Meningitis

Overview

Meningitis is a sporadic infection that affects the vulnerable meninges membranes that cover the brain and the spinal cord.

Meningitis causes the inflammation of the membranes that surround the spinal cord and the brain. The swelling that occurs from meningitis causes symptoms such as fever, headache, and a stiff neck.

Meningitis can be bacterial, viral, or fungal. Bacterial meningitis is the most fatal and can be life-threatening. It spreads between individuals in close contact with each other.

Viral meningitis is less severe, and the majority of people recover from it completely without treatment. Fungal meningitis is very rare and normally happens in individuals with a weakened immune system.

World Health Organization reports that together with sepsis, meningitis is estimated to cause more deaths in children aged 5 and below than malaria. IAMAT Organization reports that Meningococcal Meningitis is endemic in the northwest region of the country bordering Uganda, Ethiopia, and South Sudan.

Symptoms

Early meningitis symptoms may be similar to those of flu (influenza). Symptoms may develop over many hours or over a few days.

Potential signs and symptoms in persons older than 2 years include:

  • Stiff neck
  • Sudden high fever
  • Headache with vomiting or nausea
  • Severe headache that appears to be different than normal
  • Difficulty concentrating or confusion
  • Sleepiness or difficulty waking
  • Seizures
  • No appetite or thirst
  • Sensitivity to light
  • Skin rash (especially in meningococcal meningitis)

Signs in Newborns

  • Constant crying
  • High fever
  • Inactivity or sluggishness
  • Excessive sleepiness or irritability
  • Stiffness in the baby’s body and neck
  • Poor feeding

Causes

The causes differ from one type of meningitis to another. Viral infections are the most common, but bacterial infections are the most fatal.

Bacterial Meningitis

It occurs when bacteria enters bloodstream and travel to the spinal cord and brain or directly invade the meninges. It may occur because of sinus or ear infection, skull fracture, or after some surgeries (rarely).

Numerous strains of bacteria can cause acute bacterial meningitis. The common ones include:

  • Streptococcus pneumoniae (pneumococcus): It is the most common bacterium that causes bacterial meningitis in young children, infants, and adults. Other than meningitis, this bacterium also causes sinus infection and pneumonia.
  • Neisseria meningitides (meningococcus): It is also a leading cause of bacterial meningitis, especially in Africa. These bacteria often cause an upper respiratory infection but can also cause meningococcal meningitis when they find their way to the bloodstream.
  • Haemophilus influenzae (Haemophilus): Haemophilus influenzae type b (Hib) bacterium was sometimes back, the leading cause of bacterial meningitis in children. However, new Hib vaccines have immensely reduced the number of cases of meningitis caused by this bacterium.
  • Listeriamonocytogenes (Listeria): These bacteria are mostly present in unpasteurized hot dogs, cheeses, and lunchmeats. Newborns, pregnant women, older adults, and individuals with weakened immune systems are most vulnerable. The bacterium can cross the placental barrier, and infections in late pregnancy may be deadly to the baby.

Viral Meningitis

Viral meningitis is normally mild and often ends on its own. Enteroviruses are the common causes of viral meningitis. Other viruses such as HIV, herpes simplex virus, West Nile, and mumps can cause viral meningitis.

Chronic Meningitis

These are slow-growing organisms such as Mycobacterium tuberculosis and fungi that attack the membranes and fluid surrounding the brain and lead to chronic meningitis. It develops within two weeks or more and is accompanied by symptoms such as fever, headaches, mental cloudiness, and vomiting.

Fungal Meningitis

Fungal meningitis is not as common as acute meningitis, viral meningitis, and bacterial meningitis. Fungal meningitis causes chronic meningitis and often mimics acute bacterial meningitis. However, this form of meningitis is not contagious from one individual to another. The most common fungal form of the disease is cryptococcal meningitis that affects individuals with immune deficiencies such as AIDS.

Risk Factors

  • Skipping vaccinations
  • Age – children are the most vulnerable
  • Pregnancy increases the risk of listeriosis
  • Living in a community setting such as military bases, living in dormitories, and children in boarding schools, because the condition is contagious from a person to a person
  • A compromised immune system caused by alcoholism, diabetes, AIDS, use of immunosuppressant drugs, and other factors that interfere with the immune system.
  • Working in laboratories and other related settings where the pathogens are present

Diagnosis

The doctor will ask you about the symptoms you are experiencing from which he or she will determine whether to proceed with further tests or not.

If the doctor thinks you have meningitis, they will collect samples of cerebrospinal fluid or blood. A laboratory test will be conducted on the samples to see what is causing the infection.

The common diagnostic tests used include blood cultures, imaging, and a spinal tap (lumbar puncture).

It is significant to know the specific cause of meningitis (bacterial, fungal, or viral infection) so the doctors may know the best treatment.

Treatment

Bacterial meningitis

Acute bacterial meningitis is fatal and can lead to death within a short period. It must be treated immediately with intravenous antibiotics and corticosteroids. The two help to promote recovery and minimize the risk of complications such as seizures and brain swelling.

The type of antibiotic or combination to use largely depends on the type of bacteria causing the infection. The doctor may recommend a wide range of antibiotic until they can determine the exact cause of meningitis.

Other medications that may be used to treat bacterial meningitis include anticonvulsants, acetaminophen, oxygen therapy, fluids, and sedatives.

Viral Meningitis

This infection can be cured by antibiotics, and most cases improve on their own after many weeks. Treatment of mild cases of viral meningitis often includes:

  • Plenty of fluids
  • Bed rest
  • Over-the-counter pain medications to reduce fever and relieve body aches

Other forms of meningitis are either treated by antibiotics or heal on their own, especially if the patient has a strong immune system.

Prevention

The majority of viruses and bacteria that cause meningitis can spread through sneezing, coughing, kissing, or sharing a toothbrush, eating utensils, or a cigarette.

The following steps can help prevent infection:

  • Wash your hands – Helps prevent the spread of germs. Children should be taught hand hygiene, especially after using the toilet and before eating.
  • Practice good hygiene such as learning to avoid sharing foods, eating utensils, straws, drinks, lip balms, or toothbrushes. Teach children the same.
  • Cover your mouth when you need to sneeze or cough
  • Stay healthy by getting enough rest, eating healthy, and exercising regularly to maintain your immune system.
  • If you are pregnant take caution with food

Immunizations

The following vaccinations help prevent bacterial meningitis:

  • Haemophilus influenzae type b (Hib) vaccine
  • Pneumococcal conjugate vaccine (PCV13) for children below two years with additional doses for children 2 to 5 years
  • Pneumococcal polysaccharide vaccine (PPSV23) for older children and adults who need protection from pneumococcal bacteria
  • Meningococcal conjugate vaccine: A single dose to be given to children aged 11 and 12 with a booster shot at the age of 16. If given first at ages 13 and 15, booster shot should be given between ages 16 and 18.

For more information on treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.

Sources

https://www.who.int/emergencies/diseases/meningitis/en/

https://www.iamat.org/country/kenya/risk/meningococcal-meningitis

https://www.mayoclinic.org/diseases-conditions/meningitis/diagnosis-treatment/drc-20350514

https://www.medicalnewstoday.com/articles/9276.php

https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508