Meningitis Symptoms and Treatment
Between the brain and the skull are membranes called the meninges which wrap all the way around the brain and act to contain the fluid in which the brain is supported (the cerebrospinal fluid - CSF) and to protect the brain. If the meninges become infected, the patient is said to suffer from meningitis. If the brain itself is infected, the patient has encephalitis. The meninges can be infected by either viruses or bacteria. These two types of infection will be discussed separately.
The diagnosis of both types of meningitis is confirmed by taking a sample of cerebrospinal fluid and examining it under a microscope for the presence of certain cells. The sample is taken by putting a needle into the lower part of the back in a procedure called a spinal tap. The spinal cord is an extension of the brain that runs down from the head through the vertebrae. The spinal cord is also surrounded by meninges and cerebrospinal fluid.
Aseptic (viral) meningitis Viral (or aseptic) meningitis is a relatively benign condition that may be caught like any other viral infection, or it may be a complication of diseases such as mumps, glandular fever and herpes. The patient experiences fever, headache, nausea and vomiting, tiredness and sometimes muscle weakness or paralysis. Doctors may note that the patient has a stiff neck.
There is no specific treatment available for viral meningitis. With bed rest, good nursing, paracetamol, and sometimes medication for vomiting, patients will recover in one or two weeks, and it is rare for there to be any after-effects.
Bacterial meningitis is a much more serious condition, with the severity and symptoms varying depending upon which type of bacteria is infecting the meninges. These infections are caught from people who are carriers of the bacteria, but the victims are usually weak, ill, under stress or have their ability to resist infection reduced in some way.
Patients experience severe headaches, vomiting, confusion, high fevers, become delirious, unconscious and may convulse. Some types of bacterial meningitis are accompanied by a rash on the skin and inside the mouth. Neck stiffness is quite obvious, and patients may lie with their neck constantly extended as though they are looking up.
As well as examining the cerebrospinal fluid for cells, it can be cultured to find the exact bacteria that is causing the infection. Blood tests also show abnormalities.
Treatment involves giving the appropriate antibiotic in high doses, usually by injection or a continuous drip into a vein.
Other serious effects of the infection must also be treated, and these patients always require hospitalization.
Despite the best treatment, a number of complications are possible from bacterial meningitis. They can include permanent deafness in one or both ears, damage to different parts of the brain, heart or kidney damage, arthritis and the excess production of cerebrospinal fluid which can put pressure on the brain. The worst complication is called intravascular coagulation, which involves the blood clotting within the arteries and blocking them. It is frequently fatal.
Patients deteriorate very rapidly with bacterial meningitis, and most deaths occur within the first 24 hours. The overall mortality rate is about 20%, although it is higher in children.
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