Meningitis: Wikis

  
  
  






















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Meningitis
Classification and external resources

Meninges of the central nervous system: dura mater, arachnoid, and pia mater.
ICD-10 G00.G03.
ICD-9 320322
DiseasesDB 22543
MedlinePlus 000680
eMedicine med/2613 emerg/309 emerg/390
MeSH D008581
.Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.^ Gram-negative meningitis is an infection of the membranes covering the brain and spinal cord ( meninges ) caused by bac...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Meningitis is an infection of the coverings around the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[1] .The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs.^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningococcal meningitis is an infection that causes swelling and irritation (inflammation) of the membranes covering...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[2] .Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.^ Meningitis , a possibly life-threatening disease, is the inflammation of the membranes (menges) and the spinal fluid that surround the brain and the spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Meningitis is an infection of the coverings around the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[1][3]
.The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia).^ Headache is a common symptom of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Babies may not have the symptoms older children get, such as fever , headache, and a stiff neck.
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

^ The most common symptoms of either form of meningitis include: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Sometimes, especially in small children, only nonspecific symptoms may be present, such as irritability and drowsiness.^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ The clinical presentation varies with the age of the patient, and there is a distinct difference between the signs and symptoms in neonates and young infants and those in older children and adults.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash.^ A petechial (pinpoint sized hemorrhagic) rash is characteristic of meningococcal meningitis.

^ Any rash may be present with meningitis.

^ Why: Any rash may be present with meningitis.

[1][4]
.A lumbar puncture may be used to diagnose or exclude meningitis.^ How is a lumbar puncture used to diagnose meningitis?
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ If a patient has symptoms of meningitis, his or her physician may order a lumbar puncture, commonly called a spinal tap.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Table 6 summarizes historic clues that may help the physician diagnose treatable causes of aseptic meningitis.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

.This involves inserting a needle into the spinal canal to extract a sample of cerebrospinal fluid (CSF), the fluid that envelops the brain and spinal cord.^ Inflammation of the membranes of the brain or spinal cord.

^ During a spinal tap, a needle is placed in the lumbar (lower) portion of the spinal canal and a small sample of cerebrospinal fluid (CSF) is removed.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ This fluid is called cerebrospinal fluid or CSF. .
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

The CSF is then examined in a medical laboratory.[3] .The usual treatment for meningitis is the prompt application of antibiotics and sometimes antiviral drugs.^ Bacterial meningitis is usually treated with antibiotics .
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

^ Bacterial meningitis and septicaemia must be treated immedaitely with antibiotics, usually via an injection, directly into the bloodstream.

^ The antiviral drug pleconaril is currently in phase II clinical trials for treatment of adolescents and adults with enteroviral meningitis, and clinical trials for evaluation of treatment of neonatal enteroviral disease are planned for the near future.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

In some situations, corticosteroid drugs can also be used to prevent complications from overactive inflammation.[3][4] .Meningitis can lead to serious long-term consequences such as deafness, epilepsy, hydrocephalus and cognitive deficits, especially if not treated quickly.^ Although most types of aseptic meningitis do not cause serious sequelae, some types result in significant morbidity and mortality if not properly diagnosed and treated.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Also at risk are older adults and people who have long-term health problems, such as a weakened immune system .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Long-term sequelae of meningitis include neuromuscular impairments, learning disabilities and hearing loss.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

[1][4] .Some forms of meningitis (such as those associated with meningococci, Haemophilus influenzae type B, pneumococci or mumps virus infections) may be prevented by immunization.^ Vaccines can prevent some types of meningitis .
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

^ Haemophilus influenzae type b (Hib) virus.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Some types of meningitis can be prevented with vaccines.
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

[1]

Contents

Signs and symptoms

Clinical features

.In adults, a severe headache is the most common symptom of meningitis – occurring in almost 90% of cases of bacterial meningitis, followed by nuchal rigidity (inability to flex the neck forward passively due to increased neck muscle tone and stiffness).^ Symptoms classically associated with bacterial meningitis include fever, headache, and stiff neck.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ What are the symptoms of bacterial meningitis?

^ The major symptoms of meningitis are severe headache, neck pain, and fever.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

[5] .The classic triad of diagnostic signs consists of nuchal rigidity, sudden high fever, and altered mental status; however, all three features are present in only 44–46% of all cases of bacterial meningitis.^ Acute bacterial meningitis had a sudden onset with rigors and high fever.

^ Approximately half of affected adults show signs of meningeal irritation such as nuchal and/or spinal rigidity and a positive Kernig and/or Brudzinski sign.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Pyogenic (bacterial) meningitis is a potentially life-threatening disease that consists of inflammation of the meninges and the underlying subarachnoid cerebrospinal fluid (CSF).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

[5][6] If none of the three signs is present, meningitis is extremely unlikely.[6] .Other signs commonly associated with meningitis include photophobia (intolerance to bright light) and phonophobia (intolerance to loud noises).^ The symptoms your doctor may ask about (in association with Meningitis) may include: Rash?

^ Other neurologic signs include cranial nerve palsies, focal cerebral signs (10-20%), and papilledema ( <1%).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Other symptoms may include nausea, vomiting, discomfort when the patient looks into bright lights, confusion, and sleepiness.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.Small children often do not exhibit the aforementioned symptoms, and may only be irritable and looking unwell.^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Newborns and small infants may not present with the classic symptoms, or the symptoms may be difficult to detect.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Children, older adults, and people with other medical problems may have different symptoms: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .In infants up to 6 months of age, bulging of the fontanelle (the soft spot on top of a baby's head) may be present.^ A bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).See also: Fontanelles - sunken .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ There are vaccines available for H.I.B. and bacterial meningitis C. The H.I.B. vaccine is usually given to babies at the age of 2 months, along with vaccines for diphtheria , whooping cough , tetanus , and polio .

^ The clinical presentation varies with the age of the patient, and there is a distinct difference between the signs and symptoms in neonates and young infants and those in older children and adults.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.Other features that might distinguish meningitis from less severe illnesses in young children are leg pain, cold extremities, and abnormal skin color.^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Young children with meningitis may act like they have the flu (influenza), cough, or have trouble breathing.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meropenem, which has a broad range of in vitro activity and less seizure proclivity than imipenem, has been studied in both children and adults with bacterial meningitis.
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

[7]
.Nuchal rigidity occurs in 70% of adult cases of bacterial meningitis.^ Approximately half of affected adults show signs of meningeal irritation such as nuchal and/or spinal rigidity and a positive Kernig and/or Brudzinski sign.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ In cases of meningitis with septicaemia adults and children may develop a rash (see below).

^ Enhancement of the meninges is seen on contrast-enhanced CT scans and MRIs in cases of bacterial meningitis (see Images 2 , 6 , 15-17 ).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

[6] .Other signs of meningism include the presence of positive Kernig's sign or Brudzinski's sign.^ Other symptoms of meningitis include: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Other conditions with similar symptoms to meningitis include viral hepatitis and flu.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Treatment for meningitis depends on the organism causing the infection, your age, the extent of the infection, and the presence of other medical conditions or complications of meningitis .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

Kernig's sign is assessed with the patient lying supine, with the hip and knee flexed to 90 degrees. In a patient with a positive Kernig's sign, pain limits passive extension of the knee. .A positive Brudzinski's sign occurs when flexion of the neck causes involuntary flexion of the knee and hip.^ Approximately half of affected adults show signs of meningeal irritation such as nuchal and/or spinal rigidity and a positive Kernig and/or Brudzinski sign.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.Although Kernig's and Brudzinski's signs are both commonly used to screen for meningitis, the sensitivity of these tests is limited.^ Various tests are used in the diagnosis of Meningitis.

^ Both viral and bacterial meningitis are severe and potentially life-threatening illnesses that most commonly affect infants and young children.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Pending results of ongoing trials, these agents (i.e., gatifloxacin and moxifloxacin) should only be used as alternative agents in patients with bacterial meningitis (B-II) .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

[6][8] .They do, however, have very good specificity for meningitis: the signs rarely occur in other diseases.^ Of the 154 causes of Meningitis that we have listed, we have the following prevalence/incidence information: 3 causes are "very common" diseases 4 causes are "common" diseases 1 causes are "uncommon" diseases 1 causes are "rare" diseases 40 causes are "very rare" diseases 120 causes have no prevalence information.

^ Before the 1990's, H.I.B. (Haemophilus Influenzae type B) was the leading cause of bacterial meningitis in children, fortunately because of immunization this type of meningitis is now very rare.

^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[6] .Another test, known as the "jolt accentuation maneuver" helps determine whether meningitis is present in patients reporting fever and headache.^ Since the causative agent is usually not known at presentation, all newborns or infants with meningitis should be treated aggressively (Figure 1) .
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ History When considering the possibility of meningitis in an ill-appearing newborn or infant, the history of the mother and child may help in the determination of possible causative agents and assessment of the severity of the illness.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ W hen a newborn or young infant presents with fever and lethargy or irritability, meningitis is a primary concern.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

The patient is told to rapidly rotate his or her head horizontally; if this does not make the headache worse, meningitis is unlikely.[6]
.Meningitis caused by the bacterium Neisseria meningitidis (known as "meningococcal meningitis") can be differentiated from meningitis with other causes by a rapidly spreading petechial rash which may precede other symptoms.^ What causes bacterial meningitis and how is it spread?

^ What causes viral meningitis and how is it spread?

^ Since the causative agent is usually not known at presentation, all newborns or infants with meningitis should be treated aggressively (Figure 1) .
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

[7] .The rash consists of numerous small, irregular purple or red spots ("petechiae") on the trunk, lower extremities, mucous membranes, conjuctiva, and (occasionally) the palms of the hands or soles of the feet.^ These include darkening of the skin and the appearance of small warts on the palms, soles, and torso [29].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ The main symptom of septicaemia is a rash that starts as tiny red pinprick marks and then if untreated develops into purple bruises or blood blisters.

.The rash is typically non-blanching: the redness does not disappear when pressed with a finger or a glass tumbler.^ This involves pressing the side of a glass tumbler, firmly against the rash to see if the rash fades and loses colour under pressure.

.Although this rash is not necessarily present in meningococcal meningitis, it is relatively specific for the disease; it does, however, occasionally occur in meningitis due to other bacteria.^ Two other bacteria that sometimes cause meningitis are group B streptococci and Listeria monocytogenes .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ These may include bacteria or cells present due to inflammation (WBCs).

^ Although college students' overall risk of meningitis from Neisseria meningitidis bacteria is low, freshmen, especially those who live in dormitories, have a moderately higher risk than other people their age.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .Other clues as to the nature of the cause of meningitis may be the skin signs of hand, foot and mouth disease and genital herpes, both of which are associated with various forms of viral meningitis.^ Viral meningitis is caused by viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis also can be caused by other organisms and conditions .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ What causes viral meningitis and how is it spread?

[9]

Early complications

.
A severe case of meningococcal meningitis in which the petechial rash progressed to gangrene and required amputation of all limbs.
^ In severe cases, meningitis can be fatal.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ In cases of meningitis with septicaemia adults and children may develop a rash (see below).

^ With all cases of meningitis, the earlier the diagnosis is made the better the outlook for the patient.

The patient, Charlotte Cleverley-Bisman, survived the disease and became a poster child for a meningitis vaccination campaign in New Zealand.
.People with meningitis may develop additional problems in the early stages of their illness.^ People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness.

^ The majority of people with viral meningitis will make a full recovery, though they may feel severely weak and depressed for a short period of time afterwards.

^ Scientists are still not clear why a few people develop meningitis or septicaemia from bacteria that are harmless to most of us.

.These may require specific treatment, and sometimes indicate severe illness or worse prognosis.^ Morbidity, mortality, and prognosis depend on the pathogen, the patient's age and condition, and the severity of acute illness.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Bacterial or severe viral meningitis may require treatment in a hospital, including: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ People with severe meningitis or complications during illness may need to be treated in the intensive care unit of a hospital.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.The infection may trigger sepsis, a systemic inflammatory response syndrome of falling blood pressure, fast heart rate, high or abnormally low temperature and rapid breathing.^ A number of studies have found a small, but consistent association, between lead and hypertension (high blood pressure).
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Is high blood pressure related to lead exposure?
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ High Blood Pressure .

.Very low blood pressure may occur early, especially but not exclusively in meningococcal illness; this may lead to insufficient blood supply to other organs.^ People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness.

^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

^ If you do not get better or if symptoms get worse, you may need further testing to check for other causes of illness.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .Disseminated intravascular coagulation, the excessive activation of blood clotting, may cause both the obstruction of blood flow to organs and a paradoxical increase of bleeding risk.^ Factors that may increase the risk for meningitis include: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

In meningococcal disease, gangrene of limbs can occur.[1] .Severe meningococcal and pneumococcal infections may result in hemorrhaging of the adrenal glands, leading to Waterhouse-Friderichsen syndrome, which is often lethal.^ Non-neurological complications may include kidney failure and adrenal gland failure.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]

^ On physical examination, a skin rash caused by meningococcal meningitis (50%), H influenzae , pneumococcal meningitis, echovirus type 9, or Staphylococcus aureus may be present.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Causes Meningitis usually results from a viral infection, but the cause may also be a bacterial infection.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]

[10]
.The brain tissue may swell, with increasing pressure inside the skull and a risk of swollen brain tissue getting trapped.^ He's now in a coma, the swelling in his little brain is increasing by the day, killing off cells by the minute.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ In infections, the initial pressure of CSF during collection may be increased, and the sample may appear cloudy due to the presence of white blood cells (WBCs) or microorganisms.

