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Meningitis

Introduction

Meningitis can sound kind of scary. I remember learning about it when I was in primary school and was mildly terrified but then as I got older all I learnt got lost somewhere. You probably remember getting a vaccine; I definitely remember getting one or two so it’s all good right? Well, yes and no.

Meningitis is a disease in which the membranes that protect your brain and spinal cord get inflamed. This inflammation can be caused by a number of different things including viruses, bacteria, fungi or allergic reactions. Most kids in the UK are vaccinated against 3 of the more common causes of meningitis but you can still get meningitis from a number of other causes.

Meningitis is worth being a little scared of as it can be pretty dangerous. It is considered a medical emergency and meningitis left untreated can be fatal. You should learn the symptoms and if you or a friend starts to show any of them you should go to A and E immediately.

Symptoms

There are some very classic signs to meningitis. Most people who get meningitis don’t display all of them but if you don’t display any of the top 4 you are unlikely to have meningitis.

  • #1 Headache
    • A very severe headache is present in 90% of all cases
  • #2 Neck Stiffness
  • #3 Fever
    • Often sudden and very high
  • #4 Confusion or altered consciousness
    • Difficulty waking up
    • Kids tend to get very sleepy
  • Seizure
  •  Vomiting
  • Inability to look at light (photophobia) and tolerate loud noises
  • Rash
    • The rash appears in cases where the meningitis is being caused by meningococcal bacteria
    • It will likely take the form of small irregular red purple spots
    • It will not disappear under pressure if you push down on it with a finger or a glass tumbler

Diagnosing

If you go to the hospital with some of the above symptoms they will likely run a few tests to confirm whether or not you have meningitis. This may include a blood test and head or chest x-rays. However, the only sure way to confirm that you have meningitis is to test your spinal fluid. This is done by an LP test (lumbar puncture) sometimes called a spinal tap. The words spinal tap may conjure up images of big 80s hair and old school glam rock movies but in this case it’s a procedure where a needle is placed in your spine and some of your cerebrospinal fluid (the fluid that helps protect your brain and spine) is sampled. This sample can then be tested for pathogens and the doctors can work out what is exactly is making you feel so miserable.

What is and what causes Meningitis?

Meningitis is when the membranes that surround and protect the brain and spinal cord (known as the meninges) get inflamed. This is usually caused by an infection of some sort but may be due to an allergic reaction. The infection can get into the membranes through the blood stream or via direct contact – which can happen if you have had surgery or a skull fracture. 

When the body detects an infection it will send a bunch of white blood cells to fight it off the white blood cells act like your own little army and is called an immune response. The sudden influx of white blood cells and fluids to fight against infection cause your brain to swell and the pressure inside your skull to increase. This leads to the symptoms that you get. If the pressure in your skull gets too high it can make it very difficult for blood to get into your brain depriving it of much needed oxygen.

Causes

  • A virus is the most common cause of meningitis
  • Bacteria
    • 80% of bacterial cases in adults are caused by bacteria neisseria meningitidis and streptococcus pneumonia
  • Fungi – very uncommon
  • Certain drugs
    • Through allergic reaction

Treatment

Treatment will depend greatly on the cause of the meningitis and degree of the infection causing it.

  • Viral meningitis
    • Often resolves itself on its own
    • In some cases (such as when the chicken pox virus is to blame) antiviral medicine may be prescribed
    • Bed rest
    • Lots of fluids
    • Fever reducers
      • This could be over the counter medicines like Ibuprofen or may be prescription strength
  • Bacterial meningitis
    • Cases of bacterial meningitis can be more serious
    • Antibiotics
      • Broad spectrum
      • More specific if the bacteria causing can be identified
    • Steroids
      • These are often given to reduce the degree of brain swelling and the chance of seizure

Complications

The high fever caused by meningitis and the possible lack of oxygen to the brain can lead to a number of very serious complications

  • Brain damage
  • Learning disabilities
  • Hearing loss
  • Seizure
  • Memory loss
  • Kidney failure

Risk Factors

  • Age
    • Under 20s are the most likely age group to get  bacterial meningitis
  • Those who live in group settings
    • University, military bases, boarding schools
    • Meningitis is not as contagious as the common cold but it is contagious
  • People with a compromised immune system
    • If you have HIV
    • If you are taking an immunosuppressant
    • If you have lost your spleen

Prevention

There are three common vaccines that almost all children in the UK receive:

  • Hib vaccine which provides long-term protection against the illnesses caused by Haemophilus influenzae type b bacteria
    • Given to babies usually before 12 months old
  • Meningitis C vaccine which protects against meningococcal group C
    • Given o babies usually before 12 months old
    • It was only introduced in 1999 so a catch up immunization program was introduced
    • Everyone under 25 should have the vaccine. If you didn’t get it as part of the catch program you discuss getting it with your doctor
  • Vaccine against pnemoccocal meningitis
    • Given as part of childhood vaccination program

Recently a new vaccine for Meningitis B has been licensed in Europe and may become available in the UK

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