Mindful about Meningitis: Understanding and Treatment

Meningitis, a potentially life-threatening condition, strikes fear in the hearts of many due to its sudden onset and severity. However, with knowledge and mindfulness, we can empower ourselves to understand, prevent, and effectively treat this illness. In this article, we delve into the depths of meningitis, exploring its causes, symptoms, prevention strategies, and available treatments.

Defination

Meningitis is defined as “ an inflammation of pia arachnoid and the fluid contained in the space.” Three layers of meninges, that is pia mater, arachnoid mater is called subarachnoid space,  through which cerebrospinal fluid (CFS) circulates over the surface of the brain, spinal cord and in between ventricles. The infective disorders of brain and spinal cord produce characteristic changes in CSF, which form important diagnostic and differentiating features. The subarachnoid space is continuous around the brain, spinal cord, cranial nerves and communicates with the ventricular system of the brain. 

As meninges and subarachnoid space are continuous over brain and spinal cord, hence, meningitis is always cerebrospinal, hence, it is also called cerebrospinal fever. 

Causes of Meningitis 

• Bacterial Infections: Bacterial meningitis is primarily caused by bacteria such as Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib). These bacteria can spread through respiratory droplets or direct contact with an infected individual.
• Viral Infections: Viruses such as enteroviruses, herpesviruses, and the mumps virus can cause viral meningitis. These viruses are often transmitted through respiratory secretions, fecal-oral route, or close personal contact.
• Fungal Infections: Fungal meningitis is relatively rare and is usually seen in individuals with weakened immune systems. Fungi such as Cryptococcus and Histoplasma are common culprits.
• Non-infectious Causes: Itcan also be caused by non-infectious factors such as certain medications, autoimmune diseases, and cancer.

Symptoms and signs of Meningitis

These include : 

• Symptoms and signs of infection : Fever, malaise, headache, aches and pains, tachycardia, tachypnoea, vomiting and convulsions in children. 

• Symptoms and signs of meningeal irritation : Pain in neck, neck stiffness, positive kernig’s  sign and brudzinski’s sign. 

• Symptoms and signs due to raised intracranial tension : Headache, projectile vomiting, blurring of vision, papilloedema, false localising signs and impairment of consciousness. 

• Symptoms and signs due to an infecting organism : 
• Morbilliform/ purpuric/ petechial skin eruptions on lower limb, ecchymoses and lividity of skin in meningococcal meningitis. 
• Associated lung, ear, sinus infection in pneumococcal meningitis.
• Upper respiratory and ear infection in children is associated with meningitis due to H. influenzae. 

Preventing strategies

Preventing meningitis primarily involves vaccination and practicing good hygiene:

• Vaccination: Vaccines are available to protect against several bacteria and viruses that can cause meningitis, including the meningococcal, pneumococcal, and Hib vaccines. Ensuring you and your family members are up-to-date on vaccinations can significantly reduce the risk of it.
• Good Hygiene Practices: Practicing good hygiene, such as frequent hand-washing, covering your mouth and nose when coughing or sneezing, and avoiding close contact with individuals who are sick, can help prevent the spread of infectious agents that can cause it.

Investigations

• Total and differential count may show polymorphonuclear leucocytosis. 

• CSF Examination. 

• Blood and CSF culture may also be positive but not always. 

• X-ray of chest may show a patch of consolidation in a lung in pneumococcal infection.

• CT scan is helpful to diagnose hydrocephalus and brain abscess if they develop as complications. 

• MRI shows diffuse meningeal enhancement after gadolinium. 

• Serology of CSF. 

Treatment Options

Treatment for meningitis typically involves hospitalisation and may include:

• Antibiotics or Antiviral Medications: If bacterial or viral meningitis is suspected, antibiotics or antiviral medications will be administered promptly to combat the infection.
• Supportive Care: Supportive measures such as pain management, intravenous fluids to prevent dehydration, and monitoring for complications like seizures or increased intracranial pressure are essential components of treatment.
• Corticosteroids: In some cases, corticosteroids may be prescribed to reduce inflammation and prevent complications.

Conclusion

It is a serious medical condition that requires prompt recognition and treatment. By understanding the causes, symptoms, prevention strategies, and treatment options for it, we can empower ourselves to take proactive steps to protect our health and the health of our loved ones. Through vaccination, good hygiene practices, and awareness, we can work together to minimize the impact of meningitis on individuals and communities. Stay mindful, stay informed, and stay healthy.