What is Meningitis ?  

Meningitis is the inflammation of the meninges, the membranes covering the brain and spinal cord. It can be caused by various infectious agents, including viruses, fungi, and protozoa, but unusually bacteria produce the most life-threatening forms.

Among the bacteria that can cause meningitis are the meningococcus - Neisseria meningitidis, the influenzabacillus - Haemophilus influenzae, and various strains of pneumococci, streptococci, or staphylococci. 

A bacterial infection elsewhere in the body may be carried to the meninges through the bloodstream itself or from an adjacent infected organ, such as the middle ear or the nasal sinuses. The infectious agents multiply in the meninges, where they produce a pus that thickens the cerebrospinal fluid, thereby causing various symptoms, unwanted pressures and complications.

Bacterial meningitis usually has three main stages. At first, the bacteria multiply in the nasal passages and throat, often causing no painful symptoms. Next, they invade the blood, introducing toxic substances into the circulation and causing fever; if the infection is caused by N. meningitidis, a rash may appear and develop into hemorrhagic spots - petechiae, in severe cases. In the third stage, meningitis develops when the bacteria multiply in the meninges, where they produce intense inflammatory changes and excessive pus.

Are there different types of meningitis?

A characteristic of meningitis is the rapid onset of symptoms, which may result in death within only a few hours. The first symptom of meningitis is usually vomiting. A severe bursting headache develops because the meninges have become inflamed and the pressure of the cerebrospinal fluid has increased. Stiffness of the neck then develops, due to irritation of the spinal nerves supplying those muscles. The degree of stiffness varies, but often the head is retracted, and in small children the head and spine may be drawn backward like a bow. Deep reflexes are exaggerated, and convulsions may occur in infants and small children. In more severe cases, the cerebrospinal fluid becomes so thickened by pus that the passages between the ventricles, or cavities, of the brain and the spaces in the spinal meninges become blocked, causing fluid to accumulate. The accumulation of fluid in the ventricles may in turn result in internal hydrocephalus, which causes coma and death unless relieved.

A diagnosis of bacterial meningitis is made with certainty by obtaining a sample of cerebrospinal fluid by lumbar puncture and examining it microscopically for the presence of bacteria and for increases in certain types of cells.

The term meningitis most often refers to meningococcal meningitis, which is caused by N. meningitidis. Epidemics of this disease occurred at irregular intervals, with death occurring in 40–50 percent of cases, until the use of antibiotic drugs greatly reduced both mortality rates and the incidence of the disease. Meningococcal meningitis is worldwide in distribution and more likely to occur in cold weather. It is primarily a disease of youth and especially of children under age 10, though all ages may be affected. The disease is usually acquired by nasal droplet transmission. Another serious cause of meningitis is Haemophilus influenzae; it occurs in infants and young children but only rarely in older persons, and its course and symptoms resemble those of N. meningitidis. The bacterium Streptococcus pneumoniae is a common cause of meningitis in adults.

The early diagnosis and prompt treatment of meningitis is particularly important in preventing possible permanent damage to the brain, especially in affected children. Meningococcal meningitis is best treated with penicillin. Cases caused by H. influenzae are treated with ampicillin or chloramphenicol. These drugs have reduced mortality rates from bacterial meningitis to less than 5 percent in some areas. A vaccine that gives protection against the type b strain of H. influenzae became commercially available in the1980s and has proved effective in safeguarding infants and children from the disease.

Who is affected?

Various other forms of meningitis are caused by viruses and ordinarily have a short, uncomplicated, self-limited course that does not require therapy.

Meningitis is a condition that every parent and carer dreads, because of its presumed difficulty in its diagnosis. But then so many of us do not know and understands the symptoms anyway.

Under five year olds are most at risk, mainly because of an under developed immune system but then anyone can catch this infection at any age, and in fact thousands get it each, and several hundred sadly die. One reason for this is that a diagnosis is not found quickly enough. If in doubt always contact your doctor or hospital.

It can be caused by several agents of infection, but a bacterial infection is by far the most dangerous.

Meningitis is then made worse when it develops to septicaemia, this can happen very quickly and is a form of blood poisoning, due to the infection getting into the blood stream. This can affect half, and kill 20% of patients, as it can overwhelm the immune system, attacking on two fronts. And if it does not kill you it can still sometimes leave  you deaf or blind, or with other erroneous disabilities.

So a very early diagnosis, and of course treatment, is vital, to maintain the good health of the person, and give them the best chance to fight this off.

Meningitis?