This may be noticed by a decreasing level of consciousness, loss of the pupillary light reflex, and abnormal positioning.[4] .Inflammation of the brain tissue may also obstruct the normal flow of CSF around the brain (hydrocephalus).^ Only a small amount is normally present in CSF because proteins are large molecules and do not cross the blood/brain barrier easily.

^ Non-Laboratory Tests Imaging tests may be performed to look for signs of brain inflammation or abnormalities but may be unremarkable with encephalitis.

^ It is caused most often by viruses or bacteria that infect the tissues ( meninges ) and sometimes the fluid (cerebral spinal fluid, or CSF) that surround the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[4] .Seizures may occur for various reasons; in children, seizures are common in the early stages of meningitis (30% of cases) and do not necessarily indicate an underlying cause.^ In cases of meningitis with septicaemia adults and children may develop a rash (see below).

^ Enteroviruses are the most common cause of viral meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ In rare cases, some organisms that cause meningitis can be passed to people from rodents and insects.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[3] .Seizures may result from increased pressure and from areas of inflammation in the brain tissue.^ Antibiotics to treat bacterial infection Medicines to treat seizures Medicines to treat pressure on the brain Medicines to treat fever and muscle aches.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ NBC4 Columbus.com - Columbus,OH,USA Meningitis is the inflammation of the tissues which cover the brain and spinal cord.

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[4] .Focal seizures (seizures that involve one limb or part of the body), persistent seizures, late-onset seizures and those that are difficult to control with medication are indicators of a poorer long-term outcome.^ In rare cases, other bacteria cause meningitis, usually in people with long-term medical conditions.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1]
.The inflammation of the meninges may lead to abnormalities of the cranial nerves, a group of nerves arising from the brain stem that supply the head and neck area and control eye movement, facial muscles and hearing, among other functions.^ Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Meningitis , a possibly life-threatening disease, is the inflammation of the membranes (menges) and the spinal fluid that surround the brain and the spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1][6] .Visual symptoms and hearing loss may persist after an episode of meningitis (see below).^ See your doctor right away if you or your child has symptoms, because bacterial meningitis can be deadly if not treated right away.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ But it is important to see your doctor if symptoms of meningitis develop so that he or she can rule out bacterial meningitis, which is more serious.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .Inflammation of the brain (encephalitis) or its blood vessels (cerebral vasculitis), as well as the formation of blood clots in the veins (cerebral venous thrombosis), may all lead to weakness, loss of sensation, or abnormal movement or function of the part of the body supplied by the affected area in the brain.^ Shortly after exposure, lead travels in the blood to the soft tissues, such as the liver, kidneys, lungs, brain, spleen, muscles, and heart.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Most of the wells in the area are bedrock wells and, as discussed in the preceding section, the bedrock aquifer has not been affected by the contamination at the junkyard.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ The specific infective agents that are involved vary among different patient age groups, and the inflammation may evolve into ventriculitis, empyema , cerebritis, and abscess formation.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

[1][4]

Causes

.Meningitis is usually caused by infection from viruses or micro-organisms.^ Viral meningitis is caused by viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis also can be caused by other organisms and conditions .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ But exposure to an organism that causes meningitis does not mean you will get the infection.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Most cases are due to infection with viruses,[6] with bacteria, fungi, and parasites being the next most common causes.^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ A cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the clear fluid ...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[2] It may also result from various non-infectious causes.[2]

Bacterial

.The types of bacteria that cause bacterial meningitis vary by age group.^ The two main types of bacterial meningitis in the U.K. are: .

^ The type will vary depending on the bacteria causing the infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ What causes bacterial meningitis and how is it spread?

.In premature babies and newborns up to three months old, common causes are group B streptococci (subtypes III which normally inhabit the vagina and are mainly a cause during the first week of life) and those that normally inhabit the digestive tract such as Escherichia coli (carrying K1 antigen).^ People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness.

^ Could children be affected by exposures during the first years of life?
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Those traveling to countries where diseases caused by meningococcus are very common (ask your doctor).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

Listeria monocytogenes (serotype IVb) may affect the newborn and occurs in epidemics. .Older children are more commonly affected by Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (serotypes 6, 9, 14, 18 and 23) and those under five by Haemophilus influenzae type B (in countries that do not offer vaccination, see below).^ Neisseria meningitidis and Streptococcus pneumoniae bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Haemophilus influenzae type b (Hib) virus.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Most people who get bacterial meningitis get it from one of two types of bacteria: Streptococcus pneumoniae or Neisseria meningitidis .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1][3] .In adults, N. meningitidis and S. pneumoniae together cause 80% of all cases of bacterial meningitis, with increased risk of L. monocytogenes in those over 50 years old.^ Bacterial meningitis is caused by bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ What causes bacterial meningitis and how is it spread?

^ The likelihood of death from bacterial meningitis in adults is highest in those who are older than 50, have seizures during the first 24 hours of illness, delay getting treatment, are in a coma when admitted to the hospital, are in shock, or cannot breathe without help from a machine.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[3][4]
Recent trauma to the skull gives bacteria in the nasal cavity the potential to enter the meningeal space. Similarly, individuals with a cerebral shunt or related device (such as an extraventricular drain or Ommaya reservoir) are at increased risk of infection through those devices. .In these cases, infections with staphylococci are more likely, as well as infections by pseudomonas and other Gram-negative bacilli.^ People who are in poor health or have other medical conditions may be more likely to get meningitis because their bodies' natural defenses may be weak.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ People in camps, schools, and college dormitories are more likely than others to get meningitis caused by organisms that can spread easily from one person to another.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis caused by Streptococcus (S.) pneumoniae is more likely to cause death than meningitis caused by other bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[3] .The same pathogens are also more common in those with an impaired immune system.^ Immunizations against these bacteria are recommended for people who have medical conditions such as impaired immune systems or people who have had meningitis in the past.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Factors that may compromise your immune system — including AIDS, diabetes and use of immunosuppressant drugs — also make you more susceptible to meningitis.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]

^ These include people with birth defects or injuries to their skull and face, impaired immune systems , or unexpected reactions to some medicines.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .In a small proportion of people, an infection in the head and neck area, such as otitis media or mastoiditis, can lead to meningitis.^ Neuroimaging is indicated in patients who have evidence of head trauma, sinus or mastoid infection (see Images 1-4 ), skull fracture, and congenital anomalies.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Local extension from contiguous extracerebral infection (eg, otitis media, mastoiditis, or sinusitis) is a common cause.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Otitis media (silent): a potential cause of childhood meningitis.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

[3] .Recipients of cochlear implants for hearing loss are at an increased risk of pneumococcal meningitis.^ An association has been found between meningitis and cochlear implants for severe hearing loss.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Risk of bacterial meningitis in children with cochlear implants.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Having a cochlear implant for severe hearing loss.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[11]
.Tuberculous meningitis, meningitis due to infection with Mycobacterium tuberculosis, is more common in those from countries where tuberculosis is common, but is also encountered in those with immune problems, such as AIDS.^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Also at risk are older adults and people who have long-term health problems, such as a weakened immune system .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ The biggest problem with meningitis it that most of the early symptoms can be mild and similar to those you get with the flu.

[12]
.Recurrent bacterial meningitis may be caused by persisting anatomical defects, either congenital or acquired, or by disorders of the immune system.^ Bacterial meningitis is caused by bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ What causes bacterial meningitis and how is it spread?

^ Nonenhanced CT scans and magnetic resonance images (MRIs) of patients with uncomplicated acute bacterial meningitis may be unremarkable ( Image 13 ).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

[13] Anatomical defects allow continuity between the external environment and the nervous system. .The most common cause of recurrent meningitis is skull fracture,[13] particularly fractures that affect the base of the brain or extend towards the sinuses and petrous pyramids.^ Enteroviruses are the most common cause of viral meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ How Common are these Causes of Meningitis?

^ The most likely organism causing meningitis (and thus antibiotic of choice) is influenced by age e.g.

[13] .A literature review of 363 reported cases of recurrent meningitis showed that 59% of cases are due to such anatomical abnormalities, 36% due to immune deficiencies (such as complement deficiency, which predisposes especially to recurrent meningococcal meningitis), and 5% due to ongoing infections in areas adjacent to the meninges.^ Approximately half of affected adults show signs of meningeal irritation such as nuchal and/or spinal rigidity and a positive Kernig and/or Brudzinski sign.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Watchful waiting is not appropriate if you think that you or your child has meningitis, especially because you will not know whether the infection is bacterial or viral.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[13]

Aseptic

.The term aseptic meningitis refers loosely to all cases of meningitis in which no bacterial infection can be demonstrated.^ Watchful waiting is not appropriate if you think that you or your child has meningitis, especially because you will not know whether the infection is bacterial or viral.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Enhancement of the meninges is seen on contrast-enhanced CT scans and MRIs in cases of bacterial meningitis (see Images 2 , 6 , 15-17 ).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ PATTERSON Boy Dies From Suspected Case Of Bacterial Meningitis KTXL - USA http://fox40.trb.com/news/ktxl-020704meningitis,0,374645.story?coll=ktxl-news-1 .

.This is usually due to viruses, but it may be due to bacterial infection that has already been partially treated, with disappearance of the bacteria from the meninges, or by infection in a space adjacent to the meninges (e.g.^ Bacterial meningitis is treated in a hospital.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Bacterial meningitis is caused by bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ How are bacterial and viral meningitis treated?
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

sinusitis). .Endocarditis (infection of the heart valves with spread of small clusters of bacteria through the bloodstream) may cause aseptic meningitis.^ Bacterial meningitis is caused by bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ For example, a person who has come in contact with the saliva or mucus of someone with meningitis caused by Neisseria meningitidis bacteria may be given the antibiotics ciprofloxacin, ceftriaxone, or rifampin.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Gram-negative meningitis is an infection of the membranes covering the brain and spinal cord ( meninges ) caused by bac...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.Aseptic meningitis may also result from infection with spirochetes, a type of bacteria that includes Treponema pallidum (the cause of syphilis) and Borrelia burgdorferi (known for causing Lyme disease).^ This may be a result of the meningitis.

^ The type will vary depending on the bacteria causing the infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Causes Meningitis usually results from a viral infection, but the cause may also be a bacterial infection.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]

.Meningitis may be encountered in cerebral malaria (malaria infecting the brain).^ Meningitis is a serious medical condition in which the membranous tissue ( meninges ) that surrounds and protects the brain and spinal cord is infected, according to the Mayo Clinic.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ It is caused most often by viruses or bacteria that infect the tissues ( meninges ) and sometimes the fluid (cerebral spinal fluid, or CSF) that surround the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

Fungal meningitis, e.g. due to .Cryptococcus neoformans, is typically seen in people with immune deficiency such as AIDS. Amoebic meningitis, meningitis due to infection with amoebae such as Naegleria fowleri, is contracted from freshwater sources.^ Meningitis is a condition in which the meninges , a series of protective membranes around the brain and spinal cord, become inflamed due to a viral or bacterial infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Cultures of other parts of the body may be performed to detect the source of the infection that led to meningitis or encephalitis.

^ (Source: excerpt from NINDS Encephalitis and Meningitis Information Page: NINDS ) Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain.

[2]

Viral

.Viruses that can cause meningitis include enteroviruses, herpes simplex virus type 2 (and less commonly type 1), varicella zoster virus (known for causing chickenpox and shingles), mumps virus, HIV, and LCMV.^ Viral meningitis is caused by viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Many other types of viruses can cause meningitis.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[9]

Parasitic

.A parasitic cause is often assumed when there is a predominance of eosinophils in the CSF. The most common parasites implicated are Angiostrongylus cantonensis and Gnathostoma spinigerum.^ Enteroviruses are the most common cause of viral meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ It is caused most often by viruses or bacteria that infect the tissues ( meninges ) and sometimes the fluid (cerebral spinal fluid, or CSF) that surround the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ These bacteria often live in the body, most often in the nose and throat, without causing illness.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Tuberculosis, syphilis, cryptococcosis, and coccidiodomycosis are rare causes of eosinophilic meningitis that may need to be considered.^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Of the 154 causes of Meningitis that we have listed, we have the following prevalence/incidence information: 3 causes are "very common" diseases 4 causes are "common" diseases 1 causes are "uncommon" diseases 1 causes are "rare" diseases 40 causes are "very rare" diseases 120 causes have no prevalence information.

^ Why: may suggest Enterovirus as a cause of meningitis.

[14][15][16]

Non-infectious

.Meningitis may occur as the result of several non-infectious causes: spread of cancer to the meninges (malignant meningitis)[17] and certain drugs (mainly non-steroidal anti-inflammatory drugs, antibiotics and intravenous immunoglobulins).^ This may be a result of the meningitis.

^ What causes bacterial meningitis and how is it spread?

^ What causes viral meningitis and how is it spread?

[18] .It may also be caused by several inflammatory conditions such as sarcoidosis (which is then called neurosarcoidosis), connective tissue disorders such as systemic lupus erythematosus, and certain forms of vasculitis (inflammatory conditions of the blood vessel wall) such as Behçet's disease.^ Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Shortly after exposure, lead travels in the blood to the soft tissues, such as the liver, kidneys, lungs, brain, spleen, muscles, and heart.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[2] .Epidermoid cysts and dermoid cysts may cause meningitis by releasing irritant matter into the subarachnoid space.^ Why: may suggest Enterovirus as a cause of meningitis.

^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[2][13] .Mollaret's meningitis is a syndrome of recurring episodes of aseptic meningitis; it is now thought to be caused by herpes simplex virus type 2.^ For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.

