Meningitis is a condition in which the protective membranes of the brain or meninges become inflamed. This may be due to an infection or any other factor that causes physical or chemical trauma to the membranes. Infecting organisms may be bacteria, protozoa, viruses or fungi. Whenever the meninges are inflamed, there is a risk of spinal cord or brain involvement with possible loss in neurological function. The signs and symptoms of meningitis may not be picked up very easily in the initial stages if the attending physician is not well experienced.
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.
Different age groups are susceptible to different organisms known to cause meningitis. Newborns and infants are most commonly affected by the organisms belonging to group B streptococci acquired from the birth canal at birth. Other organisms include Listeria monocytogenes and E. Coli. As they grow older, cases of Neisseria meningitidis and Haemophilus influenzae (specifically type B) become more common. Adults are most likely to be affected by Streptococcus pneumoniae.
When the disease is very severe, there is a high chance that there will be systemic involvement. Organisms may enter the circulation in varying quantities. If the quantity is small, the resultant condition is referred to as bacteraemia. When large enough to cause infection is other parts it is referred to as septicaemia. Septicaemia is fairly common in cases of infection caused by Neisseria meningitidis. It causes what is known as meningococcemia characterised by abnormal bleeding into the skin and internal 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 symptoms to look out for include drowsiness or sluggishness, photophobia (sensitivity to light) and poor appetite. In very severe cases, the patient may start convulsing and go into a coma. Symptoms are particularly difficult to pick in infants and young children. The commonest presentation includes fever, poor feeding, convulsions, fatigue and irritability. Seizures in children occur in about 30% of the cases.
Meningococcal diseases results in distinct signs. There is often a change in colour of the skin. The colour becomes darker due to bleeding taking place underneath. There have also been reports of skin rashes, cold extremities, myalgia (muscle pain), joint pain (arthralgia), chills and increased rate of 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.
Different age groups are susceptible to different organisms known to cause meningitis. Newborns and infants are most commonly affected by the organisms belonging to group B streptococci acquired from the birth canal at birth. Other organisms include Listeria monocytogenes and E. Coli. As they grow older, cases of Neisseria meningitidis and Haemophilus influenzae (specifically type B) become more common. Adults are most likely to be affected by Streptococcus pneumoniae.
When the disease is very severe, there is a high chance that there will be systemic involvement. Organisms may enter the circulation in varying quantities. If the quantity is small, the resultant condition is referred to as bacteraemia. When large enough to cause infection is other parts it is referred to as septicaemia. Septicaemia is fairly common in cases of infection caused by Neisseria meningitidis. It causes what is known as meningococcemia characterised by abnormal bleeding into the skin and internal 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 symptoms to look out for include drowsiness or sluggishness, photophobia (sensitivity to light) and poor appetite. In very severe cases, the patient may start convulsing and go into a coma. Symptoms are particularly difficult to pick in infants and young children. The commonest presentation includes fever, poor feeding, convulsions, fatigue and irritability. Seizures in children occur in about 30% of the cases.
Meningococcal diseases results in distinct signs. There is often a change in colour of the skin. The colour becomes darker due to bleeding taking place underneath. There have also been reports of skin rashes, cold extremities, myalgia (muscle pain), joint pain (arthralgia), chills and increased rate of 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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