Meningitis is an infection of the clear plasma-like fluid of a person's spinal cord and the same fluid that surrounds the brain. Meningitis is sometimes referred to as Spinal Meningitis. Meningitis is usually caused by a viral or bacterial infection; itis mean inflammation, so the infection causes an inflammation of these areas. 

meninges noun. plural. The three membranes enclosing the brain and spinal cord. [Greek meaning membrane]

Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ highly. Strangely, Viral Meningitis is generally less severe and usually resolves itself without specific treatment, but it can give you very bad headaches, and make you feel very ill.

whilst Bacterial Meningitis can be quite severe and can result in brain damage,  causing learning difficulties or hearing loss. Moreover, for Bacterial Meningitis, it is also important to know which type of bacteria is causing the meningitis, the inflammation because antibiotics can prevent some types from spreading and infecting other people. 

Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of Bacterial Meningitis.

What are the signs and symptoms of Meningitis?

GENERAL   High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. 

In newborns / small infants, the classic symptoms are fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.

Very early treatment is fundamental and urgent. Symptoms can start and the patient can sadly die within 12 hours, and this becomes more frequent, proportionate to a younger age.

A main symptom is a high fever, with a stiff neck, severe headache, nausea, and vomiting. Also bright lights will be a problem. The patient will become more distant, confused and drowsy.

A baby will have a high fever and temperature; be crying hysterically with a high shrill like tone at first, and may be afraid of a bright light, but may calm down as the infection gets worse. They may well be floppy to hold or go stiff at any stage.

They may have a vacant look. You must not get to this stage, if you have any doubts, medical help must be sought. Also, when you get to the hospital or doctor, make sure that you insist that, Meningitis is ruled out without question. Do not be fobbed off, ask for a second opinion.

People who develop Meningitis -Septicaemia, may have cold hands and feet. They may have joint pains, and a red to purple rash anywhere on the body that doe NOT disappear or fade when you press it with a glass - called the Tumbler-Test.

The 'Glass Test' can be used to see if a rash might be septicaemia. If you press the side of a clear drinking glass firmly onto the spots or bruises, they will NOT fade.  N.B. In a small number of cases, the rash may fade at first, but may later change into one that does not. Septicaemia (blood poisoning) may also be a result. IF YOU HAVE ANY DOUBTS CALL FOR MEDICAL HELP AT ONCE.

How Does Your Body Fight Infection?

Immunity   -  The resistance of the body to infection, especially resistance due to antibodies. Babies have passive immunity from antibodies transferred from the mother’s blood through the placenta. Active immunity involves the formation of antibodies after exposure to an antigen - bacteria that invade the body during an infection are antigens. The two different kinds of immune response produced by antibodies involve: white blood cells called T-lymphocytes - produced by the thymus, which produce cells with antibody properties bound to their surface and are responsible for such reactions as graft rejection; B-lymphocytes, which produce cells that release free antibody into the blood.

Leucocyte - lymphocytes - or white blood cell. A colorless cell found in large numbers in the blood. There are several kinds, all involved in the body’s defense mechanisms. Granulocytes and monocytes destroy and feed on bacteria and other microorganisms that cause infection -  see also phagocyte. The lymphocytes are involved with the production of antibodies.

Phagocyte   -  A cell that engulfs and then digests particles from its surroundings: this process is called phagocytosis. In vertebrate animals, phagocytes are a type of white blood cell that protect the body by engulfing bacteria and other foreign particles.

Immunization is the production of immunity by an injection containing antibodies against specific diseases e.g. tetanus and diphtheria, which provides temporary passive immunity, or by vaccination, which produces the longer lasting active immunity.

Antibody   -  A protein produced by certain white blood cells  - lymphocytes that reacts with a particular foreign particle e.g. a bacterium,  that has entered the body. The antibody helps to destroy the foreign particle, known as the antigen. If the same bacteria invade the body in future, many more of the same antibodies are produced, enabling the body to destroy the bacteria very rapidly and so resist infection. This provides the basis of  immunity. Antibodies are also responsible for the rejection of foreign tissue or organ transplants. See also monoclonal antibody.

Monoclonal antibody  -  A type of pure antibody that can be produced artificially in large quantities and used, for example, to distinguish the major blood groups. Mouse lymphocytes producing the required antibody are fused with mouse cancer cells; the resulting hybrid cells multiply rapidly and all produce the same type of antibody as their parent lymphocytes.

Whilst all this bodily protection sounds wonderful, the problem with MRSA, is that there is no defense to it, no answer to its attack.

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