^ Review the causes of these more specific types of Meningitis: Meningoencephalitis (68 causes) Aseptic meningitis (56 causes) more types...» Review causes of more specific types of Meningitis: Acute Meningitis Chronic Meningitis more types...» See full list of 13 types for Meningitis Meningitis: Symptom Checker .

^ For example, viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpes (although people with cold sores or genital herpes are not at a greater risk of developing herpes meningitis).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.Rarely, migraine may cause meningitis, but this diagnosis is usually only made when other causes have been eliminated.^ Meningitis also can be caused by other organisms and conditions .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis can also be caused by other organisms and some medicines, but this is rare.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[2]

Mechanism

.The meninges comprise three membranes that, together with the cerebrospinal fluid, enclose and protect the brain and spinal cord (the central nervous system).^ Meningitis is an infection of the coverings around the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis is an inflammation of the three membranes that cover the brain and spinal cord (the meninges ).

^ Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

The pia mater is a very delicate impermeable membrane that firmly adheres to the surface of the brain, following all the minor contours. The arachnoid mater (so named because of its spider-web-like appearance) is a loosely fitting sac on top of the pia mater. .The subarachnoid space separates the arachnoid and pia mater membranes, and is filled with cerebrospinal fluid.^ Inflammation of the arachnoid membrane and adjacent subarachnoid space.

^ Meningitis and encephalitis can also disrupt the blood-brain barrier that separates the brain from circulating blood and regulates the distribution of substances between the blood and cerebrospinal fluid (CSF) .

^ A cerebrospinal fluid (CSF) smear is a microscopic examination of the clear fluid that moves in the space surrounding...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

The outermost membrane, the dura mater, is a thick durable membrane, which is attached to both the arachnoid membrane and the skull.
.In bacterial meningitis, bacteria reach the meninges by one of two main routes: through the bloodstream or through direct contact between the meninges and either the nasal cavity or the skin.^ There are two main kinds of meningitis: .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Bacterial meningitis is caused by bacteria.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.

.In most cases, meningitis follows invasion of the bloodstream by organisms that live upon mucous surfaces such as the nasal cavity.^ The most likely organism causing meningitis (and thus antibiotic of choice) is influenced by age e.g.

^ Most healthy adults who have recovered from meningitis do not need follow-up care.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ If you live in or visit an area of the world where there are insects (such as mosquitoes and ticks) and rodents (such as mice and rats) that carry organisms that cause meningitis, take steps to avoid contact with them.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.This is often in turn preceded by viral infections, which break down the normal barrier provided by the mucous surfaces.^ See all stories on this topic: HOSPITAL Reports Spike In Viral Meningitis Cases Turn to 10.com - Providence,RI,USA ...

.Once bacteria have entered the bloodstream, they enter the subarachnoid space in places where the blood-brain barrier is vulnerable—such as the choroid plexus.^ Only a small amount is normally present in CSF because proteins are large molecules and do not cross the blood/brain barrier easily.

^ Shortly after exposure, lead travels in the blood to the soft tissues, such as the liver, kidneys, lungs, brain, spleen, muscles, and heart.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ But the bacteria can cause meningitis if they get into the bloodstream and travel to the cerebrospinal fluid or the tissues (meninges) that surround the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Meningitis occurs in 25% of newborns with bloodstream infections due to group B streptococci; this phenomenon is less common in adults.^ Meningitis is a condition in which the meninges , a series of protective membranes around the brain and spinal cord, become inflamed due to a viral or bacterial infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Two other bacteria that sometimes cause meningitis are group B streptococci and Listeria monocytogenes .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis caused by group B streptococci bacteria occurs most often in newborns, who can become infected during or after birth.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .Direct contamination of the cerebrospinal fluid may arise from indwelling devices, skull fractures, or infections of the nasopharynx or the nasal sinuses that have formed a tract with the subarachnoid space (see above); occasionally, congenital defects of the dura mater can be identified.^ You may need to drink extra liquids because infections increase the body's need for fluids.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1]
.The large-scale inflammation that occurs in the subarachnoid space during meningitis is not a direct result of bacterial infection but can rather largely be attributed to the response of the immune system to the entrance of bacteria into the central nervous system.^ WBCs may be increased with central nervous system (CNS) infections.

^ For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.

^ Infectious disease characterized by inflammation of the meninges (the tissues that surround the brain or spinal cord) usually caused by a bacterial infection; symptoms include headache and stiff neck and fever and nausea - (Source - WordNet 2.1) .

.When components of the bacterial cell membrane are identified by the immune cells of the brain (astrocytes and microglia), they respond by releasing large amounts of cytokines, hormone-like mediators that recruit other immune cells and stimulate other tissues to participate in an immune response.^ Only a small amount is normally present in CSF because proteins are large molecules and do not cross the blood/brain barrier easily.

^ The blood-brain barrier helps keep large molecules, toxins, and most blood cells away from the brain.

^ Meningitis is a condition in which the meninges , a series of protective membranes around the brain and spinal cord, become inflamed due to a viral or bacterial infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.The blood-brain barrier becomes more permeable, leading to "vasogenic" cerebral edema (swelling of the brain due to fluid leakage from blood vessels).^ Only a small amount is normally present in CSF because proteins are large molecules and do not cross the blood/brain barrier easily.

^ Shortly after exposure, lead travels in the blood to the soft tissues, such as the liver, kidneys, lungs, brain, spleen, muscles, and heart.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Meningitis is a condition in which the meninges , a series of protective membranes around the brain and spinal cord, become inflamed due to a viral or bacterial infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.Large numbers of white blood cells enter the CSF, causing inflammation of the meninges, and leading to "interstitial" edema (swelling due to fluid between the cells).^ A CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Only a small amount is normally present in CSF because proteins are large molecules and do not cross the blood/brain barrier easily.

^ Meningitis , a possibly life-threatening disease, is the inflammation of the membranes (menges) and the spinal fluid that surround the brain and the spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.In addition, the walls of the blood vessels themselves become inflamed (cerebral vasculitis), which leads to a decreased blood flow and a third type of edema, "cytotoxic" edema.^ The bacteria releases toxins into the blood, which break down the walls of the blood vessels, allowing blood to leak out under the skin (it is this leaking that causes the rash).

.The three forms of cerebral edema all lead to an increased intracranial pressure; together with the lowered blood pressure often encountered in acute infection, this means that it is harder for blood to enter the brain, and brain cells are deprived of oxygen and undergo apoptosis (automated cell death).^ He's now in a coma, the swelling in his little brain is increasing by the day, killing off cells by the minute.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Shortly after exposure, lead travels in the blood to the soft tissues, such as the liver, kidneys, lungs, brain, spleen, muscles, and heart.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Antibiotics to treat bacterial infection Medicines to treat seizures Medicines to treat pressure on the brain Medicines to treat fever and muscle aches.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1]
It is recognized that administration of antibiotics may initially worsen the process outlined above, by increasing the amount of bacterial cell membrane products released through the destruction of bacteria. .Particular treatments, such as the use of corticosteroids, are aimed at dampening the immune system's response to this phenomenon.^ In a head-to-head trial, researchers for Novartis say that the experimental meningitis vaccine Menveo produced a more potent immune response than the standard therapy in use.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[1][4]

Diagnosis

CSF findings in different forms of meningitis[19]
Type of meningitis   Glucose   Protein Cells
Acute bacterial low high PMNs,
often > 300/mm³
Acute viral normal normal or high mononuclear,
< 300/mm³
Tuberculous low high mononuclear and
PMNs, < 300/mm³
Fungal low high < 300/mm³
Malignant low high usually
mononuclear

Blood tests and imaging

In someone suspected of having meningitis, blood tests are performed for markers of inflammation (e.g. C-reactive protein, complete blood count), as well as blood cultures.[3][20]
.The most important test in identifying or ruling out meningitis is analysis of the cerebrospinal fluid through lumbar puncture (LP, spinal tap).^ Meningitis , a possibly life-threatening disease, is the inflammation of the membranes (menges) and the spinal fluid that surround the brain and the spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ A cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the clear fluid ...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure proteins, sugar (glucose), and other c...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[21] .However, lumbar puncture is contraindicated if there is a mass in the brain (tumor or abscess) or the intracranial pressure (ICP) is elevated, as it may lead to brain herniation.^ However, in some cases it can be fatal or lead to permanent handicaps like deafness and brain damage.

^ We are concerned that there may be elevated rates of cancer in this community.
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^ However, bacterial meningitis infections are extremely serious, and may result in death or brain damage even if treated.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.If someone is at risk for either a mass or raised ICP (recent head injury, a known immune system problem, localizing neurological signs, or evidence on examination of a raised ICP), a CT or MRI scan is recommended prior to the lumbar puncture.^ Also at risk are older adults and people who have long-term health problems, such as a weakened immune system .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Newborns, children younger than 2, older adults, or people with weakened immune systems are at a greater risk of death than other people.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Immunizations against these bacteria are recommended for people who have medical conditions such as impaired immune systems or people who have had meningitis in the past.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[3][20][22] This applies in 45% of all adult cases.[4] .If a CT or MRI is required before LP, or if LP proves difficult, professional guidelines suggest that antibiotics should be administered first to prevent delay in treatment,[3] especially if this may be longer than 30 minutes.^ Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics to avoid becoming infected themselves.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[20][22] .Often, CT or MRI scans are performed at a later stage to assess for complications of meningitis.^ The doctor's feared it might have been meningitis (not good) So they did blood work chest x-rays CT Scan of the brain 3 MRI's of the entire spine and a Lumbar Puncture (which I about passed out...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[1]
.In severe forms of meningitis, monitoring of blood electrolytes may be important; for example, hyponatremia is common in bacterial meningitis, due to a combination of factors including dehydration, the inappropriate excretion of the antidiuretic hormone (SIADH), or overly aggressive intravenous fluid administration.^ Meningitis is a condition in which the meninges , a series of protective membranes around the brain and spinal cord, become inflamed due to a viral or bacterial infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Both viral and bacterial meningitis are severe and potentially life-threatening illnesses that most commonly affect infants and young children.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

[4][23]

Lumbar puncture

.A lumbar puncture is done by positioning the patient, usually lying on the side, applying local anesthetic, and inserting a needle into the dural sac (a sac around the spinal cord) to collect cerebrospinal fluid (CSF).^ Cerebral spinal fluid (CSF) collection .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ This inflammation causes changes in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

When this has been achieved, the "opening pressure" of the CSF is measured using a manometer. The pressure is normally between 6 and 18 cm water (cmH2O);[21] in bacterial meningitis the pressure is typically elevated.[3][20] .The initial appearance of the fluid may prove an indication of the nature of the infection: cloudy CSF indicates higher levels of protein, white and red blood cells and/or bacteria, and therefore may suggest bacterial meningitis.^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

^ Therefore, workers who handled the waste material on the site in the past were likely to have elevated blood lead levels and may have experienced subtle neurological effects as a result.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ If tests show that PCBs are higher than normal environmental levels, this will indicate exposure to high levels of PCBs.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

[3]
Gram stain of meningococci from a culture showing Gram negative (pink) bacteria, often in pairs
.The CSF sample is examined for presence and types of white blood cells, red blood cells, protein content and glucose level.^ Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure proteins, sugar (glucose), and other c...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ A CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Blood culture Chest x-ray Head CT scan Gram-stain and culture of CSF (cerebral spinal fluid) Lumbar puncture ("spinal tap") with CSF glucose measurement and CSF cell count Meningitis has been added to your Health Portfolio.
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[3] .Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis as they are only seen in 60% of cases; this figure is reduced by a further 20% if antibiotics were administered before the sample was taken, and Gram staining is also less reliable in particular infections such as listeriosis.^ PATTERSON Boy Dies From Suspected Case Of Bacterial Meningitis KTXL - USA http://fox40.trb.com/news/ktxl-020704meningitis,0,374645.story?coll=ktxl-news-1 .

^ MENINGITIS case at Hayden Washington Square News - New York,NY,United States A female resident of Hayden residence hall was recently diagnosed with meningitis, a potentially lethal and contagious bacterial infection.

^ They were sent to Iraq just after the funeral of their eight-year-old sister Lucy, who died of meningitis shortly before Christmas last year.

Microbiological culture of the sample is more sensitive (it identifies the organism in 70–85% of cases) but results can take up to 48 hours to become available.[3] .The type of white blood cell predominantly present (see table) indicates whether meningitis is bacterial (usually neutrophil-predominant) or viral (usually lymphocyte-predominant),[3] although in the beginning of the disease this is not always a reliable indicator.^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

^ BACTERIAL meningitis suspected in Bothell boy's death Seattle Times - Seattle,WA,USA Bacterial meningitis is suspected in the death of a Bothell teen Wednesday afternoon, two days after he showed symptoms of the disease.

^ One of the worst of these nasty illnesses is bacterial meningitis, a disease which is becoming more common across the US And experts say that college students ...

Less commonly, eosinophils predominate, suggesting parasitic or fungal etiology, among others.[24]
The concentration of glucose in CSF is normally above 40% that in blood. .In bacterial meningitis it is typically lower; the CSF glucose level is therefore divided by the blood glucose (CSF glucose to serum glucose ratio).^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

^ Therefore, it is highly unlikely that neighborhood children or adults had elevated blood lead levels as a result of trespassing on the site or contacting waste on their properties .
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Blood culture Chest x-ray Head CT scan Gram-stain and culture of CSF (cerebral spinal fluid) Lumbar puncture ("spinal tap") with CSF glucose measurement and CSF cell count Meningitis has been added to your Health Portfolio.
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.A ratio ≤0.4 is indicative of bacterial meningitis;[21] in the newborn, glucose levels in CSF are normally higher, and a ratio below 0.6 (60%) is therefore considered abnormal.^ If tests show that PCBs are higher than normal environmental levels, this will indicate exposure to high levels of PCBs.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

[3] .High levels of lactate in CSF indicate a higher likelihood of bacterial meningitis, as does a higher white blood cell count.^ CSF cell count .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ HIGH School Student Dies Of Bacterial Meningitis NBC4.TV - Los Angeles,CA,USA http://www.nbc4.tv/news/2954171/detail.html .

