Meningitis is an inflammation of the meninges that provides a protective covering of the brain and spinal cord. The inflammation of this layer leads to severe headaches and decreases brain functions.The most common cause of meningitis is viral and bacterial infections. However, fungal, parasitic infections and non-infectious causes are known to increase the risk of meningitis. Other comorbidities such as cancer, drug allergies, and chemical irritation are known to cause inflammation of the meninges.In certain cases, bacterial meningitis can be life-threatening and may cause hearing impairment and brain damage. This condition may turn to be fatal if left untreated for a long period of time.The incidence of acquiring meningitis is higher with 70% cases reported in children below 5 years and adults above 60 years of age. However, the prevalence is higher among the female population when compared to the male population.
The early signs of acquiring meningitis may be similar to flu-like symptoms. The other symptoms may develop over a few hours or days that may turn intense over a period of time. The symptoms of meningitis are explained separately for children and adults.
The symptoms of meningitis observed in children are:
- High fever
- Continuous crying
- Poor feeding
- Increased irritability during sleep
- Formation of bulge over the head
- Stiffness of the head and neck
The symptoms of meningitis observed in adults include:
- Sudden fever spikes
- Stiffness of neck
- Severe headache
- Loss of appetite
- Sensitivity to light
- Increased sleepiness and difficulty in waking up
- Difficulty in concentrating
- Skin rash
Meningitis occurs due to bacterial and viral infections that enter the bloodstream and affects the brain and spinal cord. It also occurs due to the infection of sinus or ear infections, surgeries or due to a skull fracture.
The bacterial strains that cause meningitis are:
- Streptococcus pneumoniae (Pneumococcus)
- Neisseria meningitidis (Meningococcus)
- Haemophilus influenza (Haemophilus)
- Listeria monocytogenes (Listeria)
The viral strains that cause meningitis are:
- Herpes simplex virus
- HIV virus
- West Nile virus
- Paramyxovirus (Mumps)
The following factors increase the risk of developing meningitis:
- Increased alcohol consumption
- Uncontrolled diabetes
- Autoimmune disorders
- Immunosuppressive agents
- Cigarette smoking
- Conditions like HIV/AIDS and cancer
- Organ or bone marrow transplantation
The complications that arise due to meningitis are:
- Brain damage
- Hearing impairment
- Hydrocephalus (excess fluid accumulation in the brain)
- Septicaemia (blood poisoning)
- Subdural effusion (accumulation of fluid between the brain and skull)
- Vision impairment
Meningitis is diagnosed by the following diagnostic procedures:
- Image scan: Image scans such as computed tomography (CT) scan and magnetic resonance imaging (MRI) scan are performed to determine any underlying cause of meningitis such as head injury, tumor or clot formation. It also detects the presence of swelling or inflammation in any part of the brain. X-rays and CT scan are used to detect the presence of sinuses or lung infections.
- Culture test: Blood samples are collected to perform culture test to detect the strain of microbial infections. This test provides scope for targeted treatment of microbial infections.
- Lumbar puncture: It is also called a spinal tap test. A needle is inserted into the spinal cord for the sample collection of cerebrospinal fluid. The low level of blood glucose in the CSF confirms the presence of infection and inflammation of the meninges.
- Laboratory testing: Blood and urine samples are collected to determine the presence of an underlying condition or the spread of infections to the other parts of the body.
The treatment of meningitis depends on the age and type of microbial infection.
- Bacterial meningitis: Bacterial infection can be cured by use of medications, such as antibiotics and corticosteroid agents for a specified period of time. These medications are administered in combination with analgesic and anticonvulsant drugs to relieve the symptoms of pain and seizures respectively.
A procedure involving the emptying of sinuses and mastoids are performed to prevent the risk of bacterial infections.
- Viral meningitis: There is no cure for viral meningitis. The symptoms of this infection reduce with time with adequate bed rest, plenty of fluid intake and the use of over-the-counter (OTC) medications. The doctor may also prescribe the use of anticonvulsant drugs to prevent the risk of seizures.
Management and support
Meningitis produces acute headache that may be confused with the symptoms of other medical conditions. Thus, it is advised to consult the doctor as soon as the patient develops symptoms of meningitis. Effective management of meningitis helps prevent damage to the brain and other health complications.
Meningitis is a contagious disease. The spread of the infection can be prevented by:
- Avoiding regular contact with people suffering from meningitis
- Using face mask while travelling or visiting an infected person
- Using hand sanitizers and disinfectants to prevent spread of infection
- Taking vaccination to prevent the occurrence of meningitis
- Minimizing regular contact with wild animals (worker in zoo or national parks)
The use of medications and regular follow-up post-treatment helps in better response rate from meningitis infections. Lifestyle modifications such as avoiding cigarette smoking help in reducing the risk of developing meningitis infections.