system, diabetes, AIDS, alcoholism, usage of immunosuppressant medicines, spleen removal, and any other health conditions that affect your immune system directly makes you more prone to meningitis.
Diagnosis
Your doctor may conduct a meningitis diagnosis by taking your medical history, a physical examination and diagnostic tests.
The diagnosis of meningitis includes
Blood cultures
Your doctor may recommend a blood culture if a bacterial infection is suspected.
Imaging techniques
Magnetic resonance imaging (MRI) scans or Computerized tomography (CT) of the head and neck may show swelling or inflammation of the meninges. X-rays or CT scans of the chest or sinuses may also exhibit meningitis infection.
Imaging techniques
Magnetic resonance imaging (MRI) scans or Computerized tomography (CT) of the head and neck may show swelling or inflammation of the meninges. X-rays or CT scans of the chest or sinuses may also exhibit meningitis infection.
Spinal tap (lumbar puncture)
A spinal tap to collect cerebrospinal fluid (CSF) provides a definitive diagnosis of meningitis.
Treatment
Bacterial meningitis
Intravenous (IV) antibiotics and sometimes corticosteroids are used to treat bacterial meningitis. Dexamethasone, (a steroid) decreases brain meningitis.
Viral meningitis
Antibiotics can't treat viral meningitis infection. In fact, the disease improves on its own in several weeks. Viral meningitis treatment is aimed at relieving symptoms.
Treatment of mild viral meningitis includes:
- Complete bed rest
- Drinking plenty of fluids
- Medicines to help reduce fever, headache and body ache. Avoid aspirin
Supplemental oxygen or mechanical ventilation (respirator) may be required if the condition is serious and causes shortness of breath.
Other treatments
In case of unknown meningitis, your healthcare provider may initiate antiviral and antibiotic treatment till the exact cause is diagnosed. Antifungal drugs manage fungal meningitis. A combination of certain antibiotics can cure tuberculous meningitis. Corticosteroids are used to cure noninfectious meningitis due to allergies or autoimmune diseases. In a few cases, no treatment may be required because the infection may resolve on its own. Cancer therapy is utilized to manage cancer-related meningitis.
Measles vaccine in adults
The measles vaccine is administered as a combined measles-mumps-rubella (MMR) vaccine. The chickenpox (varicella) vaccination may also be included in this MMRV vaccine. Medical experts recommend that children get their MMR vaccine shot between 12 and 15 months of age and after that, between 4 and 6 years of age, before starting the school.
Dos and Don’ts
If we follow the dos and don'ts for meningitis, it's possible to prevent meningitis disease. It is an inflammation of the meninges and is considered a serious illness; therefore prevention is better than cure.
| Do’s | Don’ts |
| Take meningococcal vaccine | Stay away from meningococcal vaccine |
| Eat fresh, newly cooked food | Eat contaminated food |
| Cover your mouth to prevent transmission | Maintain poor hygiene |
| Avoid close contact with sick people | Neglect maintaining a safe distance from sick people |
| Eat a nutritious food | Share food and utensils with sick people |
Meningitis Care at Medicover
At Medicover Hospitals, we have the most trusted team of neurologists and neurosurgeons working together to provide excellent healthcare to our patients. Our team adopts a multi-disciplinary approach to treat this condition with the active participation of experts like neurologists, neurosurgeons, paediatricians, infectious disease specialists, trained nurses and other paramedical staff, who provide the best treatment. We provide world-class healthcare services at affordable costs in all our departments to offer superior treatment outcomes and experience to our customers.