^ The same vaccine also appeared to protect against other bacterial illnesses including meningitis, blood infections, and ear infections, the AP reported.

[21]
.Various more specialized tests may be used to distinguish between various types of meningitis.^ The soil beneath the pile was tested for PCBs, lead, and cadmium using EPA's mobile field laboratory during March and May 1999 ( Table 2a ) [3,5].
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.A latex agglutination test may be positive in meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci; its routine use is not encouraged as it rarely leads to changes in treatment, but it may be used if other tests are not diagnostic.^ Arsenic was the only other metal besides lead that exceeded a health comparison value in tests of the private wells.
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^ Causes Symptoms & Signs Exams and Tests Treatments Prognosis Possible Complications When to contact a medical professional Prevention References Disclaimer Meningitis has been added to your Health Portfolio.
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^ Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure proteins, sugar (glucose), and other c...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.Similarly, the limulus lysate test may be positive in meningitis caused by Gram-negative bacteria, but it is of limited use unless other tests have been unhelpful.^ Gram-negative meningitis is an infection of the membranes covering the brain and spinal cord ( meninges ) caused by bac...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ See also: Aseptic meningitis Meningitis - gram-negative Meningitis - H. influenzae Meningitis - meningococcal Meningitis - pneumococcal Meningitis - staphylococcal Meningitis - tuberculous .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ There are several bacteria that can cause meningitis , inclu...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[3] .Polymerase chain reaction (PCR) is a technique used to amplify small traces of bacterial DNA in order to detect the presence of bacterial or viral DNA in cerebrospinal fluid; it is a highly sensitive and specific test since only trace amounts of the infecting agent's DNA is required.^ Since lead is a common and pervasive contaminant, a small amount of lead is present in the blood of all people.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Only a small amount of arsenic will pass through human skin, so this route of exposure is usually not of concern [29].
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It may identify bacteria in bacterial meningitis and may assist in distinguishing the various causes of viral meningitis (enterovirus, herpes simplex virus 2 and mumps in those not vaccinated for this).[9] .Serology (identification of antibodies to viruses) may be useful in viral meningitis.^ Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ For example, viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpes (although people with cold sores or genital herpes are not at a greater risk of developing herpes meningitis).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[9] If tuberculous meningitis is suspected, the sample is processed for Ziehl-Neelsen stain, which has a low sensitivity, and tuberculosis culture, which takes a long time to process; PCR is being used increasingly.[12] Diagnosis of cryptococcal meningitis can be made at low cost using an India ink stain of the CSF; however, testing for cryptococcal antigen in blood or CSF is more sensitive, particularly in persons with AIDS.[25][26][27]
.A diagnostic and therapeutic conundrum is the "partially treated meningitis", where there are meningitis symptoms after receiving antibiotics (such as for presumptive sinusitis).^ Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock , and seizures .
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.When this happens, CSF findings may resemble those of viral meningitis, but antibiotic treatment may need to be continued until there is definitive positive evidence of a viral cause (e.g.^ Antibiotics are not effective in viral meningitis.
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^ Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ For example, viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpes (although people with cold sores or genital herpes are not at a greater risk of developing herpes meningitis).
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

a positive enterovirus PCR).[9]

Postmortem

Meningitis can be diagnosed after death has occurred. .The findings from a post mortem are usually a widespread inflammation of the pia mater and arachnoid layers of the meninges covering the brain and spinal cord.^ Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Tuberculous meningitis is an infection of the the membranes covering the brain and spinal cord ( meninges ).See also:Me...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ The meninges are membranous coverings of the brain that protect the brain and s...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.Neutrophil leucocytes tend to have migrated to the cerebrospinal fluid and the base of the brain, along with cranial nerves and the spinal cord, may be surrounded with pus—as may the meningeal vessels.^ Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ If someone has meningitis , it affects both the brain and spinal cord; it canno...
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Viral meningitis is the inflammation of the meninges surrounding your brain and spinal cord due to a viral infection.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[28]

Prevention

For some causes of meningitis, prophylaxis can be provided in the long term with vaccine, or in the short term with antibiotics.
.Since the 1980s, many countries have included immunization against Haemophilus influenzae type B in their routine childhood vaccination schemes.^ The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Haemophilus vaccine (HiB vaccine ) in children will help prevent one type of meningitis.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

.This has practically eliminated this pathogen as a cause of meningitis in young children in those countries.^ Before the 1990's, H.I.B. (Haemophilus Influenzae type B) was the leading cause of bacterial meningitis in children, fortunately because of immunization this type of meningitis is now very rare.

In the countries where the disease burden is highest, however, the vaccine is still too expensive.[29][30] Similarly, immunization against mumps has led to a sharp fall in the number of cases of mumps meningitis, which prior to vaccination occurred in 15% of all cases of mumps.[9]
Meningococcus vaccines exist against groups A, C, W135 and Y.[31] In countries where the vaccine for meningococcus group C was introduced, cases caused by this pathogen have decreased substantially.[29] A quadrivalent vaccine now exists, which combines all four vaccines. Immunization with the ACW135Y vaccine against four strains is now a visa requirement for taking part in the Hajj.[32] .Development of a vaccine against group B meningococci has proved much more difficult, as its surface proteins (which would normally be used to make a vaccine) only elicit a weak response from the immune system, or cross-react with normal human proteins.^ In a head-to-head trial, researchers for Novartis say that the experimental meningitis vaccine Menveo produced a more potent immune response than the standard therapy in use.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[29][31] Still, some countries (New Zealand, Cuba, Norway and Chile) have developed vaccines against local strains of group B meningococci; some have shown good results and are used in local immunization schedules.[31]
.Routine vaccination against Streptococcus pneumoniae with the pneumococcal conjugate vaccine (PCV), which is active against seven common serotypes of this pathogen, significantly reduces the incidence of pneumococcal meningitis.^ The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[29][33] .The pneumococcal polysaccharide vaccine, which covers 23 strains, is only administered in certain groups (e.g.^ The vaccine for bacterial meningitis C only protects against group C meningitis and not against type B. Type B is the most common type of meningitis in the U.K., though meningitis C causes more deaths.

those who have had a splenectomy, the surgical removal of the spleen); it does not elicit a significant immune response in all recipients, e.g. small children.[33]
.Childhood vaccination with Bacillus Calmette-Guérin has been reported to significantly reduce the rate of tuberculous meningitis, but its waning effectiveness in adulthood has prompted a search for a better vaccine.^ The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[29]
Short-term antibiotic prophylaxis is also a method of prevention, particularly of meningococcal meningitis. In cases of meningococcal meningitis, prophylactic treatment of close contacts with antibiotics (e.g. rifampicin, ciprofloxacin or ceftriaxone) can reduce their risk of contracting the condition, but does not protect against future infections.[20][34]

Treatment

Initial treatment

Meningitis is potentially life-threatening and has a high mortality rate if untreated;[3] delay in treatment has been associated with a poorer outcome.[4] Thus treatment with wide-spectrum antibiotics should not be delayed while confirmatory tests are being conducted.[22] If meningococcal disease is suspected in primary care, guidelines recommend that benzylpenicillin be administered before transfer to hospital.[7] .Intravenous fluids should be administered if hypotension (low blood pressure) or shock are present.^ Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock , and seizures .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

[22] .Given that meningitis can cause a number of early severe complications, regular medical review is recommended to identify these complications early,[22] as well as admission to an intensive care unit if deemed necessary.^ There were no independent interviews of persons living in Pelham and no medical record reviews; therefore these analyses are subject to random misclassification.
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^ For the early detection of cervical cancer, we suggest regular screening by a health care professional for individuals who are considered at increased risk based on the risk factors discussed above.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ For the early detection of colon cancer, we suggest regular screening by a health care professional for individuals who are considered at increased risk based on the risk factors discussed above.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

[4]
.Mechanical ventilation may be needed if the level of consciousness is very low, or if there is evidence of respiratory failure.^ Evidence from animal studies shows that PCBs can damage the thyroid gland and reduce the levels of thyroid hormones at exposures as low as 90 ug/kg-d [27].
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^ There is no evidence that PCBs or lead adversely affect the respiratory system [27,28].
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If there are signs of raised intracranial pressure, measures to monitor the pressure may be taken; this would allow the optimization of the cerebral perfusion pressure and various treatments to decrease the intracranial pressure with medication (e.g. mannitol).[4] Seizures are treated with anticonvulsants.[4] Hydrocephalus (obstructed flow of CSF) may require insertion of a temporary or long-term drainage device, such as a cerebral shunt.[4]

Bacterial meningitis

Antibiotics

Structural formula of ceftriaxone, one of the third-generation cefalosporin antibiotics recommended for the initial treatment of bacterial meningitis.
Empiric antibiotics (treatment without exact diagnosis) must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. The choice of initial treatment depends largely on the kind of bacteria that cause meningitis in a particular place. For instance, in the United Kingdom empirical treatment consists of a third-generation cefalosporin such as cefotaxime or ceftriaxone.[20][22] In the USA, where resistance to cefalosporins is increasingly found in streptococci, addition of vancomycin to the initial treatment is recommended.[3][4][20] Empirical therapy may be chosen on the basis of the age of the patient, whether the infection was preceded by head injury, whether the patient has undergone neurosurgery and whether or not a cerebral shunt is present.[3] .For instance, in young children and those over 50 years of age, as well as those who are immunocompromised, addition of ampicillin is recommended to cover Listeria monocytogenes.^ It can occur at any age but it is most likely to affect young children and young adults.

[3][20] .Once the Gram stain results become available, and the broad type of bacterial cause is known, it may be possible to change the antibiotics to those likely to deal with the presumed group of pathogens.^ In this subsection, we discuss the known adverse health effects that have been associated with the types of exposures that are or were possible at this site.
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^ Before the 1990's, H.I.B. (Haemophilus Influenzae type B) was the leading cause of bacterial meningitis in children, fortunately because of immunization this type of meningitis is now very rare.

^ There are two main types of meningitis, bacterial (caused by bacteria) and viral (caused by a virus).

[3]
The results of the CSF culture generally take longer to become available (24–48 hours). Once they do, empiric therapy may be switched to specific antibiotic therapy targeted to the specific causative organism and its sensitivities to antibiotics.[3] .For an antibiotic to be effective in meningitis, it must not only be active against the pathogenic bacterium, but also reach the meninges in adequate quantities; some antibiotics have inadequate penetrance and therefore have little use in meningitis.^ Antibiotics are not effective in viral meningitis.
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Most of the antibiotics used in meningitis have not been tested directly on meningitis patients in clinical trials. Rather, the relevant knowledge has mostly derived from laboratory studies in rabbits.[3]
Tuberculous meningitis requires prolonged treatment with antibiotics. While tuberculosis of the lungs is typically treated for six months, those with tuberculous meningitis are typically treated for a year or longer.[12] In tuberculous meningitis there is a strong evidence base for treatment with corticosteroids, although this evidence is restricted to those without AIDS.[35]

Steroids

.Adjuvant treatment with corticosteroids (usually dexamethasone) reduces rates of mortality, severe hearing loss and neurological damage in adolescents and adults from high income countries which have low rates of HIV.[36] The likely mechanism is suppression of overactive inflammation.^ Brain damage Hearing loss or deafness Hydrocephalus Loss of vision Meningitis has been added to your Health Portfolio.
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^ Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage.
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[37] Professional guidelines therefore recommend the commencement of dexamethasone or a similar corticosteroid just before the first dose of antibiotics is given, and continued for four days.[20][22] .Given that most of the benefit of the treatment is confined to those with pneumococcal meningitis, some guidelines suggest that dexamethasone be discontinued if another cause for meningitis is identified.^ Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.
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^ The most common causes of meningitis are viral infections that usually get better without treatment.
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^ Recently, West Nile virus , spread by mosquito bites, has become a cause of viral meningitis in most of the United States.
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[3][20]
.Adjuvant corticosteroids have a different role in children than in adults.^ Children less than 5 years old and adults over 65 years old accounted for 14% of the population.
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Though the benefit of corticosteroids has been demonstrated in adults as well as in children from high-income countries, their use in children from low-income countries is not supported by evidence; the reason for this discrepancy is not clear.[38] .Even in high-income countries, the benefit of corticosteroids is only seen when they are given prior to the first dose of antibiotics, and is greatest in cases of H. influenzae meningitis,[3][39] the incidence of which has decreased dramatically since the introduction of the Hib vaccine.^ Haemophilus vaccine (HiB vaccine ) in children will help prevent one type of meningitis.
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^ This trend is also seen in New Hampshire with a rate of 14.1 cases per 100,000 in males and only 5.8 cases per 100,000 in females with a dramatic increase in rates beginning in those age 40 years and over [22].
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^ In the case of incidence, although it is unknown for certain, it has been hypothesized that the decrease could be due to an increase in screening followed by removal of diseased polyps [17].
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Thus, corticosteroids are recommended in the treatment of pediatric meningitis if the cause is H. influenzae and only if given prior to the first dose of antibiotics, whereas other uses are controversial.[3]

Viral and fungal meningitis

Viral meningitis typically requires supportive therapy only; most viruses responsible for causing meningitis are not amenable to specific treatment. Viral meningitis tends to run a more benign course than bacterial meningitis. Herpes simplex virus and varicella zoster virus may respond to treatment with antiviral drugs such as aciclovir, but there are no clinical trials that have specifically addressed whether this treatment is effective.[9] Mild cases of viral meningitis can be treated at home with conservative measures such as fluid, bedrest, and analgesics.[40] .Fungal meningitis, such as cryptococcal meningitis, is treated with long courses of highly dosed antifungals, such as amphotericin B and flucytosine.^ Bacterial meningitis and septicaemia can kill in hours if not treated or can leave people with disabilities such as brain damage, hearing loss or learning disabilities.

