The meningitis Is a disease that causes severe inflammation of the membranes (meninges) that surround and protect the brain and spinal cord (Jhons Hopkins Meidicine, 2015. Among the causes of this pathology are viruses, bacteria, fungi and parasites .
Depending on the etiology and severity, the symptoms of meningitis will include: sudden and recurrent fever; Headache and headache; Nausea and vomiting, sensitivity to light; Muscular stiffness in the neck and back; Tiredness, confusion, drowsiness and difficulty concentrating; Muscle weakness accompanied by difficulty in walking; Loss of consciousness, seizures and / or symptoms related to Cognitive impairment (National Institute of Neurological Disorders and Stroke, 2016).
In addition to these signs and symptoms, in the most severe cases, individuals may have trouble speaking, hearing, vision and presentation of hallucinations. National Institute of Neurological Disorders and Stroke, 2016).
When a clinical course that is compatible with meningitis suddenly appears, the symptoms require emergency treatment (National Institute of Neurological Disorders and Stroke, 2016).
Although it is a medical condition that seriously jeopardizes the survival of the person, the use of pharmacological intervention with antibiotic or antiviral drugs can reduce the inflammation of the Meninges In the brain and spinal cord (National Institute of Neurological Disorders and Stroke, 2016).
In general, mild cases usually present a complete recovery after a slow and progressive process. However, there are more serious cases that can be resolved with the development of secondary sequelae, such as neurological or physical alterations (National Institute of Neurological Disorders and Stroke, 2016).
What is meningitis?
Meningitis is a disease caused by an inflammation of the meninges, the membranes surrounding the brain and spinal cord (Jhons Hopkins Meidicine, 2015.
The brain and spinal cord are covered and protected by three layers of connective tissue called meninges (National Institutes of Health, 2014)
The meninges are composed of an inner layer, piamadre; An intermediate layer, dura mater and an outer layer, arachnoid meninges. The essential function of all these is to protect the brain and meninges from any external damage, protect the blood vessels and contain the cerebrospinal fluid (National Institutes of Health, 2014).
Different pathological agents can cause an infection of any of the layers of the meninges, and consequently the inflammation, cause significant damages at the cerebral level.
Although there are different types of meningitis, the most common are bacterial meningitis. Thus, when meningitis cases are mentioned in most texts, this type is usually referred to (Mapfre Salud, 2015).
About us
Although there are few statistical data that refer to the general prevalence of meningitis, in the case of Spain, approximately 2,000 new cases are reported every year, of which 200 cause the death of the patient (Sociedad Española de Farmacia Comunitario, 2015) .
More specifically, about 80% of the cases are diagnosed in children and adolescents (Spanish Society of Community Pharmacy, 2015).
This pathology, can cause the death of the individual in just one hour after the presentation of the first symptoms. However, medical specialists point out that early diagnosis and intervention can prevent more than 75% of deaths (Spanish Society of Community Pharmacy, 2015).
Signs and symptoms
The first symptoms of meningitis can appear after several hours or a few days after having contracted the disease, in addition some of these can mimic the influenza processes.
Depending on the cause, severity and age of the person suffering from meningitis, symptoms may vary, however some of the most common in people over two years of age are (Mayo Clinic, 2016):
- Significant increase in body temperature.
- Muscle stiffness, pain, or difficulty performing movements with the neck.
Severe headache.
- Nausea and vomiting.
- Difficulty concentrating and maintaining attention.
- Confusion.
- Need for sleep, difficulty waking up, drowsiness.
- Convulsive episodes.
- Sensitivity to light.
- Loss of appetite.
- Eruptions or inflammation of the skin.
In the case of younger people (two years or less) and newborns, the most common symptoms are (Mayo Clinic, 2016):
- Constant and recurrent crying, irritability.
- High increase in body temperature.
- Drowsiness.
- Slowness or inactivity.
- Lack of appetite.
- Bulking in soft areas? (Fontanelle) of the head in infants.
- Stiffness in the muscles of the back and neck.
In addition, other symptoms, such as petechia (small red bumps appearing on the skin of the extremities and trunk), may be an indicator of the condition of a particular type of bacterial meningitis type (Mapfre Salud, 2015) .
Causes
In the case of meningitis, 5 main causes are distinguished: viruses, bacteria, fungi, parasites and non-infectious factors (Meningitis Foundation of America, 2013)
Viral meningitis
This type of meningitis is caused by a viral infection and is the most common type of meningitis in the United States (Meningitis Foundation of America, 2013)
In general, cases are usually velas and may resolve on its own (Mayo Clinic, 2016). Some people may have symptoms for 7-10 days, while others may have symptoms for 3-4 months (Meningitis Foundation of America, 2013)
Many cases of viral meningitis occur due to a group of viruses known as enteroviruses, common in the summer or early fall.
The virus of Simple herpes , VHI , mumps , Among others, may also cause meningitis (Mayo Clinic, 2016).
Viral meningitis can be transmitted through biological secretions (coughing, sneezing, saliva, etc.).
Bacterial meningitis
When a pathological agent such as a bacterium accesses the organism, it can lead to the development of meningitis through the bloodstream or to direct invasion in the meninges.
The most common bacteria related to meningitis are (Mayo Clinic, 2016):
- Streptococcus pneumonia ( pneumococcus ): Is the most common in cases of bacterial meningitis in infants, children and adults.
- Haemophilus influenzae ( Haemophilus ): It was a major cause in children, however, new generations of vaccines have significantly reduced its incidence.
