Meningitis is an inflammation of the meninges. The meninges are membranes covering the central nervous system (brain and spinal cord). Three membranes, and including cerebrospinal fluid circulates.
There are different types of meningitis are major acute bacterial meningitis, ie meningitis caused by bacterial infection. Normally when discussing cases of meningitis, you are referring to this type of meningitis. Medical information below will refer to acute bacterial meningitis. The final section is a brief explanation of other types of meningitis.
The acute bacterial meningitis are caused by different types of bacteria:
In cases of meningitis more common (pneumonia or meningitis), these bacteria normally colonize the mucosa of the nasopharynx of the individual. The risk of severe disease in a healthy carrier depends on the virulence of the microorganism and the carrier’s defense mechanisms.
The bacteria in the nasopharyngeal mucosa can pass into the bloodstream and then reach the central nervous system and infect the meninges and cerebrospinal fluid. It produces an inflammatory reaction to these bacteria and found ourselves before meningitis.
In the case of Listeria meningitis, the mechanism is different because the bacteria can be ingested through contaminated food and settles in the gut. From there you can go to the bloodstream and then reach the central nervous system.
The classic symptoms of meningitis are fever, headache (headache), neck stiffness and vomiting.
A negligible percentage may have convulsions (seizures). The decreased level of consciousness and coma are a sign of elevated intracranial pressure due to all the inflammatory reaction of meningitis, and is a poor prognostic sign.
Other clinical signs: it is noteworthy that in the case of meningococcal meningitis may appear petechiae (small red spots) on the skin of the trunk and limbs or eyes. They are a sign of generalized meningococcal infection.
Pneumococcal meningitis in a stroke can occur along the course of the disease.
Meningitis can be a devastating and fatal disease in a few hours or it may have a slower evolution in several days.
Clinical suspicion of meningitis, the diagnosis is made by analyzing the cerebrospinal fluid by lumbar puncture.Analyses and cerebrospinal fluid culture let you know the bacteria causing the disease in most cases.
Often it is necessary to perform imaging studies such as computed tomography or magnetic resonance imaging head, to supplement the information.
Bacterial meningitis is a medical emergency because it is a serious, life-threatening, requiring hospitalization for diagnosis and treatment.
Treatment is with intravenous antibiotics. It is very important to start treatment as soon as possible, so that in health care protocols exist for empirical antibiotic treatment of the disease. These protocols recommend what antibiotic should be administered by age input and manner of acquisition of the disease (extra-or intra), without having to wait to find out exactly what bacteria is causing the meningitis. Typically use one or two antibiotics.
Once you know the bacteria will be assessed as long as medically, changing to a more specific antibiotic.
In addition to antibiotic therapy, provides complementary treatment usually includes intravenous corticosteroids to reduce the inflammatory reaction in the entire central nervous system, and specific treatment of complications such as seizures, coma, stroke, etc..
The mortality of bacterial meningitis vary by the same bacteria that causes: the Pneumococcal meningitis can have a mortality rate of up to 20%, while in meningococcal meningitis is much lower (3 to 7%).
The prognosis is worse if convulsions or decreased level of consciousness in the early hours of the onset of the disease, or when it occurs in infants or elderly.
While most people overcome and heal without sequelae of meningitis in some cases may be impaired memory, diminished intellectual capacity or seizures.
Routine vaccination of children against Haemophilus influenzae type b meningitis has decreased by this germ.Today, also included the immunization schedule for children vaccination against one type of meningitis (serotype C).
There pneumococcal vaccine, which is not mandatory in all regions, but has also been decreases the incidence of serious pneumococcal disease in young children.
A case of meningitis is always displayed great outcry, and the people around wondering what to do to avoid transmission and new cases of the disease. Only in cases of meningococcal meningitis and Haemophilus influenza meningitis is necessary to locate the contacts and take preventive measures such as antibiotic prophylaxis. In all other cases this is not necessary meningitis.
Antibiotic prophylaxis is to give antibiotics to people who have been in contact with the patient to minimize the risk of new cases and eradicate nasopharyngeal meningococcal carriers.
In the case of meningococcal meningitis, antibiotic prophylaxis is performed with the antibiotic rifampicin for two days. As meningococcal meningitis is a notifiable disease to the health authorities, and they will be medical personnel indicating the guidelines and who should receive prophylactic antibiotics. By general rule is indicated in the following contacts:
Usually no antibiotic prophylaxis is indicated in the co-workers or friends without close relationship, or to people who have attended the same social event, or people who have traveled in the passenger seat on public transport.
In the case of influenza Heamophilus meningitis, antibiotic prophylaxis is given with rifampicin for 4 days.
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