[25][41]

Prognosis

Untreated, bacterial meningitis is almost always fatal. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal. .With treatment, mortality (risk of death) from bacterial meningitis depends on the age of the patient and the underlying cause.^ What causes bacterial meningitis and how is it spread?

^ Before the 1990's, H.I.B. (Haemophilus Influenzae type B) was the leading cause of bacterial meningitis in children, fortunately because of immunization this type of meningitis is now very rare.

^ There are vaccines available for H.I.B. and bacterial meningitis C. The H.I.B. vaccine is usually given to babies at the age of 2 months, along with vaccines for diphtheria , whooping cough , tetanus , and polio .

Of the newborn patients, 20–30% may die from an episode of bacterial meningitis. This risk is much lower in older children, whose mortality is about 2%, but rises again to about 19–37% in adults.[1][4] .Risk of death is predicted by various factors apart from age, such as the pathogen and the time it takes for the pathogen to be cleared from the cerebrospinal fluid,[1] the severity of the generalized illness, decreased level of consciousness or abnormally low count of white blood cells in the CSF.[4] Meningitis caused by H. influenza and meningococci has a better prognosis compared to cases caused by group B streptococci, coliforms and S. pneumoniae.^ Assuming that a relationship exists, lead exposure would be just one of many risk factors for hypertension, such as age, sex, genetics, lifestyle, sodium intake, excessive alcohol intake, obesity, and stress [40].
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^ To understand how adverse health effects could be caused by a specific chemical, it is helpful to review factors related to how the body processes such a chemical.
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[1] In adults, too, meningococcal meningitis has a lower mortality (3–7%) than pneumococcal disease.[4]
.In children there are several potential disabilities which result from damage to the nervous system.^ Complications There are several potential disabilities resulting from damage to the nervous system.

^ In children there are several potential disabilities which result from damage to the nervous system.

^ Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability.
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Sensorineural hearing loss, epilepsy, learning and behavioral difficulties, as well as decreased intelligence, occur in about 15% of survivors.[1] Some of the hearing loss may be reversible.[42] In adults, 66% of all cases emerge without disability. The main problems are deafness (in 14%) and cognitive impairment (in 10%).[4]

Epidemiology

Demography of meningococcal meningitis.     meningitis belt     epidemic zones     sporadic cases only
Disability-adjusted life year for meningitis per 100,000 inhabitants in 2002.[43]
     no data      ≤ 10      10-25      25-50      50-75      75-100      100-200      200-300      300-400      400-500      500-1000      1000-1500      ≥ 1500
.Although meningitis is a notifiable disease in many countries, the exact incidence rate is unknown.^ In the case of incidence, although it is unknown for certain, it has been hypothesized that the decrease could be due to an increase in screening followed by removal of diseased polyps [17].
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[9] .Bacterial meningitis occurs in about 3 people per 100,000 annually in Western countries.^ In New Hampshire, the rate of cervical cancer over the period of 1993-1997 is 8 cases per 100,000.
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^ Permanent brain damage can occur at BLLs as low as 100-120 micrograms of lead per deciliter of blood (ug/dL) [28].
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.Population-wide studies have shown that viral meningitis is more common, at 10.9 per 100,000, and occurs more often in the summer.^ In New Hampshire, the rate of cervical cancer over the period of 1993-1997 is 8 cases per 100,000.
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^ Permanent brain damage can occur at BLLs as low as 100-120 micrograms of lead per deciliter of blood (ug/dL) [28].
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.In Brazil, the rate of bacterial meningitis is higher, at 45.8 per 100,000 annually.^ In New Hampshire, the rate of cervical cancer over the period of 1993-1997 is 8 cases per 100,000.
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^ This trend is also seen in New Hampshire with a rate of 14.1 cases per 100,000 in males and only 5.8 cases per 100,000 in females with a dramatic increase in rates beginning in those age 40 years and over [22].
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^ Nationally, the Surveillance Epidemiology and End Results (SEER) program data for cervical cancer over the period of 1973-1997 indicates that for white females, the age-adjusted rate is 7.1 cases per 100,000 [25].
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.In sub-Saharan Africa, large epidemics of meningococcal meningitis occur in the dry season, leading to it being labeled the "meningitis belt"; annual rates of 500 cases per 100,000 are encountered in this area, which is poorly served by medical care.^ In New Hampshire, the rate of cervical cancer over the period of 1993-1997 is 8 cases per 100,000.
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^ In 2000, it is estimated that approximately 12,800 new cases of cervical cancer will be diagnosed in the United States, with 100 of those being diagnosed in New Hampshire [17].
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^ The five-year survival rate for invasive cervical cancer is 70% however for those cases of cervical cancer detected in situ (confined to original tissues) the survival rate approaches 100%.
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These cases are predominantly caused by meningococci.[6] The most recent epidemic, affecting Nigeria, Niger, Mali and Burkina Faso, started in January 2009 and is ongoing.[44]
Meningococcal disease occurs in epidemics in areas where many people live together for the first time, such as army barracks during mobilization, college campuses[1] and the annual Hajj pilgrimage.[32]
.There are significant differences in the local distribution of causes for bacterial meningitis.^ However, there is controversy about the cause and significance of this association [28].
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.For instance, N. meningitides groups B and C cause most disease episodes in Europe, while group A meningococci are more common in China and amongst Hajj pilgrims.^ This has been attributed to more frequent use of Pap screening, which detects early stages of the disease when it is most curable [17].
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In the "meningitis belt" of Africa, group A and C meningococci cause most of the outbreaks. Group W135 meningococci have caused several recent epidemics in Africa and during the Hajj.[29] These differences are expected to change further as vaccines against common strains are introduced.[29]

History

Some suggest that Hippocrates may have realized the existence of meningitis,[6] and it seems that meningism was known to pre-Renaissance physicians such as Avicenna.[45] The description of tuberculous meningitis, then called "dropsy in the brain", is often attributed to Edinburgh physician Sir Robert Whytt in a posthumous report that appeared in 1768, although the link with tuberculosis and its pathogen was not made until the next century.[45][46]
It appears that epidemic meningitis is a relatively recent phenomenon.[47] The first recorded major outbreak occurred in Geneva in 1805.[47][48] Several other epidemics in Europe and the United States were described shortly afterward, and the first report of an epidemic in Africa appeared in 1840. African epidemics became much more common in the 20th century, starting with a major epidemic sweeping Nigeria and Ghana in 1905–1908.[47]
The first report of bacterial infection underlying meningitis was by the Austrian bacteriologist Anton Weichselbaum, who in 1887 described the meningococcus.[49] Mortality from meningitis was very high (over 90%) in early reports. In 1906, antiserum was produced in horses; this was developed further by the American scientist Simon Flexner and markedly decreased mortality from meningococcal disease.[50][51] In 1944, penicillin was first reported to be effective in meningitis.[52] The introduction in the late 20th century of Haemophilus vaccines led to a marked fall in cases of meningitis associated with this pathogen,[30] and in 2002 evidence emerged that treatment with steroids could improve the prognosis of bacterial meningitis.[37][38][51]

See also

References

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  2. ^ a b c d e f g Ginsberg L (March 2004). "Difficult and recurrent meningitis". Journal of Neurology, Neurosurgery, and Psychiatry 75 Suppl 1: i16–21. doi:10.1136/jnnp.2003.034272. PMID 14978146. PMC 1765649. http://jnnp.bmj.com/cgi/content/full/75/suppl_1/i16. 
  3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab Tunkel AR, Hartman BJ, Kaplan SL, et al. (November 2004). "Practice guidelines for the management of bacterial meningitis". Clinical Infectious Diseases 39 (9): 1267–84. doi:10.1086/425368. PMID 15494903. http://www.journals.uchicago.edu/doi/full/10.1086/425368. 
  4. ^ a b c d e f g h i j k l m n o p q r s t u van de Beek D, de Gans J, Tunkel AR, Wijdicks EF (January 2006). "Community-acquired bacterial meningitis in adults". The New England Journal of Medicine 354 (1): 44–53. doi:10.1056/NEJMra052116. PMID 16394301. 
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  11. ^ Wei BP, Robins-Browne RM, Shepherd RK, Clark GM, O'Leary SJ (January 2008). "Can we prevent cochlear implant recipients from developing pneumococcal meningitis?". Clin. Infect. Dis. 46 (1): e1–7. doi:10.1086/524083. PMID 18171202. http://www.journals.uchicago.edu/doi/full/10.1086/524083. 
  12. ^ a b c Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J (March 2000). "Tuberculous meningitis". Journal of Neurology, Neurosurgery, and Psychiatry 68 (3): 289–99. doi:10.1136/jnnp.68.3.289. PMID 10675209. PMC 1736815. http://jnnp.bmj.com/cgi/content/full/68/3/289. 
  13. ^ a b c d e Tebruegge M, Curtis N (July 2008). "Epidemiology, etiology, pathogenesis, and diagnosis of recurrent bacterial meningitis". Clinical Microbiology Reviews 21 (3): 519–37. doi:10.1128/CMR.00009-08. PMID 18625686. 
  14. ^ Panackel C, Vishad, Cherian G, Vijayakumar K, Sharma RN (2006). "Eosinophilic meningitis due to Angiostrongylus cantonensis". Ind J Med Microbiol 24 (3): 220–1. PMID 16912445. 
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  17. ^ Chamberlain MC (May 2005). "Neoplastic meningitis". Journal of Clinical Oncology 23 (15): 3605–13. doi:10.1200/JCO.2005.01.131. PMID 15908671. 
  18. ^ Moris G, Garcia-Monco JC (June 1999). "The Challenge of Drug-Induced Aseptic Meningitis". Archives of Internal Medicine 159 (11): 1185–94. doi:10.1001/archinte.159.11.1185. PMID 10371226. http://archinte.ama-assn.org/cgi/content/full/159/11/1185. 
  19. ^ Provan, Drew; Andrew Krentz (2005). Oxford Handbook of Clinical and Laboratory Investigation. Oxford: Oxford University Press. ISBN 0198566638. 
  20. ^ a b c d e f g h i j Chaudhuri A, Martinez-Martin P, Martin PM, et al. (July 2008). "EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults". European Journal of Neurolology 15 (7): 649–59. doi:10.1111/j.1468-1331.2008.02193.x. PMID 18582342. 
  21. ^ a b c d Straus SE, Thorpe KE, Holroyd-Leduc J (October 2006). "How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis?". JAMA : the journal of the American Medical Association 296 (16): 2012–22. doi:10.1001/jama.296.16.2012. PMID 17062865. 
  22. ^ a b c d e f g Heyderman RS, Lambert HP, O'Sullivan I, Stuart JM, Taylor BL, Wall RA (February 2003). "Early management of suspected bacterial meningitis and meningococcal septicaemia in adults". The Journal of infection 46 (2): 75–7. doi:10.1053/jinf.2002.1110. PMID 12634067.  – formal guideline at British Infection Society & UK Meningitis Research Trust (December 2004). "Early management of suspected meningitis and meningococcal septicaemia in immunocompetent adults". British Infection Society Guidelines. http://www.britishinfectionsociety.org/drupal/sites/default/files/MeningitisAlgorithm03.pdf. Retrieved 2008-10-19. 
  23. ^ Maconochie I, Baumer H, Stewart ME (2008). "Fluid therapy for acute bacterial meningitis". Cochrane Database Syst Rev (1): CD004786. doi:10.1002/14651858.CD004786.pub3. PMID 18254060. 
  24. ^ Weller PF, Liu LX (June 1993). "Eosinophilic meningitis". Semin Neurol 13 (2): 161–8. PMID 8356350. 
  25. ^ a b Bicanic T, Harrison TS (2004). "Cryptococcal meningitis". British Medical Bulletin 72: 99–118. doi:10.1093/bmb/ldh043. PMID 15838017. http://bmb.oxfordjournals.org/cgi/content/full/72/1/99. 
  26. ^ Saag MS, Graybill RJ, Larsen RA, et al. (April 2000). "Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America". Clin. Infect. Dis. 30 (4): 710–8. doi:10.1086/313757. PMID 10770733. http://www.journals.uchicago.edu/doi/full/10.1086/313757. 
  27. ^ Sloan D, Dlamini S, Paul N, Dedicoat M (2008). "Treatment of acute cryptococcal meningitis in HIV infected adults, with an emphasis on resource-limited settings". Cochrane Database Syst Rev (4): CD005647. doi:10.1002/14651858.CD005647.pub2. PMID 18843697. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005647/frame.html. 
  28. ^ Warrell, David A; et al. (2003). Oxford Textbook of Medicine Volume One. Oxford. pp. 1115–29. ISBN 0-19852787-X. 
  29. ^ a b c d e f g Segal S, Pollard AJ (2004). "Vaccines against bacterial meningitis". British Medical Bulletin 72: 65–81. doi:10.1093/bmb/ldh041. PMID 15802609. http://bmb.oxfordjournals.org/cgi/content/full/72/1/65. 
  30. ^ a b Peltola H (April 2000). "Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates". Clinical Microbiology Reviews 13 (2): 302–17. doi:10.1128/CMR.13.2.302-317.2000. PMID 10756001. PMC 100154. http://cmr.asm.org/cgi/content/full/13/2/302. 
  31. ^ a b c Harrison LH (January 2006). "Prospects for vaccine prevention of meningococcal infection". Clinical microbiology reviews 19 (1): 142–64. doi:10.1128/CMR.19.1.142-164.2006. PMID 16418528. PMC 1360272. http://cmr.asm.org/cgi/content/full/19/1/142. 
  32. ^ a b Wilder-Smith A (October 2007). "Meningococcal vaccine in travelers". Current Opinion in Infectious Diseases 20 (5): 454–60. doi:10.1097/QCO.0b013e3282a64700. PMID 17762777. 
  33. ^ a b Weisfelt M, de Gans J, van der Poll T, van de Beek D (April 2006). "Pneumococcal meningitis in adults: new approaches to management and prevention". Lancet Neurol 5 (4): 332–42. doi:10.1016/S1474-4422(06)70409-4. PMID 16545750. 
  34. ^ Fraser A, Gafter-Gvili A, Paul M, Leibovici L (2006). "Antibiotics for preventing meningococcal infections". Cochrane Database of Systematic Reviews (Online) (4): CD004785. doi:10.1002/14651858.CD004785.pub3. PMID 17054214. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004785/frame.html. 
  35. ^ Prasad K, Singh MB (2008). "Corticosteroids for managing tuberculous meningitis". Cochrane Database of Systematic Reviews (Online) (1): CD002244. doi:10.1002/14651858.CD002244.pub3. PMID 18254003. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD002244/frame.html. 
  36. ^ Assiri AM, Alasmari FA, Zimmerman VA, Baddour LM, Erwin PJ, Tleyjeh IM (May 2009). "Corticosteroid administration and outcome of adolescents and adults with acute bacterial meningitis: a meta-analysis". Mayo Clin. Proc. 84 (5): 403–9. doi:10.4065/84.5.403. PMID 19411436. 
  37. ^ a b de Gans J, van de Beek D (November 2002). "Dexamethasone in adults with bacterial meningitis". The New England Journal of Medicine 347 (20): 1549–56. doi:10.1056/NEJMoa021334. PMID 12432041. http://content.nejm.org/cgi/content/full/347/20/1549. 
  38. ^ a b van de Beek D, de Gans J, McIntyre P, Prasad K (2007). "Corticosteroids for acute bacterial meningitis". Cochrane Database of Systematic Reviews (Online) (1): CD004405. doi:10.1002/14651858.CD004405.pub2. PMID 17253505. 
  39. ^ McIntyre PB, Berkey CS, King SM, et al. (September 1997). "Dexamethasone as adjunctive therapy in bacterial meningitis. A meta-analysis of randomized clinical trials since 1988". JAMA 278 (11): 925–31. doi:10.1001/jama.278.11.925. PMID 9302246. 
  40. ^ "Meningitis and Encephalitis Fact Sheet". National Institute of Neurological Disorders and Stroke (NINDS). 2007-12-11. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm. Retrieved 2009-04-27. 
  41. ^ Gottfredsson M, Perfect JR (2000). "Fungal meningitis". Seminars in Neurology 20 (3): 307–22. doi:10.1055/s-2000-9394. PMID 11051295. 
  42. ^ Richardson MP, Reid A, Tarlow MJ, Rudd PT (February 1997). "Hearing loss during bacterial meningitis". Archives of Disease in Childhood 76 (2): 134–38. doi:10.1136/adc.76.2.134. PMID 9068303. PMC 1717058. http://adc.bmj.com/cgi/content/full/76/2/134. 
  43. ^ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls. 
  44. ^ "Meningococcal Disease: situation in the African Meningitis Belt". WHO. http://www.who.int/csr/don/2009_03_25/en/index.html. Retrieved 2009-03-29. 
  45. ^ a b Arthur Earl Walker, Edward R. Laws, George B. Udvarhelyi (1998). "Infections and inflammatory involvement of the CNS". The Genesis of Neuroscience. Thieme. pp. 219–21. ISBN 1-879-28462-6. http://books.google.co.uk/books?id=UaSaRzw8gYEC&pg=PP1&lr=#PPA219,M1. 
  46. ^ Whytt R (1768). Observations on the Dropsy in the Brain. Edinburgh: J. Balfour. 
  47. ^ a b c Greenwood B (June 2006). "100 years of epidemic meningitis in West Africa – has anything changed?". Tropical Medicine & International health: TM & IH 11 (6): 773–80. doi:10.1111/j.1365-3156.2006.01639.x. PMID 16771997. http://www3.interscience.wiley.com/cgi-bin/fulltext/118598775/HTMLSTART. 
  48. ^ Vieusseux G (1806). "Memoire sur la maladie qui regnéà Geneve au printemps de 1805". Journal de Médecine, de Chirurgie et de Pharmacologie (Bruxelles) 11: 50–53. 
  49. ^ Weichselbaum A (1887). "Ueber die Aetiologie der akuten Meningitis cerebro-spinalis". Fortschrift der Medizin 5: 573–583. 
  50. ^ Flexner S (1913). "The results of the serum treatment in thirteen hundred cases of epidemic meningitis" (PDF). J Exp Med 17: 553–76. doi:10.1084/jem.17.5.553. http://jem.rupress.org/cgi/reprint/17/5/553. 
  51. ^ a b Swartz MN (October 2004). "Bacterial meningitis--a view of the past 90 years". The New England Journal of Medicine 351 (18): 1826–28. doi:10.1056/NEJMp048246. PMID 15509815. 
  52. ^ Rosenberg DH, Arling PA (1944). "Penicillin in the treatment of meningitis". JAMA 125: 1011–1017.  reproduced in Rosenberg DH, Arling PA (April 1984). "Penicillin in the treatment of meningitis". JAMA 251 (14): 1870–6. doi:10.1001/jama.251.14.1870. PMID 6366279. 

