Meningitis

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Meningitis is an inflammation of the meninges — the protective membranes surrounding the brain and spinal cord. It is a medical emergency that can be caused by viruses, bacteria, fungi, or parasites. Prompt diagnosis and treatment are critical because bacterial meningitis, in particular, can lead to death or permanent disability within hours.

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🧠 TYPES OF MENINGITIS

Type	Cause	Severity
Bacterial	Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae	Most severe and life-threatening
Viral	Enteroviruses, HSV, mumps, HIV	Milder; often self-limiting
Fungal	Cryptococcus (mostly in immunocompromised people)	Serious but rare
Parasitic	Rare (e.g., Naegleria fowleri)	Almost always fatal
Non-infectious	Cancer, lupus, head injury, certain drugs	Not caused by pathogens

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😷 SYMPTOMS

In Adults	In Infants/Children
Sudden fever	Bulging fontanelle (soft spot)
Severe headache	High-pitched cry
Stiff neck	Poor feeding
Nausea/vomiting	Vomiting or diarrhea
Sensitivity to light	Irritability
Confusion or seizures	Lethargy
Sleepiness or difficulty waking	Seizures
Skin rash (in meningococcal meningitis)	Cold extremities, mottled skin

Symptoms often appear suddenly and can worsen very rapidly, especially in bacterial meningitis.

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🧪 DIAGNOSIS

Test	Purpose
Lumbar puncture (spinal tap)	Gold standard: analyze cerebrospinal fluid (CSF)
CSF analysis	Cell count, glucose, protein, culture
Blood cultures	Identify systemic infection
CT/MRI	Brain imaging if swelling or abscess suspected
PCR testing	Viral meningitis identification
Latex agglutination	Detects bacterial antigens in CSF

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💊 TREATMENTS

🔹 1. Bacterial Meningitis

• Hospitalization required

• Empiric IV antibiotics immediately (before diagnosis confirmed):

Antibiotic	Target
Ceftriaxone / Cefotaxime + Vancomycin	Broad coverage
Ampicillin	For Listeria (in elderly, neonates, immunocompromised)
Dexamethasone	Given before/with first antibiotic dose to reduce brain inflammation (especially in S. pneumoniae)

Delay in antibiotics = increased mortality

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🔹 2. Viral Meningitis

• Usually self-limiting

• Supportive care:

  • Rest

  • Fluids

  • Pain relievers

• Antivirals (e.g., acyclovir) if HSV is suspected

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🔹 3. Fungal or Parasitic Meningitis

• Antifungal agents (e.g., Amphotericin B for cryptococcal meningitis)

• Antiparasitics (usually ineffective in Naegleria infection)

• Prolonged treatment in immunocompromised patients

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🧬 COMPLICATIONS

• Brain damage

• Seizures

• Hearing loss

• Learning disabilities

• Hydrocephalus (fluid buildup in the brain)

• Death (10–20% in bacterial cases even with treatment)

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🛡️ PREVENTION

💉 Vaccines

Vaccine	Protects Against
MenACWY / MenB	Neisseria meningitidis
PCV13 / PPSV23	Streptococcus pneumoniae
Hib vaccine	Haemophilus influenzae type b
MMR vaccine	Mumps, measles viruses
BCG vaccine	Mycobacterium tuberculosis (can cause TB meningitis)

🧼 Other Measures

• Avoid sharing food, drinks, or utensils

• Good hygiene (especially in dorms or military barracks)

• Post-exposure antibiotics for close contacts of meningococcal cases