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Meningitis is one of the world's leading health problems that individual faces. Learn more.

Sep 20, 2023 By Nancy Miller

Inflammation of the brain and spinal cord membranes, known as meningitis, requires immediate medical intervention. Meninges membranes are sensitive to many pathogenic pathogens, which can cause different meningitis symptoms and problems. This article discusses what is meningitis, what causes meningitis, and major meningitis symptoms.

Virus Meningitis

Meningeal inflammation results from aseptic or viral meningitis. Although more common than bacterial meningitis, its symptoms are mild and may resemble the flu.

Agents of cause

Most meningitis viruses are enteroviruses. U.S. enterovirus cases average 10,000–15,000 per year. Herpes simplex virus types 1 and 2 are infrequent but can cause issues. Viral meningitis can result from chickenpox and shingles.

Transmission and Risk Factors

Transmission often occurs through person-to-person contact. For instance, enteroviruses are usually transmitted via fecal matter, emphasizing the importance of proper hand hygiene. Other viruses can spread through respiratory droplets. Certain factors increase the risk of contracting viral meningitis: compromised immune systems, age (children are more susceptible), and crowded environments.

Prognosis and Recovery

The majority of viral meningitis cases see full recovery without specific treatment. However, severe symptoms may require hospitalization, especially for newborns and individuals with weaker immune systems. Rest, fluids, and OTC painkillers can help settle symptoms.

Bacterial Meningitis

Bacterial meningitis is one of the most severe kinds. Fast disease progression can cause long-term problems or mortality; thus, early management is essential.

In babies and elders, Streptococcus pneumoniae is a significant cause. Neisseria meningitidis, rare, can cause epidemics in college dorms. Regular childhood immunizations have reduced Hib prevalence. Listeria monocytogenes can infect newborns; thus, pregnant women should be careful.

Transmission And Prevention

The most common transmission cause is through respiratory droplets. Bacterial meningitis is best prevented by immunization. U.S. immunizations cover Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b.

Treatment and Outcomes

Immediate antibiotic treatment is vital for this disease. The specific antibiotic type depends on the causative bacteria. Despite prompt treatment, some survivors might face long-term complications, highlighting the illness's severity.

Fungal Meningitis

A less frequent cause, fungal meningitis, typically affects those with compromised immune systems. It's not transmitted from person to person, reducing the risk of outbreaks.

Causative Fungi

Cryptococcus neoformans is a leading cause, particularly in individuals with HIV/AIDS. Another fungus, Histoplasma, can lead to meningitis, especially in endemic areas around the Mississippi and Ohio river valleys.

Sources of Exposure

Many fungal meningitis cases result from inhaling fungal spores. Like bird and bat droppings, these spores can exist in soil and specific environments. Avoiding areas with a high concentration of fungus or wearing masks in such regions can reduce risk.

Treatment and Challenges

Antifungal medications are essential for treating fungal meningitis. The duration and type depend on the causative fungus and the patient's health. The treatment period can be lengthy, sometimes requiring months of medication.

Parasitic Meningitis

Parasitic, although less common than its viral and bacterial counterparts, presents unique challenges. Meningitis often has a more prolonged illness from parasites and can be associated with specific regions or exposures.

The most notorious meningitis parasite is Naegleria fowleri. The "brain-eating amoeba," which causes meningitis, is rare but deadly. The rat lungworm Angiostrongylus cantonensis can also cause eosinophilic meningitis. The latter is less severe but a rising infectious issue in several countries.

Exposure Sources

Naegleria fowleri loves warm freshwater lakes, rivers, and hot springs. Water contamination in the nose allows amoeba to move to the brain, causing infections. However, Angiostrongylus cantonensis is spread by eating raw or undercooked snails, slugs, or other vectors that have eaten rat excrement.

Signs and Progress

Like other meningitis, headache, fever, and neck stiffness are early signs. As the condition advances, hallucinations, convulsions, and loss of consciousness may occur. Naegleria fowleri is severe and progresses quickly, requiring emergency medical intervention.

Treatment and Prevention

For Naegleria fowleri, a medication named miltefosine has shown some promise, but early detection and treatment remain essential due to the infection's aggressive nature.

Preventative measures include avoiding water-related activities in warm, stagnant freshwater or using nose clips if engaging in such activities. For eosinophilic meningitis caused by Angiostrongylus cantonensis, treatment typically involves pain management and sometimes antiparasitic drugs.

Non-infectious Meningitis

Meningitis isn't strictly an infectious condition. There are instances where inflammation of the meninges arises without a contagious agent, termed non-infectious meningitis. This form can be as concerning and debilitating as its infectious counterpart.

Common Causes

Many factors can cause non-infectious meningitis:

  • Drufgs: Drug-induced meningitis can result from NSAIDs, antibiotics, and intravenous immunoglobulin.
  • Cancers: It can cause carcinomatous meningitis, especially brain and other metastases.
  • Systemic diseases: SLE and sarcoidosis can cause meningeal inflammation.

Symptoms

Non-infectious meningitis resembles infectious symptoms, making it perplexing. Fever, headaches, photophobia, and stiff neck may occur. However, other symptoms like rash may not be present without a contagious agent.

Diagnose and Treat

Distinguishing non-infectious from infectious meningitis is paramount. Lumbar puncture, or spinal tap, is a standard procedure to obtain cerebrospinal fluid for analysis. In non-infectious cases, this fluid might show elevated white blood cells but no organisms. A detailed medical history can also provide clues, especially regarding recent medication use or underlying systemic conditions.

Prevention of Meningitis

The best defense against meningitis is to prevent it from occurring in the first place. Vaccination is crucial in protecting individuals from several strains of bacteria that can cause meningitis.

There are vaccines available against Neisseria meningitidis (meningococcal vaccine), Streptococcus pneumoniae (pneumococcal vaccine), and Haemophilus influenzae type b (Hib vaccine). These vaccines are typically administered during infancy and childhood, but booster doses might be recommended for specific individuals or areas where outbreaks occur.

In addition to vaccinations, good personal hygiene practices can prevent the spread of viral and bacterial infections. This includes regular hand washing with soap and water, covering the mouth and nose when coughing or sneezing, and avoiding close contact with sick individuals. For those traveling to areas where meningitis is prevalent, especially parts of sub-Saharan Africa known as the "meningitis belt," it's advisable to receive appropriate vaccinations and be aware of the latest health advisories.

Lastly, pregnant women should avoid consuming raw or undercooked meats and unpasteurized products to prevent listeriosis, a potential cause of bacterial meningitis. These preventive measures can significantly reduce the risk of contracting or spreading meningitis.

Conclusion

Understanding the diverse causes of meningitis is vital for timely diagnosis and appropriate treatment. As symptoms can often mimic milder illnesses, maintaining a high index of suspicion, especially in high-risk populations, is paramount. Awareness, vaccination, and early intervention remain vital in managing and preventing this severe condition.

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