- Listeria ( Listeria monocytogenes ): Many times this type of bacteria is found in pasteurized foods or uncooked meats. At-risk populations such as pregnant women, children or older adults are more likely to contract it.
Bacterial meningitis can be one of the most serious types, can cause both general physical damage and brain damage. This type is extremely dangerous and can become deadly (Meningitis Foundation of America, 2013).
Fungal Meningitis
Fungal meningitis develops as a consequence of a fungus that spreads through the bloodstream. It happens with a greater proportion in people with a weakened immune system: patients with cancer or AIDS (Meningitis Foundation of America, 2013).
Although not contagious, it can produce the same symptoms as other types of meningitis (Meningitis Foundation of America, 2013).
Parasitic Meningitis
This type of meningitis is caused by Naegleria fowleri , A type of parasite found in the sweet and temperate waters (lakes, lagoons, etc.).
This parasite can cause primary meningoencephalitis, which is a type of infection that destroys brain tissue progressively Meningitis Foundation of America, 2013).
Other causes of meningitis
It is also possible to develop meningitis as a consequence of other non-infectious causes: chemical reactions, drug allergies, cancer, inflammatory diseases, etc.
Risk factor's
In the case of meningitis, several factors have been identified that increase the likelihood of suffering, most of them related to the individual's immune system (Mayo Clinic, 2016):
- Not being vaccinated : It is advisable to complete the immunization schedule in children and adults, as there are some aimed at combating the viruses related to meningitis.
- Age : Most cases of meningitis occur in young children due to the presence of a weaker immune system.
- Environment : Living in a reduced environment increases the likelihood of suffering from some types of bacterial meningitis, as some bacteria can pass through the respiratory tract and spread rapidly through the air.
- Pregnancy : During gestation especially increases the risk of listeria, which can also cause meningitis. In addition, listeriosis increases the risk of miscarriage, stillbirth, or preterm delivery.
- Deficit of the immune system: AIDS, alcoholism, diabetes , Use of immunological drugs, can also lead to a weaker immune system and therefore an increased susceptibility to meningitis.
Diagnosis
As in many other pathologies that have a neurological component, in addition to the elaboration of a complete medical history and the detailed physical examination, in this case, some specific diagnostic tests (Jhons Hopkins Meidicine, 2015) may be used:
- Lumbar puncture : With the introduction of a needle in the region into the spinal canal, a small amount of cerebrospinal fluid is removed to examine the possible existence of infectious agents.
- Blood analysis : As with lumbar puncture, blood tests are used to detect the presence of infectious agents.
- Image Techniques : Computed tomography or magnetic resonance imaging (MRI) can be used to detect inflammation in the brain or spinal area.
Treatment
Depending on the cause of the meningitis, different intervention measures may be adopted (Mayo Clinic, 2016):
- Bacterial meningitis treatment : Meningitis caused by bacterial agents is necessary to treat it urgently. In the emergency services antibiotics or corticosteroids are usually used. In general, these drugs ensure recovery, reduce the risk of possible complications, and control brain inflammation or seizures.
- Viral meningitis treatment : Unlike bacterial meningitis, in this case antibiotics do not cure meningitis. Although in general, viral meningitis tends to improve on its own in a short time. Medical specialists usually prescribe: rest, fluid intake, pain medications (reduce pain) and antipyretics (reduce fever), Corticosteroids (Reduce inflammation) or Anticonvulsants . In the case of herpes simplex meningitis, there is an antiviral medication.
- Treatment of other types of meningitis : When there is no specific cause of meningitis, some specialists usually start antiviral or antibiotic treatment while clarifying the cause. In the case of fungal meningitis, antifungal drugs are often used in combination with other specific antibiotics.
Forecast
The prognosis usually varies depending on the severity, time and individual health conditions.
In milder cases, a complete recovery usually takes 2 to 4 weeks. Although the process may be slow, the presentation of symptoms in the acute phase is usually satisfactorily resolved when an early therapeutic approach is used (National Institute of Neurological Disorders and Stroke, 2016).
Despite this, there are more serious cases that will cause different sequels so that neurological symptoms may require much more time for control or recovery (National Institute of Neurological Disorders and Stroke, 2016).
In addition, there are several conditions that make some types of meningitis a potential cause of death, so it is essential that both rapid detection and prescription of medical treatment be performed.
References
- CDC. (2016). Meningitis . Retrieved from the Centers for Disease Control and Prevention: cdc.gov/meningitis.
- Johns Hopkins Medicine. (2015). Meningitis . Retrieved from Jhons Hopkins Medicine: hopkinsmedicine.org.
- Mapfre. (2015). Meningitis . Obtained from Mapfre Health: mapfre.es.
- Mayo Clinic. (2016). Meningitis . Obtained from Mayo Clinic.
- Medscape. (2016). Practice Essentials . Obtained from Medscape: emedicine.medscape.com.
- Meningitis Now. (S.f.). Meningitis . Obtained from Meningitis Now: meningitisnow.org.
- MFA. (2013). Types of Meningitis . Retrieved from Meningitis Foundation of America: musa.org/types.
- MRF. (2016). What are meningitis and septicaemia? Retrieved from Meningitis Research Foundation: meningitis.org.
- NIH. (2016). Meningitis and Encephalitis . Retrieved from the National Institute of Neurological Disorders and Stroke: ninds.nih.gov/disorders.
- WHO. (2015). Meningococcal Meningitis . Retrieved from who.int.
- SEFC. (2015). Tips for early detection of meningitis . Retrieved from the Spanish Society of Community Pharmacy: contralameningitis.org.