Ineffective meningitis: symptoms, causes, diagnosis, treatment, prevention

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How to reduce ineffective meningitis

They are three membranes that surround the brain and the spinal cord, which from the outside to the inside are the dura mater, the arachnoid and the pia mater. Between the middle membrane and the internal membrane, in the subarachnoid space, is the cerebrospinal fluid (CSF).

How to reduce ineffective meningitisHow to reduce ineffective meningitis

This fluid circulates from the ventricles through the communication openings that pass through the subarachnoid space, after which it flows over the surface of the brain and spinal cord. Infectious meningitis is a condition that is associated with inflammation of the arachnoid and pineapple matter with the presence of bacteria, viruses, fungi or protozoa in the CSF.

Meningitis is one of the most emotive infectious diseases, and for good reason: even today, infectious meningitis is associated with significant mortality and the risk of serious sequelae in survivors.

Causes of infectious meningitis

In the United Kingdom, more than 1500 cases of meningitis are reported annually. The most common cause of meningitis is recorded as a virus and is often less severe than the bacterial or fungal forms of the disease.

Bacterial meningitis

Bacterial meningitis is observed in all age groups, is observed mainly in young children, with 40-50% of all cases that occur in the first 4 years of life. They are two bacteria, N. meningitidis and S. pneumoniae that represent approximately 75% of the cases. However, the pattern of microorganisms that cause meningitis is related to the age of the patient and the presence of an underlying disease.

Viral meningitis

Human enteroviruses, such as echoviruses and Coxsackie viruses, account for approximately 70% of cases of viral meningitis in the United Kingdom. The herpes virus and varicella zoster viruses are responsible for most other cases.

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Fungal meningitis

Candida species are a rare cause of meningitis associated with shunting. Cryptococcus neoformans is considered an important cause of meningitis in patients with late-stage HIV infection and other severe defects of T cell function.

Signs and symptoms of infectious meningitis

Acute bacterial meningitis: the patient has sudden headache, stiff neck, photophobia, fever and vomiting.
In the exam, the Kernig sign can be positive. This is the resistance to the extension of the leg when the hip is flexed, due to the meningeal irritation in the lumbar area. If the patient suffers from septicemia with meningitis, there may be septic shock. The presence of a hemorrhagic cutaneous eruption is highly suggestive, but not pathognomonic, of meningococcal infection.
Patients not treated with bacterial meningitis deteriorate rapidly, with the development of seizures, focal brain signs and cranial nerve palsies. In babies with meningitis, the early onset of signs is usually nonspecific, including fever, diarrhea, lethargy, feeding difficulties, and respiratory distress. Focal signs of the disorder, such as seizures or a bulging fontanelle, occur at a late stage. Viral meningitis usually presents with an acute onset of low grade fever, headache, photophobia, and neck stiffness.


The most common diagnosis of meningitis is made by detecting the causative organism and / or demonstrating biochemical changes and the response of cells in the cerebrospinal fluid.

The CSF is collected with the help of the lumbar puncture, where a needle is inserted between the posterior space of the third and fourth lumbar vertebrae in the subarachnoid space. Before performing this procedure, the possibility of precipitating or aggravating existing cerebral hernia in patients with intracranial hypertension should be considered.
A CT scan should be performed before performing this lumbar puncture procedure if neurological abnormalities occur.

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Drug treatment

Acute bacterial meningitis is an emergency condition that requires the urgent administration of antibiotics. In other forms of meningitis may be the use of complementary therapy such as steroids and the administration of antibiotics to prevent secondary cases.

Antimicrobial therapy

Empirical antimicrobial therapy should be prescribed before the identity of the causative organism or its sensitivities to antibiotics are known. The epidemiological characteristics of the case are considered, together with the microscopic examination of the CSF, which is often useful to identify the probable pathogen.

The selection of empirical antimicrobial therapy depends on the four categories:

Newborns and infants under 3 months; Immunocompetent older babies, children and adults; Immunocompromised patients; and those with ventricular shunts.

Prevention of person-to-person transmission.

Patients with meningitis can be infectious for others. Newborns with meningitis usually have generalized infections, and the causative organisms can often be isolated from body fluids and feces. Therefore, babies with meningitis should be isolated to prevent the infection from spreading to other patients. Patients with meningococcal meningitis or Hib should be isolated until after at least 48 hours of antibiotic treatment. The contacts of these patients can be asymptomatic carriers and potentially infectious for others and / or at risk of developing an invasive infection themselves. Chemoprophylaxis and vaccination can reduce these risks (see above). Patients with most other types of meningitis do not pose a significant infectious risk and, in general, no further precautions are necessary to control the infection.

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