Meningitis is a condition in which meninges (protective membranes of the central nervous system) become inflamed. The condition is most commonly caused by microorganisms that may be bacteria, virus, protozoa or fungi. When caused by other factors other than microorganisms, it is referred to as being aseptic. The meninges are in close proximity to brain tissue and diseases affecting them often spread to the brain and spinal cord if not treated early. Unfortunately, the signs and symptoms of meningitis are not always specific to the condition.
The symptomatology is mainly dependent on the stage of the disease. Earlier stages are usually characterised with subtle signs and symptoms that are suggestive of flu. As the disease progresses the presentation becomes clearer. Another factor that determines the initial and subsequent presentation is the causative agent. Symptoms usually develop within hours or days. Viral disease progresses faster than disease caused by other factors.
The causative organisms vary from one age group to another. Group B streptococci have been established to be especially common among newborns and young infants. The newborns get infected as they pass through the birth canal of infected mothers. Other possible organisms in this age group are E. Coli and Listeria monocytogenes. Children more than 6 weeks old are likely to be affected by H. Influenzae type b and Neiserria meningitidis. Adults are affected mainly by Streptococcus pneumoniae (80% of the cases).
Severe disease is characterised by systemic involvement. When microbes enter the circulation they lead to either of two conditions: septicaemia or bacteraemia. The former condition is the more serious of the two as it indicates a large quantity of organisms that are enough to infect organs. The term meningococcemia is used to refer to septicaemia caused by Neisseria meningitidis. This is one of the most serious complications and is characterised by damage to vessels and bleeding into the skin as well as other organs.
The commonest presentation consists of a triad of symptoms. The triad comprises altered mental status, high fever and neck rigidity. Close to 45% of persons with the condition will have all these three signs. If all are absent then there is a big probability that meningitis is not one of the differential diagnoses. Neck stiffness which is the result of increased muscular tone is seen in as many as 70% of the cases. About 90% of patients have a persistent headache although this is not pathognomic of the condition.
Other common symptoms that may be observed include drowsiness, irritability when exposed to bright light (photophobia) and loss of appetite. In severe cases, patients may start to convulse and even become comatose. A lot of expertise is required in make a diagnosis in newborns and young infants since their presentation is not straight forward. 30% of them will have convulsions. Other signs include fever, lethargy, diarrhoea, irritability and poor feeding.
Meningococcal disease is associated with a number of specific clinical signs.it frequently causes a change in skin colour. This results from excessive bleeding beneath the skin. Other features are coldness of extremities, muscle pain, joint pain, stomach cramps, chills, skin rashes and rapid breathing.
When any of any of the signs and symptoms of meningitis is seen, one should seek medical attention immediately. This will ensure that treatment is started in a timely manner. Depending on the offending organism, one may receive a course of antibacterial, antiviral or antiprotozoal agents. It is common for corticosteroids to be administered concomitantly. If not treated, the condition may cause a number of complications such as epilepsy, cognitive deficits, hydrocephalus and deafness.
The symptomatology is mainly dependent on the stage of the disease. Earlier stages are usually characterised with subtle signs and symptoms that are suggestive of flu. As the disease progresses the presentation becomes clearer. Another factor that determines the initial and subsequent presentation is the causative agent. Symptoms usually develop within hours or days. Viral disease progresses faster than disease caused by other factors.
The causative organisms vary from one age group to another. Group B streptococci have been established to be especially common among newborns and young infants. The newborns get infected as they pass through the birth canal of infected mothers. Other possible organisms in this age group are E. Coli and Listeria monocytogenes. Children more than 6 weeks old are likely to be affected by H. Influenzae type b and Neiserria meningitidis. Adults are affected mainly by Streptococcus pneumoniae (80% of the cases).
Severe disease is characterised by systemic involvement. When microbes enter the circulation they lead to either of two conditions: septicaemia or bacteraemia. The former condition is the more serious of the two as it indicates a large quantity of organisms that are enough to infect organs. The term meningococcemia is used to refer to septicaemia caused by Neisseria meningitidis. This is one of the most serious complications and is characterised by damage to vessels and bleeding into the skin as well as other organs.
The commonest presentation consists of a triad of symptoms. The triad comprises altered mental status, high fever and neck rigidity. Close to 45% of persons with the condition will have all these three signs. If all are absent then there is a big probability that meningitis is not one of the differential diagnoses. Neck stiffness which is the result of increased muscular tone is seen in as many as 70% of the cases. About 90% of patients have a persistent headache although this is not pathognomic of the condition.
Other common symptoms that may be observed include drowsiness, irritability when exposed to bright light (photophobia) and loss of appetite. In severe cases, patients may start to convulse and even become comatose. A lot of expertise is required in make a diagnosis in newborns and young infants since their presentation is not straight forward. 30% of them will have convulsions. Other signs include fever, lethargy, diarrhoea, irritability and poor feeding.
Meningococcal disease is associated with a number of specific clinical signs.it frequently causes a change in skin colour. This results from excessive bleeding beneath the skin. Other features are coldness of extremities, muscle pain, joint pain, stomach cramps, chills, skin rashes and rapid breathing.
When any of any of the signs and symptoms of meningitis is seen, one should seek medical attention immediately. This will ensure that treatment is started in a timely manner. Depending on the offending organism, one may receive a course of antibacterial, antiviral or antiprotozoal agents. It is common for corticosteroids to be administered concomitantly. If not treated, the condition may cause a number of complications such as epilepsy, cognitive deficits, hydrocephalus and deafness.
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