Meningitis2019-02-11T14:47:48+00:00


QUICK FACTS:

  • Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord.
  • Meningitis is usually caused by a viral infection but can also be bacterial or fungal. Vaccines can prevent some forms of meningitis.
  • Symptoms include headache, fever, and stiff neck.

Depending on the cause, meningitis may get better on its own, or it can be life-threatening, requiring urgent antibiotic treatment.

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MENINGITIS

Overview

 

Meningitis is the acute inflammation of the protective membranes that cover the brain and spinal cord.  These protective membranes, which are shown below, are collectively identified as the meninges. 

According to the Center for Disease Control and Prevention, more than 4,000 people contract bacterial meningitis each year in the United States.  Of these people, between 400 and 500, will die.  

If untreated, bacterial meningitis is almost always fatal.  A delay in the diagnosis of bacterial meningitis and the initiation of needed antibiotics can result in devastating consequences.

In addition to bacterial meningitis, meningitis can also be caused by viral or fungal sources. Viral meningitis is most often caused by Enterovirus, Herpes Simplex Virus and the West Nile Virus. Viral meningitis usually occurs in the late summer and early fall and typically resolves without any treatment. However, it too has been associated with patient deaths and other serious long-term disabilities including brain damage, hearing loss, and neurologic issues.   People with weakened immune systems, such as infants, the elderly and those with chronic health issues, are at increased risk for viral meningitis.

Fungal meningitis is a much rarer form of the disease which usually affects people with a severely compromised immune system.  As a result, patients who do not have a spleen or suffer from a disease, such as AIDS, are at increased risk for fungal meningitis.

 

Risk Factors

 Anyone can develop meningitis.  However, meningitis most often strikes:

  • Newborns and infants who are less than one year of age.
  • Adults older than 60.
  • Those living in crowded environments, such as college dorms and military bases.
  • Individuals who have failed to complete the recommended childhood or adult vaccine regimens.
  • Individuals who have a damaged or missing spleen.
  • Individuals who have been exposed to a meningitis outbreak.

Generally, the germs that cause meningitis are spread person-to-person.

Symptoms

In adult patients, the most common symptoms of meningitis are fever and neck stiffness. Meningitis can also cause patients to experience confusion and altered consciousness or lethargy.  This is why the “class triad” of meningitis has been defined to include fever, neck stiffness and altered mental status. However, less than one-half of patients diagnosed with meningitis, present with all 3 of the “classic” symptoms.  In addition, to the so-called “classic” symptoms, patients with meningitis often complain of headache, light and noise sensitivity and fatigue.

Unlike adult patients, in children, the symptoms of meningitis are often much less specific.  Oftentimes, the child will be extremely irritable to the point where he or she becomes inconsolable. 

Causes

Bacterial Meningitis is a potentially life-threatening disease which has a high mortality rate if untreated.  The most common sources of bacterial meningitis are:

  • Streptococcus pneumoniae: This bacterium is the most common cause of bacterial meningitis in infants, young children, and adults in the United States.  It more commonly causes pneumonia or ear or sinus infections.    

 

  • Niesseria meningitis: This bacterium is another leading cause of bacterial meningitis. It commonly causes an upper respiratory infection but can cause meningococcal meningitis when it enters the bloodstream. This is a highly contagious infection that affects mainly teenagers and young adults. It may cause local epidemics in college dormitories, boarding schools, and military bases.   

 

  • Listeria monocytogenes: These bacteria can be found in unpasteurized cheeses, hot dogs, and lunchmeats.  Pregnant woman, newborns, older adults and people with weakened immune systems are mot susceptible.  Listeria can cross the placental barrier, and infections in late pregnancy may be fatal to the baby.

 

Bacterial meningitis often begins when bacteria enters the bloodstream from the sinuses, ears, or throat.  After entering the bloodstream, the bacteria can travel to the brain, causing Meningitis.  

Viral Meningitis is both more common and usually less serious than bacterial meningitis as it usually will resolve on its own, without treatment, within a week or so after the onset of symptoms.

The best way to prevent bacterial meningitis is to be vaccinated as vaccines are available for the major strains of bacteria known to cause meningitis.   There are also vaccines available to prevent some kinds of viral meningitis. 

Diagnosis

Lumbar puncture is the “gold standard” for diagnosing bacterial meningitis.  A lumbar puncture is performed by positioning the patient on his or her side, applying a local anesthetic, and then inserting a needle into the dural sac to collect Cerebral Spinal Fluid. The fluid is then sent to the lab for evaluation. 

Because there are so many potential causes of meningitis, it is crucial to identify the correct source as treatment varies greatly depending upon the cause.

Consequences

Unfortunately, meningitis is often misdiagnosed by doctors.  If a patient presents to a doctor with complaints of a fever and fatigue, its easy to jump to the conclusion or diagnosis of the Flu.  Without asking about other more subtle symptoms associated with meningitis, such as light or noise sensitivity or examining the patient to determine if they can place their chin on their chest without pain, the patient can be prematurely sent home without consideration of meningitis. When this occurs, the patient is deprived of treatment and can quickly become dangerously ill.

IF YOU OR A LOVED ONE HAS BEEN HARMED BY THE FAILURE TO DIAGNOSE MENINGITIS, CALL US.  WE HAVE THE KNOWLEDGE AND THE EXPERIENCE TO HELP.

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