Bacterial of Meningitis
Wednesday, April 1, 2015
1 Comment
This is a medical emergency.
Meningitis is the inflammation of the meninges, the coverings of the brain: dura, arachnoid, and pia. It carries a high mortality rate despite medical advances.
Meningitis may be caused by various agents including trauma, chemicals e.g released from tumours and several infectious agents. However, bacterial meningitis represents the best known type of meningitis and perhaps, the most dangerous.
Types
- Acute
- Chronic
- Recurrent
- Post-traumatic
Terminologies
- Recurrent bacterial meningitis: new episode of bacterial meningitis occurring after a period without clinical or laboratory evidence of meningitis. Recurrence is due to reinfection with the same or different bacterial species rather than to persistence of the original infection.
- Recrudescence denotes the reappearance, during therapy, of findings of meningitis and a positive cerebrospinal fluid culture after an initial clinical response and sterilization of the cerebrospinal fluid.
- Relapse: reappearance of bacterial meningitis within 3 weeks after completion of the initial course of therapy.
Both recrudescence and relapse are caused by the same organism isolated from the initial episode, and both represent persistence of the initial infection rather than reinfection.
Meningitis is the inflammation of the meninges, the coverings of the brain: dura, arachnoid, and pia. It carries a high mortality rate despite medical advances.
Meningitis may be caused by various agents including trauma, chemicals e.g released from tumours and several infectious agents. However, bacterial meningitis represents the best known type of meningitis and perhaps, the most dangerous.
Types
- Acute
- Chronic
- Recurrent
- Post-traumatic
Terminologies
- Recurrent bacterial meningitis: new episode of bacterial meningitis occurring after a period without clinical or laboratory evidence of meningitis. Recurrence is due to reinfection with the same or different bacterial species rather than to persistence of the original infection.
- Recrudescence denotes the reappearance, during therapy, of findings of meningitis and a positive cerebrospinal fluid culture after an initial clinical response and sterilization of the cerebrospinal fluid.
- Relapse: reappearance of bacterial meningitis within 3 weeks after completion of the initial course of therapy.
Both recrudescence and relapse are caused by the same organism isolated from the initial episode, and both represent persistence of the initial infection rather than reinfection.
Causative Organisms
The causative organisms of acute bacterial meningitis are clearly associated with the age of the patient. The common organisms in each age group are as detailed below:
Neonatal period: Escherichia coli, group B streptococci (S. agalactiae), and L. monocytogenes.
Ages 2 months to 5 years: H. influenzae
Above 5 years: S. pneumoniae and N. meningitidis.
In addition to the age of the patient, another factor that determines the causative pathogens is the presence of immunosuppression. In immunosuppressed patients, the most frequent pathogens include L. monocytogenes (especially in patients with cell-mediated immunity deficiency), S. pneumoniae (in patients with humoral immunity deficiency), and P. aeruginosa, enteric gram-negative bacilli, and S. aureus (in neutropenic patients).
The causative organisms of acute bacterial meningitis are clearly associated with the age of the patient. The common organisms in each age group are as detailed below:
Neonatal period: Escherichia coli, group B streptococci (S. agalactiae), and L. monocytogenes.
Ages 2 months to 5 years: H. influenzae
Above 5 years: S. pneumoniae and N. meningitidis.
In addition to the age of the patient, another factor that determines the causative pathogens is the presence of immunosuppression. In immunosuppressed patients, the most frequent pathogens include L. monocytogenes (especially in patients with cell-mediated immunity deficiency), S. pneumoniae (in patients with humoral immunity deficiency), and P. aeruginosa, enteric gram-negative bacilli, and S. aureus (in neutropenic patients).
Clinical Features
The clinical features of acute bacterial meningitis vary with the age and immune status of the patient.
Children may present with fever, convulsions, refusal of feeds, irritability, excessive cry and vomiting.
Adults may present with fever, headache, vomiting, lethargy, confusion, and a stiff neck.
The manifestations, however, may be subtle, especially in newborns, immunosuppressed patients, and the aged. In addition, patients who develop meningitis after head trauma or neurosurgical procedure may have features that are difficult to distinguish from the underlying pathology. As such, a high index of suspicion is needed in this category of patients to make a early diagnosis.
Clinical examination may reveal neck stiffness/retraction, positive Kernig's and Brudzinski signs and features of acute ill-health with deranged neuro-vital signs.
The clinical features of acute bacterial meningitis vary with the age and immune status of the patient.
