Meningitis: Causes, Symptoms, Complications, Treatments and Prevention

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Meningitis refers to the inflammation of the meninges. Infections (bacterial, viral, fungal) are the common cause of meningitis, but it can also be a result of an injury, cancer or certain medications. The symptoms such as headache, neck stiffness and high fever develop suddenly, and the severity of symptoms varies based on the type and age of the individual. Examination of the cerebrospinal fluid is done to give a confirmatory diagnosis of meningitis and the treatment options for meningitis depend on the type of meningitis.

Meningitis

What is Meningitis?

Meningitis is a condition in which the meninges gets inflamed and damaged. Meninges are three layers (dura mater, arachnoid mater and pia mater) of protective tissue which surround the brain. Meningitis is caused by an infection of the cerebrospinal fluid (CSF) and/or the meninges. Cerebrospinal fluid is a fluid that is primarily produced in the ventricles of the brain and present between the space of arachnoid and pia mater.

What Causes Meningitis?

Meningitis is mostly caused when the microorganisms, such as bacteria, virus, fungus or parasite enters the bloodstream and reaches the brain and spinal cord. These organisms settle inside the cerebrospinal fluid or the meninges and develop an advanced infection.

Based on the type of organisms that causes infection, meningitis is of the following types:

Bacterial Meningitis:

Bacterial meningitis is caused due to bacterial infection. It is a life-threatening condition and can spread from one person to another. Bacterial meningitis usually occurs when the bacteria enters the bloodstream and reaches the brain and the spinal cord.

Bacterial meningitis if left untreated may lead to stroke, brain damage, hearing loss, paralysis and ultimately death. Haemophilus influenza, Neisseria meningitides, and Streptococcus pneumoniae are the most common form of bacteria that cause bacterial meningitis.

Viral Meningitis:

Viral meningitis is mostly caused due to enterovirus. It can also occur due to other viruses, such as measles, chicken pox, and mumps.

Fungal Meningitis:

Fungal meningitis is a rare condition that occurs due to the entry of fungus in the bloodstream. Fungal meningitis is caused when the person inhales fungal spores from the contaminated soil or from the bird or bats droppings.

Parasitic Meningitis:

Parasitic meningitis is a fatal and rarest form of meningitis. It is mostly caused by the parasite Naegleria fowleri.

Non-infectious Meningitis:

Non-infectious meningitis is caused by certain medical conditions, such as cancer, brain surgery, lupus, and head injury. Medications, such as antibiotics (trimethoprim-sulfamethoxazole, amoxicillin) and non-steroidal anti-inflammatory drugs (NSAIDs) can also cause non-infectious meningitis.

Symptoms of Meningitis:

The symptoms of meningitis depend on the age of a person and the type of meningitis.

  • Stiffness of neck
  • Loss of appetite
  • Sleepiness
  • Irritability
  • Lethargy
  • Fever
  • Nausea
  • Vomiting
  • Severe headache
  • Sensitivity to light
  • Confusion
  • Skin rash
  • Difficulty in concentrating

Signs of Meningitis in Newborns and Infants:

  • Constant crying
  • High fever
  • Jaundice
  • Stiffness in the body and neck
  • Sleepiness
  • Swelling of fontanel region (soft spot on a baby’s head)

Risk Factors for Meningitis:

Factors that increase the risk of meningitis include:

An incomplete course of vaccination: An individual who has not completed the course of vaccination is at increased risk of developing meningitis.

Age: Meningitis mostly occur in children below the age of five years and individuals older than 60 years.

Suppressed immune system: The risk of meningitis in more in the individuals having certain conditions that suppress the immune system, such as:

Individuals using immunosuppressants, such as corticosteroids and chemotherapy areat increased risk of meningitis. Removal of the spleen also increases the risk of meningitis.

Living and working in crowded areas:

Individuals living and working in crowded areas are at increased risk of meningitis. This is because the risk of transfer of microorganism is more in large groups.

Pregnancy:

Pregnant women are at greater risk of developing meningitis associated with listeriosis (an infection caused due to listeria bacteria).

Complications of Meningitis:

Meningitis may lead to severe, life-threatening complications if left untreated for a long duration. It may lead to:

  • Hearing impairment
  • Vision loss
  • Memory problems
  • Arthritis
  • Brain damage
  • Hydrocephalus (Buildup of cerebrospinal fluid in the cavities of the brain)
  • Migraine
  • Seizures (sudden, uncontrolled movements of the body due to electrical disturbances in the brain)
  • Subdural empyema (accumulation of pus between the brain and the skull)
  • Shock
  • Gait problems
  • Kidney failure

Diagnosis of Meningitis:

The doctor initiates the diagnosis by reviewing the medical history and signs and symptoms of the individual. A physical examination is conducted to determine:

  • Signs of infections near the head, ears and the spine
  • Fever
  • Heart rate
  • Stiffness of neck
  • Consciousness

For confirming the diagnosis, the doctor recommends certain diagnostic tests, such as:

  • Lumbar puncture (a.k.a: spinal tap) is a diagnostic procedure in which the cerebrospinal fluid (CSF) is collected for examination. Microscopic examination is done to identify the causative organism.
  • A blood culture is done to determine the type of microorganism causing the infection.
  • Chest X-ray is performed to determine other infections, such as tuberculosis, pneumonia, or other fungal infections, which may have led to meningitis.
  • Imaging tests: Magnetic resonance imaging (MRI) or computerized tomography (CT) scan of the head is also performed to evaluate the inflammation or to determine any complications such as brain abscess or sinusitis.

Treatment for Meningitis:

The doctor initiates treatment depending on the cause and type of meningitis.

Bacterial Meningitis:

Bacterial meningitis should be treated immediately and requires hospitalization.  The doctor prescribes:

  • Antibiotics to reduce the infections
  • Corticosteroids to reduce inflammation
  • Non-steroidal anti-inflammatory drugs, such as paracetamol is recommended to reduce fever
  • Anti-convulsants are prescribed if the patient has seizures
  • Intravenous fluids are recommended to prevent dehydration

Viral Meningitis:

Viral meningitis improves on its own within several weeks. Viral meningitis can be treated by:

  • Taking adequate rest
  • Drinking plenty of fluids
  • Using over-the-counter drugs for reducing fever and body pains

In some cases, the doctor prescribes corticosteroids to reduce the inflammation of the brain. The doctor may prescribe anti-convulsant drugs if the patient is experiencing seizures.

Other Types of Meningitis:

  • Fungal meningitis can be treated by using anti-fungal agents.
  • Non-infectious meningitis caused due to an autoimmune disease or due to an allergy is treated with corticosteroids. Usually in this type of meningitis treatment is not required as the condition gets cured on its own.

Prevention of Meningitis:

Meningitis can be prevented by:

  • Completing the course of vaccination
  • Washing the hand before eating food and after using the toilet
  • Eating a healthy diet
  • Taking adequate rest
  • Exercising regularly
  • Covering the mouth while coughing and sneezing
  • Smoking cessation
  • Avoiding contact with an infected person

 

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