What is Meningitis?
Meningitis is the swelling or inflammation of the meninges, which are the three specific membranes covering the brain and the spinal cord. The primary function of the meninges is to protect the central nervous system. Meningitis is an uncommon infection that affects the delicate membranes of the brain. It is an infection that can be caused by bacteria, viruses, or fungi. Each of these will influence the way the condition develops in a person.
Quick Facts about Meningitis
- About 10-12% of cases of meningitis develop severe complications, making them fatal.
- 20% of individuals who survive meningitis end up with long-term implications of the disease that could result in brain damage, kidney disorders, loss of hearing, or limb amputation.
- In the UK, approximately 2,300 cases of meningitis and meningococcal septicemia are reported each year.
- Approximately 70% of the patients who contract meningitis are either below 5 years of age or over 60 years.
- In the USA, approximately 3 out of 100,000 people acquire bacterial meningitis.
- In the USA, approximately 10 out of 100,000 people suffer from viral meningitis every year.
- Haemophilus influenza type B was known to be the prime cause of bacterial meningitis, but this has dropped by 90% after the introduction of the HiB vaccine.
- The major factor that places meningitis on the list of the most dreaded diseases is its antibiotic resistance.
How is Meningitis Triggered?
Meningitis is usually triggered by an infection caused by bacteria, viruses, fungi, parasites, or various other microorganisms. An immune system that is compromised or has an inherent defect is often associated with the recurrence of bacterial meningitis. In most cases, the reason behind meningitis is a virus, although meningitis can be non-infectious, too.
Viral meningitis is the most prevalent form of meningitis infection but is not a very critical infection. It is triggered by various viruses, such as mosquito-borne viruses. There are no specific ways to treat this form of meningitis as this condition gets better on its own within a week or so and normally does not create any complications.
This form of meningitis is normally considered quite serious and in some cases, becomes fatal. It is triggered by three kinds of bacteria--namely, Haemophilus influenza type b, Neisseria meningitides, and Streptococcus pneumonia bacteria. Meningitis that is triggered by Neisseria meningitides is called meningococcal meningitis, while the one that is triggered by Streptococcus pneumoniae is called pneumococcal meningitis. Bacterial meningitis is infectious and spreads from person to person when they come in close contact with the nasal discharge or saliva of the infected person.
HiB (Haemophilus influenza type b) used to be considered the primary cause of bacterial meningitis. But with the introduction of the new HiB vaccines administered to children, this infection has been largely controlled.
Which Forms of Bacterial Meningitis Usually Affect Specific Age Groups?
In order to begin the right treatment, it is crucial for a doctor to understand which form of meningitis has affected the patient. The common causes of meningitis vary by age group; therefore a doctor often looks to the usual causes of meningitis for the age group in which the patient belongs.
Bacterial meningitis affecting newborn and premature babies
A certain type of streptococci bacteria known as group B streptococci attacks the vagina and can cause meningitis. This type is particularly seen in the case of premature babies and newborns in their first week. Escherichia coli, which attacks the digestive tract, is also a bacteria known to cause meningitis in babies. Newborn babies are also particularly susceptible to meningitis that spreads in an epidemic.
Bacterial meningitis affecting children under 5 years
As part of the normal vaccination schedule, vaccines that guard against meningitis are administered to young children. However, in some countries, these vaccines may not be available. Children below the age of 5 years who are not vaccinated against meningitis can easily get infected by the Haemophilus influenza type B virus, resulting in a severe or mild form of meningitis.
Bacterial meningitis occurring in older children
Older children normally get meningitis due to Neisseria meningitides (meningococcus) and Streptococcus pneumoniae.
Bacterial meningitis occurring in adults
Around 80% of adults who suffer from meningitis contract the disease from N. meningitides and S. pneumoniae. People above 50 years of age have higher chances of acquiring meningitis due to L. monocytogenes.
What Special Medical Conditions Make One Particularly Vulnerable to Bacterial Meningitis?
A skull fracture or other penetrating injury
Patients who have sustained a skull injury are at higher risk for bacteria entering their meningeal spaces through the nasal passages. This can also occur in people who have cerebral shunts or other medical devices in the brain and meninges.
A compromised immune system
People who are suffering from weakened immune systems are at higher risk for contracting infections from staphylococci and pseudomonas.
What Are the Symptoms of Meningitis?
Meningitis can be difficult to diagnose because in some cases, the disease may progress internally although not show any outward symptoms at all. In the early stages, the signs and symptoms of meningitis may be very similar to those of the flu. However, people suffering from meningitis can become seriously ill, and the worsening of their condition may occur in only a few hours. It is extremely important to know the early signs of the disease, as speedy diagnosis is the only way to prevent it from getting worse. Though not all the symptoms always appear, nor do they always appear in the same order, the telltale symptoms of both viral and bacterial meningitis are fever, headache, and neck stiffness. These are the early signs and symptoms of meningitis:
- High fever
- Neck pain and stiffness. (The pain makes drawing the chin down to the chest difficult.)
- Severe headaches and muscle aches
- Nausea and vomiting
- Disorientation or confusion
- Hands and feet turning cold
- A distinctive skin rash, but not in all cases. (This rash looks like pink, red, or purple pinpricks at first, then spreads all over the body, getting larger and deeper in color.)
Symptoms of meningitis in babies are naturally more difficult to identify, since babies are not able to express themselves. Here are some symptoms of the disease to watch out for in babies:
- Continuous crying, normally high-pitched and with a moaning sound
- Difficulty staying awake
- Not eating properly or refusing to be fed
- Breathing difficulties
- Pale skin
- Red or purple spots
How Is Meningitis Treated?
The treatment for meningitis largely depends on the factors that have caused the condition. Following are some treatment courses adopted in treating this condition.
Severe bacterial meningitis is often a cause for concern and requires immediate and aggressive treatment. Various antibiotics and corticosteroids are administered to treat bacterial meningitis. These fight the infection and reduce the risk of complications due to swelling in the brain and seizures.
The doctor prescribes an antibiotic or a combination of antibiotics depending on the type of bacteria that has been identified as the cause of the infection. When the exact cause of the disease is not detected, as it may sometimes happen, the doctor may administer a wide range of antibiotics to control the infection till the actual problem is determined.
The doctor may perform a procedure to drain the infected sinuses containing fluid infected with the bacteria.
Antibiotics are not used to treat meningitis resulting from a virus. In most cases, the infection improves on its own within a few days to a few weeks. The recommended treatment for mild viral meningitis normally includes the following:
- Adequate sleep and bed rest
- Increasing fluid intake
- Over-the-counter drugs that help in reducing the symptoms of fever and pain
In some cases, the doctor may suggest corticosteroids to help reduce the inflammation of the brain and medication to prevent seizures. Antiviral medicines are normally used in treating meningitis caused by the herpes virus.