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Meningitis Meningitis (or cerebrospinal meningitis) is the inflammation or infection of the tissues (dura mater of brain or spinal cord, pia mater of brain, cranial arachnoid or arachnoid of spinal cord) that cover spinal cord and the brain. Consequently, different types of microorganisms (viruses, bacteria, funds, etc) can cause meningitis. Infectiologists consider that under certain circumstances any microorganism can cause meningitis at any person of any age. However, infants and children up to 10 years old belong to a high-risk group. Meningitis is an ancient disease. First it was described by Hippocrates, who called it phrenic.
In XVII pathologist Morgan examined the case of cavernous tuberculosis, where during the autopsy he discovered specific thickenings on dura mater of brain and accumulation of cerebrospinal fluid in optic chips (Routh 12). There are different types of meningitis, according to the responsiveness, rapidity of disease progression, severity of disease, frequency, and methods of treatment: pachymeningitis (inflammation of dura mater of brain), arachnoid itis (inflammation of arachnoid ea encephala), leptomeningitis (inflammation of pia mater of brain and of arachnoid ea encephala) (Strong 137). Meningitis can be divided into cerebral (congenital and basal) and spinal according to specific localization. Meningitis can be bacterial, viral (with more than 450 cases of viral meningitis reported among New York City residents in 2003 (Viral Meningitis 2007) and fungal. Further, according to the character of inflammatory process and changes in cerebrospinal fluid, meningitis can be purulent (caused by Meningococcus, pneumococcus, streptococcus, Hemophilus influenza, colon bacillus, and blue pus bacillus) and non-purulent (serous) (often caused by enteric viruses (Coxsackie virus, : enteric cyto pathogenic human orphan virus, poliomyelitis, measles, varicella, epidemic parotitis, Mycobacterium tuberculosis, and treponema). Non-purulent meningitis is characterized by minimal complications and successful outcomes.
Meningitis can be caused by various types of infectious agents (bacteria, viruses, funds, and protozoa) penetrating into brain tissues. Meningococcus, Mycobacterium tuberculosis, Hemophilus influenza, pneumococcus, hemophilic streptococcus, and staphylococcus are the most popular etiological factors (Strong 85). Compared to other inflectional agents, Meningococcus causes the cohort ictus more often; therefore Meningococcal meningitis is often called the epidemic disease. Poliomyelitis viruses, enterocytopathic viruses and Coxsackie viruses are the main causative agents of viral meningitis. Fungal Meningitis (cryptococcus meningitis) is usually caused by Cryptococcus. The causative agents are replicated in brain tunics and cerebrospinal fluid.
They enter the organism through nasal and pharyngeal cavities via middle ear (auris media), mastoid bone, or via blood vessels. Nidus of infection in lungs, bones, and skin can also cause the infection. Meningitis declares itself via temperature rise, headache and cephalalgia, nausea, vomiting (Viral ("Aseptic" 2007) Meningitis), excessive sleepiness, and central nervous system depression. Patients often suffer from aches and stiffness in the neck and loin. The throbbing of the pulse can be irregular, weak, or dropped-beat and slow. Other symptoms may include bruises or haematoma's.
In case during the respiratory infection the person suffers from the above-listed symptoms, he should be subjected to corresponding medical examinations. Clinical symptoms are as follows: incubation period reaches 2 - 12 days. Further, during 1 - 3 day period the patient suffers from acute naso pharyngitis with high temperature (up to 38 C). In the case of complications or severe clinical course the patient has from psychomotor agitation, delirium. In the case of acute cerebral edema coma, convulsions and dyspnea may take place. Further meningeal symptoms become weaker, and pulmonary edema or hemi paresis may occur.
The diagnosis is made by lumbar puncture and diagnostic of cerebrospinal fluid in order to determine whether the quantity of cells (mainly, lymph cells) increased. In case bacterial meningitis is supposed, bacterial flora is also examined. Although meningitis is very dangerous, it is still treatable through various approaches. The epidemic form of meningococcosisis responds more rapidly to treatment, compared to other forms of bacterial meningitis. Early diagnosis and usage of sulfonamides and antibiotics allow lowering the death rate from 60 - 70 % to 5 %. The disease is contagious and can be transmitted from one person to another by droplet or contact way (e.
g. through objects containing patients saliva or mucus). In order to avoid contagion, persons who have to contact the patient should be vaccinated with low doses of sulfanilamidtimes per day) during a period of three days. Other forms of bacterial meningitis are also treatable, with the exception of certain cases of tuberculous meningitis and meningitis caused by H. influenzae. Yet, some improvements have been noted in the last few years, indicating significantly decreased death rate as well as cases of ultimate recovery.
Although the usage of sulfanilamide and antibiotics enhances the results of treatment, timely diagnosis and identification of meningitis infectious agent have great impact on possible ultimate recovery. Moreover, vaccination may prevent the disease. However, it is important to take into account that vaccine may protect the organism from several types of meningitis alone. It is reported that vaccine may be effective in about 85 % of all cases (except of viral meningitis). For example, MCV 4 (Meningococcal conjugate vaccine) and Meningococcal polysaccharide vaccine (MPSV 4) may protect the person from four types of meningitis. Meningococcal (epidemic cerebrospinal) and pneumococcal meningitis are effectively cured by intravenous introduction of ampicillin or penicillin G (benzyl penicillin).
Penicillin is used for pneumococcal meningitis. When the tuberculous meningitis is diagnosed, the patient is prescribed a combination of riphampicine or streptomycin and isoniazid, pyrazinamide, or ethambutol. Many forms of scarce fungal brain infections and inflammations of arachnoid membranes are almost incurable. However, certain types of funds respond to treatment (e. g. cryptococcus meningitis can be cured by antibiotic amphotericin B, and fluconazole.
Intravenous introduction of Acyclovir is used for treatment of viral meningitis). Basically, the patient should be hospitalized. It is recommended to use medicines aimed to enhance cerebral blood flow; antioxidants, medicines of anti hypoxic action, and noo tropic agent (cinnarizine, nootropil or pyracetam). Meningitis is dangerous due to possible complications.
In case the disease was diagnosed untimely, the patient can suffer from hearing and vision injury (especially in infants and children), dural sinus thrombosis, disseminated intravascular coagulation, obstructing hydrocephalus, adrenal haemorrhage causing hypo function, brain damage, endocarditis, etc. After the patient is discharged from the hospital, he / she should remain under medical supervision of neurologist. Recovering patients are recommended to avoid excessive physical and physical emotional activity, avoid a long-term stay under the sun, to control salt, to avoid excessive water and alcohol consumption. Works Cited Routh, Kristina. Meningitis (Need to Know). Heinemann Library, 2004.
Strong, Phyllis V. Focus On Meningitis Research. Nova Biomedical, 2004. Viral ("Aseptic") Meningitis. 30 April 2007 < web >. Viral Meningitis. 30 April 2007 < web >.
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