Children may present with fever, convulsions, refusal of feeds, irritability, excessive cry and vomiting.
Adults may present with fever, headache, vomiting, lethargy, confusion, and a stiff neck.
The manifestations, however, may be subtle, especially in newborns, immunosuppressed patients, and the aged. In addition, patients who develop meningitis after head trauma or neurosurgical procedure may have features that are difficult to distinguish from the underlying pathology. As such, a high index of suspicion is needed in this category of patients to make a early diagnosis.
Clinical examination may reveal neck stiffness/retraction, positive Kernig's and Brudzinski signs and features of acute ill-health with deranged neuro-vital signs.
Diagnosis
The definite diagnosis of bacterial meningitis is based on the findings of cerebrovascular fluid (CSF) examination. The CSF is obtained from lumbar puncture. The usual picture is pleocytosis with cell count over 1,000 cells per mm3 (with polymorphonuclear cells predominating), hypoglycorrhagia with glucose under 30 mg per dL and elevated protein usually over 200 mg per dL. Gram staining and microscopy may reveal the causative organism.
Differential Diagnosis
- Systemic Lupus Erythematosus and other connective tissue diseases
- Drug-induced meningitis
- Tumours
- Epidermoid & Parasitic cysts
Treatment
Antibiotics are the mainstay of treatment of bacterial meningitis. It is essential to use antibiotics which readily cross the blood brain barrier. The third generation cephalosporins are in wide use for the treatment of meningitis especially in adults.
Broad-spectrum agents are used initially, while specific drugs are commenced as soon as results of CSF analysis are available.
The use of corticosteroids in the management of bacterial meningitis is controversial. While some studies have documented its benefits, especially reduction in hearing impairment, others have not found it so useful. If dexamethazone is to be used, it needs to be started before, or along with the first dose of antibiotics to reduce the patient's inflammatory response.
The definite diagnosis of bacterial meningitis is based on the findings of cerebrovascular fluid (CSF) examination. The CSF is obtained from lumbar puncture. The usual picture is pleocytosis with cell count over 1,000 cells per mm3 (with polymorphonuclear cells predominating), hypoglycorrhagia with glucose under 30 mg per dL and elevated protein usually over 200 mg per dL. Gram staining and microscopy may reveal the causative organism.
Differential Diagnosis
- Systemic Lupus Erythematosus and other connective tissue diseases
- Drug-induced meningitis
- Tumours
- Epidermoid & Parasitic cysts
Treatment
Antibiotics are the mainstay of treatment of bacterial meningitis. It is essential to use antibiotics which readily cross the blood brain barrier. The third generation cephalosporins are in wide use for the treatment of meningitis especially in adults.
Broad-spectrum agents are used initially, while specific drugs are commenced as soon as results of CSF analysis are available.
The use of corticosteroids in the management of bacterial meningitis is controversial. While some studies have documented its benefits, especially reduction in hearing impairment, others have not found it so useful. If dexamethazone is to be used, it needs to be started before, or along with the first dose of antibiotics to reduce the patient's inflammatory response.
Don’t think of anything else just contact Dr Abalaka and purchase some of his herbal medication and your depression will go away. This was my state of mind when my doctor told me that i will not be able to conceive due to the Fibroid that was rolling in my family life and when i decide to reach out to the priest, and the Priest told me what to do in other to get the medication. Eventually I receive all the Herbal medications that cure my Fibroid and give me the chance to become a proud mother: Dr Abalaka is a great spiritualist, He did it for me, you can contact Dr on (dr.abalaka@outlook.com). If you are suffering from the following gynecology disease::
ReplyDeleteFibroid
High Blood Pressure (herbs to reduce your BP within 7days)
Diabetes
Infection, regular body pains
Blockage from the fallopian Tube
Cyst from the ovaries
Unpleasant smell from the virginal
Irregular menstruation
Weakness of the penis (not able to have sex with your partner or inability to satisfy your partner sexually)
Watering sperm (low sperm count) not able to get woman pregnant.
Infertility for easy Conception.......
Erectile dysfunction treatment
Skin diseases, Toilet infection and bad body odor…….Etc..
Get your ex back
Happiness in relationship
Command respect in the society
Enlarge your Penis/breast with no side effect
Impotent solution
Obesity solution
Romanticism solutions
Cancer of the blood
Parkinson disease
General consultation
Those are the things he does, You can simply contact the spiritualist Dr Abalaka on (dr.abalaka@outlook.com) to get his Herbal Medication to cure your disease and put yourself on a motherhood side of life..