External links



1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

Medical warning!
This article is from the 1911 Encyclopaedia Britannica. Medical science has made many leaps forward since it has been written. .This is not a site for medical advice, when you need information on a medical condition, consult a professional instead.^ In no event will The Integrated Medical Clinic be liable for any decision made or action taken in reliance upon the information provided through this web site.
  • dreddyclinic.com - Meningitis 28 January 2010 0:27 UTC www.dreddyclinic.com [Source type: FILTERED WITH BAYES]

^ NOTE: All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions.
  • Immunizations Branch, Medical Terminology Definitions 28 January 2010 0:27 UTC www.dshs.state.tx.us [Source type: Academic]

^ You can experience iron overload if you have one of these conditions and use large amounts of vitamin C. For more information see the Safety Appendix .
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

MENINGITIS (from Gr. .,Avcy , a membrane), a term in medicine applied to inflammation affecting the membranes of the brain (cerebral meningitis) or spinal cord (spinal meningitis) or both.^ Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord.
  • Meningitis 2007-09-01 00:00:00.0 28 January 2010 0:27 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

^ Meningitis is an infection of the coverings around the brain and spinal cord.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Meningitis is an inflammation of the three membranes that cover the brain and spinal cord (the meninges ).

.Tubercular cerebral meningitis (or Acute Hydrocephalus) is a disease due to inflammation of the meninges of the brain produced by the presence of a tubercle bacillus.^ Meningitis is an inflammation of the meninges, the membranes that surround the brain.
  • Meningitis, Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 28 January 2010 0:27 UTC www.rwjuh.edu [Source type: Academic]

^ Otherwise, the CT or MRI should be performed after the LP, with MRI preferred over CT due to its superiority in demonstrating areas of cerebral edema, ischemia, and meningeal inflammation.

^ These include sensorineural hearing loss, epilepsy, diffuse brain swelling, hydrocephalus, cerebral vein thrombosis, intra cerebral bleeding and cerebral palsy.

.This disease is most common in children under ten years of age, but may affect adults.^ Most cases are seen in children under age 16.
  • Meningitis and Encephalitis Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS) 28 January 2010 0:27 UTC www.ninds.nih.gov [Source type: Academic]

^ Acute bacterial meningitis is most common in children aged 1 month to 2 years.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Most infections occur in children under the age of 5.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

The tubercular constitution is an important factor in this malady. .In numerous cases it is manifestly connected with bad hygienic conditions, with insufficient or improper feeding, or with over exercise of the mental powers, all of which will doubtless more readily exert their influence where an inherited liability exists, and the same may be said regarding its occasional occurrence as one of the after consequences of certain of the diseases of childhood, especially measles and whooping-cough.^ The largest epidemic outbreak was in 1996, when over 250,000 cases occurred and 25,000 people died as a consequence of the disease.

^ Health insurance is important to everyone, especially people with chronic conditions like Crohn's disease and ulcerative colitis.
  • Meningitis - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: General]
  • Meningitis Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Most cases of bacterial meningitis are localized over the dorsum of the brain; however, under certain conditions, meningitis may be concentrated at the base of the brain, such as with fungal diseases and tuberculosis (TB).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.There are certain typical features characterizing the disease in each of its stages.^ There are typically no physical symptoms associated with cervical cancer until late stage disease, however there are medical tests that can be performed to determine the presence of the cancerous cells in the cervix [23].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.The premonitory symptoms are mostly such as relate to the general nutrition.^ In newborns, symptoms such as lethargy, irritability, tremors, seizures, and poor feeding generally develop between 4 and 11 days after delivery.
  • Meningitis and Encephalitis Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS) 28 January 2010 0:27 UTC www.ninds.nih.gov [Source type: Academic]

A falling off in flesh and failure of strength are often observed for a considerable time before the characteristic phenomena of the disease appear. The patient, if a child, becomes listless and easily fatigued, loses appetite, and is restless at night. .There is headache after exertion, and the child becomes unusually irritable.^ The child exhibited lethargy, vomiting, headache, dry cough, fever, irritability, and meningeal irritation.
  • Meningitis & vaccine citations 28 January 2010 0:27 UTC www.whale.to [Source type: Academic]

.These symptoms may persist during many weeks; but on the other hand such premonitory indications may be entirely wanting, and the disease be developed to all appearance suddenly.^ But note: not all symptoms may occur.
  • Meningitis and Septicaemia | Health | Patient UK 28 January 2010 0:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ The symptoms of bacterial meningitis usually develop suddenly and last for 2 to 3 weeks.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Symptoms can occur in any order, and not all may occur.
  • Meningitis and Septicaemia | Health | Patient UK 28 January 2010 0:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

.The onset is in most instances marked by the occurrence of vomiting, often severe, but sometimes only slight, and there is in general obstinate constipation.^ Although there are many potential pathogens that can complicate AIDS, in most circumstances only a very limited number affect the brain.

^ Fungal meningitis is the most rare form and generally occurs only in people with weak immune systems, such as people with AIDS. .
  • GHI Your Health: Meningitis Basics 28 January 2010 0:27 UTC www.ghi.com [Source type: Academic]

^ The clinical manifestations of symptomatic primary HIV infection are myriad and most often include the acute onset of fever, generalized lymphadenopathy, pharyngitis, erythematous maculopapular rash.

.In not a few cases the first symptoms are convulsions, which, however, may in this early stage subside, and remain absent, or reappear at a later period.^ Treatment may be delayed if the cause of early symptoms is not clear at first.
  • Meningitis and Septicaemia | Health | Patient UK 28 January 2010 0:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ However, in some cases, the disease progresses so rapidly that death occurs during the first 48 hours, despite early treatment.
  • Meningitis Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Other symptoms that may occur in older children and adults Fever and shivering - however, the hands and feet often feel cold.
  • Meningitis and Septicaemia | Health | Patient UK 28 January 2010 0:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

.Headache is one of the most constant of the earlier symptoms, and is generally intense and accompanied with sharper paroxysms, which cause the patient to scream, with a peculiar and characteristic cry.^ Infection with C. neoformans is the most common systemic fungal infection in patients infected with HIV and the most common cause of meningitis ( 1 ).

^ The most common ones in children are: Neisseria meningitidis (causing meninogcoccal meningitis) Streptococcus pneumonia .
  • Parenting and Child Health - Health Topics - Meningitis 28 January 2010 0:27 UTC www.cyh.com [Source type: FILTERED WITH BAYES]

^ Other than the most likely cause, what are possible causes for my symptoms or condition?
  • Meningitis | Health Book 28 January 2010 0:27 UTC www.thebookonbush.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

There is great intolerance of light and sound, and general nervous sensitiveness. .Fever is present to a greater or less extent, the temperature ranging from 100° to 103° F.; yet the pulse is not quickened in proportion, being on the contrary rather slow, but exhibiting a tendency to irregularity, and liable to become rapid on slight exertion.^ A 29-day-old male infant was brought to the office with a history of tympanic fever ranging up to 37.7°C (100.0°F) for two days.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ If you measure by rectum (bum) or by ear, fever means a temperature over 38°C (100.4°F).
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

The breathing, too, is somewhat irregular. .Symptoms of this character, constituting the stage of excitement, continue for a period varying from one to two weeks, when they are succeeded by the stage of depression.^ Enterovirus meningitis usually occurs in the summer and fall, with acute onset of symptoms that last one to two weeks.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Meningitis symptoms may develop over a period of one or two days and typically include: .
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

.There is now a marked change in the symptoms, which is apt to lead to the belief that a favourable turn has taken place.^ Your doctor will want to know if you had cold or flu-like symptoms leading up to the symptoms you're experiencing now.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

The patient becomes quieter and inclines to sleep, but it will be found on careful watching that this quietness is but a condition of apathy or partial stupor into which the child has sunk. .The vomiting has ceased, and there is less fever; the pulse is slower, and shows a still greater tendency to irregularity than before, while the breathing is of markedly unequal character, being rapid and shallow at one time, and long drawn out and sinking away at another.^ Would there be any effects for teens who used to occasionally (less than 10 times) play on the site?
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ In fact, pregnant women have a 20 times greater risk of becoming ill from this bacterium than other adults do.
  • dreddyclinic.com - Meningitis 28 January 2010 0:27 UTC www.dreddyclinic.com [Source type: FILTERED WITH BAYES]

^ Skin discoloration effects began to be observed only for exposures 10 times greater than these.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.There is manifestly little suffering, although the peculiar cry may still be uttered, and the patient lies prostrate, occasionally rolling the head uneasily upon the pillow, or picking at the bedclothes or at his face with his fingers.^ Babies also may have a stiff body and bulging soft spots on their heads that are not caused by crying.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Although cerebrospinal fluid values may help to differentiate bacterial from viral etiologies, culture is still the gold standard.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Occasionally, if the patient has been taking antibiotics for another infection, the symptoms can take longer to develop or they may be less intense.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

He does not ask for food, but readily swallows what is offered. The countenance is pale, but is apt to flush up suddenly for a time. The eyes present important alterations, the pupils being dilated or unequal, and scarcely responding to light. There may be double vision, or partial or complete blindness. .Squinting is common in this stage, and there may also be drooping of an eyelid, due to paralysis of the part, and one or more limbs may be likewise paralysed.^ In cases of acute septicaemia there may be severe tissue damage and so you may need skin grafts or to have a limb or digit amputated .

