Bacterial Meningitis: Information on Causes, Diagnosis & Treatments

Bacterial meningitis is an inflammation of the spinal cord and brain membranes that is typically drawn on by a serious infection. The condition is rare and affects approximately 200,000 individuals in the United States annually. Some forms of the disease can be prevented by vaccinations. Typically, the infectious diseases spread by airborne droplets. Diagnosing the condition often requires imaging and laboratory tests. Treatment must be made by a medical professional and healing from the condition typically takes days or weeks.

Bacterial meningitis vaccinations are designed to prevent various forms of meningitis. Common symptoms include a stiff neck, fever, and/or a headache. Some cases of meningitis resolved without medical treatment. However, others are life-threatening and require immediate antibiotic treatments.

• What Causes Bacterial Meningitis?
• Who Gets Bacterial Meningitis?
• Bacterial Meningitis Symptoms
• Diagnosing Bacterial Meningitis
• Treating Bacterial Meningitis

What Causes Bacterial Meningitis?

Bacterial meningitis can affect everyone, from newborns to the elderly. The condition is spread through a variety of specific bacterium including:

• Pneumococcus (Streptococcus pneumonia)


• Meningococcus (Neisseria meningitides)


• Hib (Haemophilus influenza)


• Group B strep


• E. coli


• Listeria monocytogenes

Bacterial meningitis can thrive inside the body and into the bloodstream to travel to the spinal cord and brain to initiate an infection. This type of bacterial infection is easily transmitted through close personal contact including kissing, sneezing and coughing. In addition, the infected individual can transmit the disease through throat secretions including saliva and phlegm that is infected by the bacteria.

Fortunately, the microorganisms associated with bacterial meningitis are not contagious. However, consuming certain foods infected with listeria bacterium can cause the infection. These foods include sandwich meats, hot dogs, and soft cheeses.

Common areas of the body that are likely to be infected with meningitis-causing bacteria include those affected by trauma that injured membranes of the brain caused by a sinus infection, surgery, or head fracture. These conditions can diminish health and function of the immune system and disrupt natural barriers of the body while increasing the susceptibility to all forms of infections including bacterial meningitis.

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Who Gets Bacterial Meningitis?

Individuals who are highly susceptible to bacterial meningitis include the elderly, newborns (one month to two years), and pregnant women. Adults who are highly susceptible to developing bacterial infections usually have specific risk factors including alcohol abuse, chronic ear or nose infections, a history of pneumococcal pneumonia, or sustaining a head injury.

A high susceptibility to developing bacterial meningitis include those who have had a spleen removed, are taking corticosteroids to treat sickle cell disease or kidney failure and those with a weakened immune system. Additionally, individuals who have undergone spinal or brain surgery or have suffered through widespread broad infections tend to be highly susceptible to acquiring bacterial meningitis.

Bacterial meningitis outbreaks tend to occur in certain environmental situations where humans live in close contact situations including military barracks, locker rooms, and college dormitories.

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Bacterial Meningitis Symptoms

Many of the symptoms associated with early stage bacterial meningitis mimic influenza (the common flu). The initial warning signs and symptoms can display themselves in just a few hours or over the course of many days. Common bacterial meningitis symptoms in humans or three years or older include:

• Sudden onset high fever


• Seizures


• Difficulty concentrating (confusion)


• Headaches associated with vomiting or nausea


• Severe headaches


• Stiff neck


• Loss of appetite and drink


• Difficulty in sleeping or waking


• Skin rash including those associated with meningococcal meningitis

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Common bacterial meningitis symptoms in infants

can be somewhat different than the symptoms associated with older humans. These include:

• High fever


• A lack of desire to feed/eat


• Sluggishness


• Inactivity


• Irritability


• Excessive sleepiness


• Constant crying


• Neck or body stiffness


• Fontanel bulge

Providing treatment for bacterial meningitis in newborns can be significantly more difficult compared older humans. In many cases, a baby suffering from bacterial meningitis will cry much harder than normal when being held.

A baby suffering from bacterial meningitis can develop septicemia. While meningitis is known to inflame the spinal cord and the lining around the brain, septicemia is a result of blood that is poisoned by the same microorganisms causing meningitis. However, septicemia is significantly more life-threatening to the infant's body than meningitis. This condition is dangerous and parents who believe their child has septicemia or meningitis should seek out immediate medical attention. Without treatment, the child usually becomes ill quickly and the conditions worsen just as fast.

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Diagnosing Bacterial Meningitis

Doctors, pediatricians, and diagnosticians can diagnose bacterial meningitis based on a variety of factors including the results of a diagnostic test, a complete physical examination, and a family/personal medical history. As a part of the examination, the physician will usually look for indicators of an infection on the skin along the spine, in the throat, ears, or head. Usually, comprehensive diagnostic testing will include:

• Blood Cultures – The diagnostician will take a blood sample and allow it to culture over time to detect microorganisms, specifically bacteria. The doctor may stain the sample to observe bacterium under the microscope more closely and in better detail.


• Imaging Tests – Performing a magnetic resonance imaging (MRI) scan or computerized tomography (CT) scan of the patients had can show signs of inflammation or swelling. Usually, the doctor will recommend the CT scan or x-ray of the sinuses or chest to look for obvious signs of infection associated with meningitis.


• Lumbar Puncture (Spinal Tap) – In cases where bacterial meningitis cannot be definitively diagnosed, the doctor will order a lumbar puncture (spinal tap). During this procedure, the technician will collect CSF (cerebral spinal fluid) that could reveal low glucose (sugar) levels with increased protein and white blood cell counts that would indicate that the patient has acquired bacterial meningitis.

Analyzing cerebrospinal fluid can assist the diagnostician in identifying the meningitis is being bacterial or viral. If viral meningitis is suspected, the doctor might order a test to analyze the organism's DNA or check for antibodies to accurately diagnose the specific cause to ensure the patient receives the most effective treatment.

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Treating Bacterial Meningitis

Typically, acute bacterial meningitis conditions progress rapidly and require corticosteroid and antibody treatments as quickly as possible. The type of treatment through antibiotics will be determined by the type of bacterium causing meningitis. In some cases, the meningitis bacterium is resistant to nearly every form of antibiotic. At that time, the physician will likely prescribe Vancomycin because it is highly aggressive against many forms of bacteria that are resistant to most antibiotic medications.

In addition to providing the patient antibiotics for treatment, the doctor must also consider other complications that could be occurring. In its advanced stage, bacterial meningitis could cause:

• Shock or hypotension (low blood pressure)


• Stroke


• Cardiac ischemia (inadequate heart muscle blood supply) or arrhythmias (irregular heartbeat)


• Hyponatraemia (abnormally low blood stream sodium levels) caused by dehydration


• The exacerbation of the patient's chronic diseases


• Hypoxemia (abnormally low bloodstream oxygen concentration levels)

To ensure that the patient will fully recover from the life-threatening condition, the doctor must look for any indicators of increasing intracranial pressure (ICP) and hydrocephalus. The doctor will need to manage the patient's pain and fever while controlling coughing and straining and preventing seizures. The doctor must ensure that the patient avoids systemic hypotension (abnormally low blood pressure throughout the body).

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Sources:

http://www.mayoclinic.org/diseases-conditions/meningitis/home/ovc-20169520

https://www.fda.gov/Drugs/DrugSafety/FungalMeningitis/

https://blogs.fda.gov/fdavoice/index.php/tag/bacterial-meningitis/

https://my.clevelandclinic.org/health/articles/meningitis

https://my.clevelandclinic.org/health/articles/bacterial-meningitis