Meningitis : causes, symptoms, treatment
Meningitis:-
Meningitis is the inflammation of the protective layers of central nervous system. The protective layers are, arachnoid, durameter, and piameter together called as meningial layers. Infection by several micro organisms, injury, and certain drugs may cause meningitis. The occurrence of meningitis varies from mild to severe form. Mild meningitis resolves easily and severe cases to be treated with antibiotic. Potential, untreated meningitis may lead to severe neurological problems, lead to fatal condition.
Causes of meningitis:-
Meningitis may be caused by various bacteria, viruses, protozoa or fungi.
The usual bacterias:
* Neisseria meningitidis
* Haemophilus influenza
* Streptococcus pneumoniae
* Escherichia coli.
The infection that causes meningitis usually occur secondary to other bacterial infection, such as pneumonia, endocarditis, sinusitis, encephalitis, or brain abscess.
The viruses which cause meningitis are adenovirus, enterovirus, herpes simplex virus, mumps virus, lymphocytic choriomeningitis virus etc.
Meningitis also occurs following head injury , skull fracture, penetrating head wound, lumbar puncture or ventricular shunting procedures.
Signs and symptoms:-
* Headache is the main symptom of meningitis, associated with neck stiffness.
* Due to meningeal infection fever is present.
* The person get irritability when exposed to bright light is called photo-phobia.
* Phonophobia – irritability to tolerate loud noises.
* Irritability, seizures, and delirium are found in small children.
* Bulging of fontanels is seen in infants.
Diagnosis of meningitis:-
On physical examination, signs and symptoms suspect the meningitis infection.
Blood test reveals increased white blood cells and culture test shows the infective organism.
Analysis of cerebrospinal fluid is done to confirm meningitis and is obtained by lumbar puncture.
Skull fracture or sinusitis is found using x – ray.
During lumbar puncture intracranial pressure is assessed, and increased intracranial pressure indicates meningitis. The CSF pressure of over 180 Mm of water. The CSF in meningitis cloudy or milky in appearance. High protein and less glucose in CSF also confirm meningitis.
Chest x- ray reveals pneumonitis or lung abscess, tubercular lesions.
The lumbar puncture is contraindicated in some cases due to chance of brain herniation. In such cases MRI (magnetic radio imaging) or CT (computed tomography) scan are performed to find out any cerebral tissue changes such as cerebral edema, ischemia, cerebral hematoma, hemorrhage, or tumor.
Treatment for meningitis:-
Appropriate antibiotic therapy and vigorous supportive care is given to treat meningitis.
Usually for first two weeks intravenous antibiotics are given followed by oral antibiotics, such as penicillin G, ampicillin, or nafcillin. If the person is allergic to penicillin, chloramphenicol, tetracycline or kanamycins are given.
supportive measures: The supportive measures of meningitis treatment are
* absolute bed rest.
* reduce headache and fever by administering analgesics.
* fluid therapy is given to prevent dehydration.