^ Posted On May 12, 2008 12:08:23 AM My prayers are with your family Hang in there Read More .
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ One quarter of affected patients have a fulminant onset within 24 hours of infection, and there may be a history of a respiratory illness within the preceding 7 days (50%).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

To this succeeds the third or final stage, in which certain of the former symptoms recur, while others become intensified. .There is generally a return of the fever, the temperature rising sometimes very high.^ High temperature and fever.

^ That quick meningitis shot will likely prevent him from dealing with the headaches, vomiting and high fevers associated with the disease, which sometimes lasts ...

The pulse becomes feeble, rapid, and exceedingly irregular, as is also the case with the breathing. .Coma is profound, brit yet the patient may still be got to swallow nourishment, though not so readily as before.^ If the patient is very sick and bacterial meningitis is suspected (but not yet proven with a culture), antibiotics are generally started before the specific bacteria are identified.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

Convulsions are apt to occur, while paralysis, more or less extensive, affects portions of the body or groups of muscles. The pupils are now. widely dilated, and there is generally complete blindness and often deafness. In this condition the patient's strength undergoes rapid decline, and the body becomes markedly emaciated. Death takes place either suddenly in a fit, or more gradually from exhaustion. .Shortly before death it is not uncommon for the patient, who, it may be for many days previously, lay in a state of profound stupor, to awake up, ask for food, and talk to those around.^ Patients diagnosed with mild viral meningitis may improve quickly enough to not require admission to a hospital, whilst others may be hospitalised for many more days for observation and supportive care.

^ They were sent to Iraq just after the funeral of their eight-year-old sister Lucy, who died of meningitis shortly before Christmas last year.

^ METHODS: We performed a cohort study of all patients who received a diagnosis of postoperative meningitis from January 1998 through May 2005 in a teaching hospital....
  • Meningitis - Kosmix : Reference, Videos, Images, News, Shopping and more... 28 January 2010 0:27 UTC health.kosmix.com [Source type: FILTERED WITH BAYES]

.The duration of a case varies somewhat, but in general death takes place within three weeks from the onset of the symptoms.^ People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness.

^ Enterovirus meningitis usually occurs in the summer and fall, with acute onset of symptoms that last one to two weeks.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ With mild cases of viral meningitis, you may need only home treatment and can recover within 2 weeks.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.The disease may be said to be almost invariably fatal, yet cases presenting all the principal symptoms occasionally recover.^ The five-year relative survival rate is 53%, with half of all cases diagnosed in the late stage of disease [17,22].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ These two risk factors, when they are combined, multiply the risk for this disease and account for approximately 75% of all cases on oral cancer in the United States [21].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Occasionally, if the patient has been taking antibiotics for another infection, the symptoms can take longer to develop or they may be less intense.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.Much may be done in the way of prevention of this disease, and, in its earlier stages, even in the way of cure.^ This suggests that genistein may help reduce the severity of the disease and have a preventative effect (Sokolova O et al 2004).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Too much TV may mean earlier death 9 Miep Gies, Anne Frank protector, dies...
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

^ Unfortunately, there has been no screening tool developed for the early detection of this type of cancer, therefore prevention is the best way to reduce incidence of the disease.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.It is most important in families where the history indicates a tuberculous or scrofulous tendency, and particularly where acute hydrocephalus has already occurred, that every effort should be used to fortify the system and avoid the causes already alluded to as favouring the development of the disease during that period in which children are liable to suffer from it.^ However, in some cases, the disease progresses so rapidly that death occurs during the first 48 hours, despite early treatment.
  • Meningitis Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: Academic]

^ As the focal point of tradition in Japan, during the Tokugawa Shogunate the family was denied modern "Dutch" medical treatment then in use among the upper caste; despite extensive modernization during the Meiji Restoration the Emperor insisted on traditional medical care for his children.

^ Those that contract the disease during the neonatal period and those infected by S. pneumoniae and gram negative bacilli are at greater risk of developing neurological, auditory, or intellectual impairments or functionally important behaviour or learning disorders which can manifest as poor school performance.

With this view wholesome food, warm clothing, cleanliness, regularity,:and the avoidance of over-exertion, physical and mental, are of the utmost consequence.
.Timely use of remedies may mitigate and even occasionally remove the symptoms when they arise.^ The majority of people with viral meningitis will make a full recovery, though they may feel severely weak and depressed for a short period of time afterwards.

^ People who suffer a mild attack of viral meningitis, may not even need to go to their doctor, so they won't realise they have had meningitis.

^ Occasionally, if the patient has been taking antibiotics for another infection, the symptoms can take longer to develop or they may be less intense.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.The maintenance of the patient's strength by light nourishment and the use of sedatives to compose the nervous system are the measures most likely to be attended with success.^ Infection with C. neoformans is the most common systemic fungal infection in patients infected with HIV and the most common cause of meningitis ( 1 ).

^ The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) is the most commonly used system of classification for the worlds illnesses.

^ Neurological examinations may be performed to assess the status of the patient’s nervous system, their sensory and motor function, coordination, vision, hearing, strength and mental status.
  • Meningitis - Kosmix : Reference, Videos, Images, News, Shopping and more... 28 January 2010 0:27 UTC health.kosmix.com [Source type: FILTERED WITH BAYES]

Bromide, combined with iodide of potassium, is the medicinal agent of most value for this purpose. Should convulsions occur, they are best treated by chloral or chloroform.
.In what is known as suppurative, or simple acute meningitis (non-tubercular), the disease arises from various causes, and the symptoms are similar to those described above.^ Many bacteria are known to cause disease.
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

^ Other clues to the nature of the cause may be the skin signs of hand, foot and mouth disease and genital herpes, both of which may be associated with viral meningitis.

^ Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite, and corticosteroids may help reduce inflammation of the meninges, depending on the cause of the disease.
  • Meningitis 2007-09-01 00:00:00.0 28 January 2010 0:27 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

.In posterior-basic meningitis, inflammation of the membranes investing the posterior basic spinal cord, the chief symptoms are fever, with severe pain in the back or loins shooting downwards into the limbs (which are the seat of frequent painful involuntary startings), accompanied with a feeling of tightness round the body.^ Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord.
  • Meningitis 2007-09-01 00:00:00.0 28 January 2010 0:27 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

^ The major symptoms of meningitis are severe headache, neck pain, and fever.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Meningitis is inflammation of the tissue covering the brain and spinal cord (the meninges).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

The local symptoms bear reference to the portion of the cord the membranes of which are involved. .Thus when the inflammation is located in the cervical portion the muscles of the arms and chest are spasmodically contracted, and there may be difficulty of swallowing or breathing, or embarrassed heart's action, while when the disease is seated in the lower portion, the lower limbs and the bladder and rectum are the parts affected in this way.^ Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ In cases of acute septicaemia there may be severe tissue damage and so you may need skin grafts or to have a limb or digit amputated .

^ Some kids may need supplemental oxygen or mechanical ventilation if they have difficulty breathing.
  • Meningitis 2007-09-01 00:00:00.0 28 January 2010 0:27 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

At first there is excited sensibility (hyperaesthesia) in the parts of the surface of the body in relation with the portion of cord affected. .As the disease advances these symptoms give place to those of partial loss of power in the affected muscles, and also partial anaesthesia.^ Eye symptoms Mouth and Throat Hearing and Ear symptoms Joint symptoms Heart symptoms Muscle symptoms Skin symptoms Respiratory symptoms Digestive symptoms Urinary symptoms   Diseases .

.These various phenomena may entirely pass away, and the patient after some weeks or months recover; or, on the other hand, they may increase, and end in permanent paralysis.^ People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness.

^ Within 1 week of presentation; some authorities would not perform a lumbar puncture on patients with prolonged seizures or would delay lumbar puncture for 30 minutes in patients with short, convulsive seizures .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

^ However, in the future, groundwater contamination may spread and impact some of these wells.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.Some observers regard these forms as sporadic cases of cerebrospinal fever; and Still, William Hunter and George Nuttall have isolated an organism similar to the diplococcus intracellularis, while Henry Koplik in New York found cases of typical posteriorbasic meningitis due to the diplococcus intracellularis.^ These are some ways to prevent meningitis from spreading: .
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

^ PATTERSON Boy Dies From Suspected Case Of Bacterial Meningitis KTXL - USA http://fox40.trb.com/news/ktxl-020704meningitis,0,374645.story?coll=ktxl-news-1 .

^ Some of the comorbid or associated medical symptoms for Meningitis may include these symptoms: Head symptoms Brain symptoms Pain Fever Nerve symptoms Temperature symptoms more associated symptoms...» All associated co-morbid symptoms for Meningitis Causes of General Symptom Types .

The treatment is directed to allaying the pain and inflammatory action by opiates. Ergot is recommended by many physicians. The patient should have perfect rest in the recumbent, or better still in the prone, position. .Cold applications to the spine may be of use, while attention to the functions of the bladder and bowels, and to the condition of the skin with the view of preventing bedsores, is all-important.^ During the exam, your doctor may check for signs of infection around the head, ears, throat and the skin along the spine.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

^ The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs.
  • Meningitis - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: General]
  • Meningitis Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: Academic]

.Cerebro-spinal fever or epidemic cerebro-spinal meningitis, popularly called "spotted fever," is an infectious disease occurring sporadically or in epidemics, and due to the diplococcus intracellularis discovered by Weichselbaum in 1887. This disease was not recognized until the 19th century.^ Spinal meningitis is an infectious disease.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ Bacterial meningitis Acute bacterial meningitis usually occurs when bacteria enter the bloodstream and migrate to the brain and spinal cord.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

^ Infectious disease characterized by inflammation of the meninges (the tissues that surround the brain or spinal cord) usually caused by a bacterial infection; symptoms include headache and stiff neck and fever and nausea - (Source - WordNet 2.1) .
  • Meningitis - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: General]
  • Meningitis Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 28 January 2010 0:27 UTC www.wrongdiagnosis.com [Source type: Academic]

.It was first described at Geneva in 1805 and small outbreaks followed in Paris (1814), Metz and Genoa (1815), and Westphalia (1822), but in the United States there was a widespread epidemic, including New England and spreading as far as Kentucky and Ohio.^ Reports of the illness date to the 16th century, and the disease was first accurately described in 1805 (Rosenstein NE et al 2001).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Recently, West Nile virus , spread by mosquito bites, has become a cause of viral meningitis in most of the United States.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]
  • Meningitis 28 January 2010 0:27 UTC www.drexelmed.edu [Source type: Academic]

^ But new Hib vaccines — available as part of the routine childhood immunization schedule in the United States — have greatly reduced the number of cases of this type of meningitis.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

Fresh outbreaks in Europe took place between 1837 and 1850. In 1837 it prevailed in the south of France chiefly amongst troops in garrison, and fresh outbreaks continued throughout France in 1846 with epidemics in Algiers, Italy and Sicily. In Great Britain it first showed itself in the Irish workhouses in 1846, where it was known as "the black death" or "malignant purpuric fever." After 1866 except for sporadic cases it disappeared from Great Britain, but small outbreaks took place in 1885 to 1900 in Dublin. .In 1905 there was an extensive epidemic in New York, followed by an outbreak in Scotland in 1906, and in Scotland and Ireland in 1907-1908. The registrargeneral's returns for 1907 give 1018 deaths in Scotland due to the disease, of which 711 were at Glasgow and 148 at Edinburgh.^ The American Cancer Society estimates that there will be 93,800 new cases of colon cancer in 2000 with an estimated 47,700 deaths [17].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ BABY saved as meningitis kills mother The Scotsman - Edinburgh,Scotland,UK http://news.scotsman.com/aberdeen.cfm?id=246902004 .

^ In the case of incidence, although it is unknown for certain, it has been hypothesized that the decrease could be due to an increase in screening followed by removal of diseased polyps [17].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

In the same year Belfast was visited by a severe epidemic, 495 deaths out of the total death-rate of 631 taking place in that district.
.The mode of infection is obscure, but the organism is thought to gain access to the circulation through the mucous membrane of the nose and conjunctiva, as the organism has been isolated from the mucous membrane of the nose, not only of those suffering from the disease but from healthy persons who have been in contact with cases.^ Some infectious organisms can spread through a person's stool, and someone who comes in contact with the stool — such as a child in day care — may contract the infection.
  • Meningitis 2007-09-01 00:00:00.0 28 January 2010 0:27 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]

^ The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ The decision about what medicine to use depends on the organism causing the infection, the extent of the infection, and the person's age and general health.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

Cerebro-spinal fever has an undoubted tendency to follow bad sanitary conditions and to prevail in damp, sunless houses. It is a disease of temperate climates, and the outbreaks usually take place in the spring of the year. .The victims are mostly children and young adults, and Koplik states that few recoveries take place in children under two years of age.^ It can occur at any age but it is most likely to affect young children and young adults.

^ It usually develops in the late summer and early fall, and often affects children and adults under age 30.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]
  • Meningitis 28 January 2010 0:27 UTC www.drexelmed.edu [Source type: Academic]

^ Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.The onset of symptoms is sudden, as contrasted with tubercular meningitis, in which the onset is gradual.^ Symptoms of viral meningitis may appear suddenly or develop gradually over a period of days.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

The attack comes on sharply with intense headache, rigors and vomiting. .The pain soon localizes itself in the back of the neck and occiput, and may thence radiate down the spine, limbs and abdomen.^ Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ A throat culture can find and identify the bacteria causing throat pain, neck pain and headache, but can't determine what pathogens may be in your spinal fluid.

^ Almost any type of movement can cause the neck pain, and it may even be impossible to lower the chin to the chest.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

The pain is soon followed by a characteristic symptom, namely retraction of the head. .The head is drawn back and rigidly fixed, the spine arched and the limbs drawn up, and muscular spasms may take place.^ Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

There is general hyperaesthaesia, the slightest contact producing pain. More or less fever is present, but the temperature is not characteristic. .The headache continues with great severity and restlessness and delirium supervene, or there may be long periods when the patient is comatose.^ The majority of people with viral meningitis will make a full recovery, though they may feel severely weak and depressed for a short period of time afterwards.

^ In cases of acute septicaemia there may be severe tissue damage and so you may need skin grafts or to have a limb or digit amputated .

^ One quarter of affected patients have a fulminant onset within 24 hours of infection, and there may be a history of a respiratory illness within the preceding 7 days (50%).
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

Twitching of the limbs and general convulsions may occur and facial paralysis is frequent. .Paralysis of the ocular nerves causing squint, dilatations and contractions of the pupil are common as in other varieties of meningitis.^ Meningitis also can be caused by other organisms and conditions .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Including dilated nonreactive pupil, abnormalities of ocular motility, abnormal visual fields, gaze palsy, arm or leg drift .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

^ Viruses associated with mumps, herpes infection, West Nile virus or other diseases also can cause viral meningitis.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

.Some of the most striking symptoms are the rashes.^ The most common signs and symptoms of enteroviral infections are rash, sore throat, joint aches and headache.
  • Meningitis 28 January 2010 0:27 UTC www.cnn.com [Source type: General]
  • Meningitis 28 January 2010 0:27 UTC edition2.cnn.com [Source type: General]

.These usually occur about the fourth day of illness and vary widely in character, resembling erythema, urticaria, rose spots or purpuric spots.^ The mother should be questioned about any fever or complicating illness occurring during pregnancy or around the time of delivery.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

.The rashes have usually no relation to the gravity of the disease, but severe cutaneous haemorrhages usually indicate a severe form of illness.^ The rash can appear anywhere on the body and is usually a late symptom, in severe cases it may spread as you watch it.

^ Symptoms such as tiredness and lightheadedness can last for several months after recovery from the acute form of the disease.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.Should the patient survive the first shock of the attack serious complications may arise; the eyes may be attacked by severe conjunctivitis, iritis or keratitis or inflammation of the deeper parts may take place leading to detachment of the retina.^ The specific infective agents that are involved vary among different patient age groups, and the inflammation may evolve into ventriculitis, empyema , cerebritis, and abscess formation.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ People with severe meningitis or complications during illness may need to be treated in the intensive care unit of a hospital.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Occasionally, if the patient has been taking antibiotics for another infection, the symptoms can take longer to develop or they may be less intense.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

.More frequent even is disease of the auditory apparatus, and purulent otitis media or disease of the labyrinth may lead to permanent deafness.^ Although bacterial organisms are frequently associated with a more fulminant course, HSV and Enterovirus may also produce viral septic shock.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ However, in some cases it can be fatal or lead to permanent handicaps like deafness and brain damage.

^ Risk factors for bacterial meningitis include pulmonary infection, otitis media , mastoiditis, head trauma, alcoholism, splenectomy, sickle cell disease , and immunosuppression.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

Serous effusion may take place into joints which are painful, red and swollen as in acute rheumatism.
.Certain forms of the disease are rapidly fatal, these are known as the fulminant type, and death may take place within 12 to 24 hours of the onset.^ Vaccines against these diseases may be partly responsible for the decrease in viral meningitis in children (Beghi E et al 1984).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ It is a degenerative, rapidly progressing disease that can result in death or permanent disability.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Zinc —A number of studies have shown that, if zinc lozenges are taken within 24 hours of the onset of cold symptoms, the severity and duration of the cold are reduced (Hulisz D 2004).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.Death usually occurs between the fifth and the eighth day, but many cases drag on for weeks with rapid and progressive emaciation, and recovery is slow.^ Enterovirus meningitis usually occurs in the summer and fall, with acute onset of symptoms that last one to two weeks.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Viral meningitis cases are usually self-limited to 10 days or less.

The mortality has varied in different epidemics. Hirsch's tables of forty-one epidemics give a mortality of from 25 to 75%, and Koplik rates it at 48 to 90%. .During 1907, 623 cases of cerebro-spinal fever were notified in Belfast, and the deaths numbered 495. During that year the disease was made notifiable in 48 Irish urban and 55 rural districts.^ In recent years, researchers have made a number of advances against meningitis, ranging from the introduction of vaccines that target the pathogens that cause meningitis to a deeper understanding of how inflammation is crucial to the disease course.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

The mortality in Dublin was 75%. Osler states that in children under one year (in New York) the mortality reached 87.6%.
.The changes found after death from cerebro-spinal fever are an acute inflammation of the pia-arachnoid membrane both of the brain and spinal cord, with effusion of serum or pus into the ventricular and subarachnoid spaces.^ Meningitis is an inflammation of the three membranes that cover the brain and spinal cord (the meninges ).

^ Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.
  • Meningitis | LIVESTRONG.COM 28 January 2010 0:27 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Meningitis is inflammation of the tissue covering the brain and spinal cord (the meninges).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.With such rapidity may the effusion become purulent that it has been found purulent in a case where death took place within five hours from the apparent onset.^ In rare cases, other viruses, such as human immunodeficiency (HIV) or mumps , may cause meningitis.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Zinc —A number of studies have shown that, if zinc lozenges are taken within 24 hours of the onset of cold symptoms, the severity and duration of the cold are reduced (Hulisz D 2004).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.The operation of lumbar puncture (or puncture of the spinal canal between the lumbar vertebrae) has enabled the physician to make an accurate diagnosis by bacteriological examination of the contents of the spinal fluid.^ During a spinal tap, a needle is placed in the lumbar (lower) portion of the spinal canal and a small sample of cerebrospinal fluid (CSF) is removed.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ If a patient has symptoms of meningitis, his or her physician may order a lumbar puncture, commonly called a spinal tap.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ A procedure in which spinal fluid is taken out from the spinal canal.
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

Lumbar puncture too has been found to be of eminent service in many cases, the withdrawal of from 30 to 50 cc. of the spinal fluid serving to relieve pressure and at least temporarily ameliorate the symptoms.
.Up to a few years ago it may be said that there was no effective treatment for cerebro-spinal fever but that of endeavouring to alleviate pain by the administration of opium, but with the recent introduction of serum therapy the future is full of hope.^ Sometimes no treatment is needed for fever.
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ There is no surgical treatment for meningitis .
  • CIGNA - Meningitis 28 January 2010 0:27 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Although there have been no studies that examined the use of essential fatty acids in meningitis, if the recent research implicating widespread inflammatory damage in meningitis withstands scientific scrutiny, supplementing with EPA and DHA may have some benefit.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.In the epidemic in New York (1905) the serum of Flexner and Jobling was used, and the most striking results were seen in young patients, the death-rate where the serum was used sinking to 46.3% as against 90% without.^ Pending results of ongoing trials, these agents (i.e., gatifloxacin and moxifloxacin) should only be used as alternative agents in patients with bacterial meningitis (B-II) .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

^ Latex agglutination may be most useful for the patient who has been pretreated with antimicrobial therapy and whose Gram stain and CSF culture results are negative (B-III) .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

^ Imipenem has been successfully used in 2 patients with pneumococcal meningitis caused by penicillin- and cephalosporin-resistant strains and in 1 patient with Acinetobacter meningitis, although the potential for seizure activity (which was 33% in one study of children with bacterial meningitis) argues against its use in most patients with bacterial meningitis (D-II) .
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]

.Like other serum treatments, to get the best results the serum must be administered early in the disease.^ Other sexually transmitted diseases may cause congenital or perinatal infection and must be considered in the differential diagnosis since they may require specific therapy.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Starting treatment early in the course of the disease is crucial.
  • Meningitis, Bacterial: eMedicine Radiology 28 January 2010 0:27 UTC emedicine.medscape.com [Source type: Academic]

^ Unfortunately, there has been no screening tool developed for the early detection of this type of cancer, therefore prevention is the best way to reduce incidence of the disease.
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.Of 221 patients injected during the first week of illness the mortality was only 18%, while of 107 others injected after the first week of the disease the mortality was double that amount.^ Reports of the illness date to the 16th century, and the disease was first accurately described in 1805 (Rosenstein NE et al 2001).
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

.When given subcutaneously, as in diphtheria, the serum has little or no effect, and to obtain good results it must be injected directly into the spinal canal after the removal of a certain amount of the spinal fluid.^ During a spinal tap, a needle is placed in the lumbar (lower) portion of the spinal canal and a small sample of cerebrospinal fluid (CSF) is removed.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Bacterial meningitis and septicaemia must be treated immedaitely with antibiotics, usually via an injection, directly into the bloodstream.

^ A procedure in which spinal fluid is taken out from the spinal canal.
  • AboutKidsHealth: Health A-Z: Meningitis 28 January 2010 0:27 UTC www.aboutkidshealth.ca [Source type: FILTERED WITH BAYES]

The injections are then continued daily as required according to the severity of the case. .Dr Robb of Belfast reports that during the epidemic there, of 275 cases treated by ordinary means, the death-rate was 72.3%, but in 90 cases treated with injections of Flexner and Jobling's serum the death-rate was only 30%.^ The American Cancer Society estimates that there will be 93,800 new cases of colon cancer in 2000 with an estimated 47,700 deaths [17].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ In New Hampshire, over the period of 1987-1997 there were 660 new cases of cervical cancer reported [22].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

^ It is estimated, by the American Cancer Society, that in 2000 there will be 30,200 new cases of cancer of the oral cavity and pharynx [17].
  • ATSDR - PHA - Gendron Junkyard, Pelham, Hillsborough County, New Hampshire 19 September 2009 8:22 UTC www.atsdr.cdc.gov [Source type: FILTERED WITH BAYES]

.Dr Ivy McKenzie and Dr W. B. Martin of Glasgow have published a series of cases treated with the highly immune serum of patients who have recovered from the disease with encouraging results.^ Although most types of aseptic meningitis do not cause serious sequelae, some types result in significant morbidity and mortality if not properly diagnosed and treated.
  • Aseptic Meningitis in the Newborn and Young Infant - May 15, 1999 - American Academy of Family Physicians 28 January 2010 0:27 UTC www.aafp.org [Source type: Academic]

^ Bacterial meningitis is a serious disease that can cause death or permanent brain damage if not treated by a physician immediately.
  • Meningitis: Online References For Health Concerns 28 January 2010 0:27 UTC www.lef.org [Source type: Academic]

^ Some experts would only administer adjunctive dexamethasone if the patient had moderate-to-severe disease (Glasgow Coma Scale score < 11).
  • NGC - NGC Summary 28 January 2010 0:27 UTC www.guideline.gov [Source type: Academic]



Simple English

[[File:|thumb|right|A map of the world showing different things. Countries in red: Meningitis is common (So-called Meningitis belt in Africa). Countries in brown: Sometimes there are epidemics of Meningitis. Countries in grey: They may be a few cases of meningitis, each year. Note the map is not completely accurate though.]] Meningitis is an infection of certain membranes and tissues of the nervous system. Those are called meninges (singular:Meninx). Their function is to protect the central nervous system. Most often, this infection is caused by microorganisms, like viruses, bacteria, fungi or parasites. The most common cause of meningitis are viruses, followed by bacteria. Meningitis is a life-threatening condition. It affects all age groups.

Some kinds of meningitis are very easy to spread. For this reason, in certain countries, like Germany, doctors have to tell the authorities that someone might have meningitis.

Contents

Signs of meningitis

Some signs of meningitis can be: high fever, sometimes with chills; very strong headache; nauseas and vomiting; drowsiness or confusion; twitching; sleepiness; sore throat; delirium (especially in children); seizures; stiff neck (in less than 50% of the cases, but may be a telltale sign).

Types

The two main forms of meningitis are Bacterial meningitis and Viral meningitis. In bacterial meningitis, most patients die without treatment, whereas in viral meningitis most patients get better on their own. Herpes virus meningitis may respond to an antiviral drug.[1]

References

Other websites


Citable sentences

Up to date as of December 14, 2010

Here are sentences from other pages on Meningitis, which are similar to those in the above article.








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