Bacterial meningitis
exist different types of meningitisThe main ones are acute bacterial meningitis caused by a bacterial infection. Normally when talking about cases of meningitis, it is referring to this type of disease.
How does bacterial meningitis occur?
Acute bacterial meningitis are caused by different types of bacteria:
- In Adults, the main cause of meningitis is the.
- In the kids, the most common bacteria is N. In children, the frequency of other bacteria like him has drastically decreased since the inclusion of their vaccine in the vaccination schedule.
- Meningitis occur in neonates (newborns less than one month old) or in people with some chronic diseases such as cirrhosis.
- Meningitis that appear as complications of neurosurgical interventions on the central nervous system, are caused by a large percentage.
Pneumococcal or meningococcal meningitis
In the cases of meningitis due to (the most frequent), the bacteria colonize the mucosa of the nasopharynx of the individual and can pass into the bloodstream, and from there, reach the central nervous system and infect the cerebrospinal fluid and meninges. There is an inflammatory reaction against these bacteria and we are before a meningitis.
Lysteria meningitis
In the case of Lysteria meningitis, the mechanism is different, since this bacterium can be ingested through contaminated food and is installed in the digestive tract. From there it can pass into the bloodstream and later reach the central nervous system.
Symptoms of meningitis
Meningitis can be a fulminant disease and be fatal in a few hours or it may have a slower evolution in several days. The classic symptoms and signs of meningitis are:
- Fever
- Headache (headache)
- Stiff neck
- Vomiting
- Some people have seizures (seizures).
- Decreased level of consciousness and coma, consequence of intracranial hypertension (a poor prognostic sign).
- In meningitis due to thechia in the trunk, lower extremities or mucosa (small red spots) and / or cerebral infarction throughout the evolution of the disease.
How do I know if I have meningitis?
Given the clinical suspicion of meningitis, the diagnosis is made analyzing cerebrospinal fluid using a lumbar puncture. Analysis and culture of the cerebrospinal fluid reveal the bacteria that cause the disease in most cases.
Many times it is necessary to practice neuroimaging studies such as cranial magnetic resonance imaging, to complement the information.
Which is the treatment?
It is essential to carry out a analysis to find out which is the causative bacteria of meningitis and thus, personalize the treatment. However, since bacterial meningitis is a serious and life-threatening disease, immediate hospital admission is required. The Health Centers have protocols for intravenous antibiotic treatment according to age and route of infection (extra or intra-hospital). It's very important start antibiotics as soon as possibleeven before knowing the particular bacteria. Once the analysis to know the bacteria has been carried out, the antibiotic can be changed to a more specific one.
In addition to antibiotic treatment, complementary treatment is established that normally includes corticosteroids endovenous to reduce all the inflammatory reaction in the central nervous system, and specific treatment of complications such as seizures, coma, cerebral infarction, etc.
Mortality
Bacterial meningitis mortality varies according to the bacteria causing it: meningitis can have a mortality of up to 20%, while in meningitis it is much lower (from 3 to 7%). The prognosis is worse if seizures or a decrease in the level of consciousness appear in the first hours of the evolution of the disease, or when it occurs in infants or the elderly.
Although most people overcome and heal from meningitis without sequelae, in some cases there may be memory disturbances, decreased intellectual capacity or epileptic seizures.
Precautionary measures
Vaccines
Routine vaccination of children against Haemophilus influenza type b has reduced meningitis caused by this germ. Today, the vaccination schedule for children is also included in the vaccination against one of the types of meningococcus (serotype C).
There is the one against pneumococcus, which is not mandatory in all autonomous communities, but it has also been seen to decrease the incidence of severe pneumococcal disease in younger children.
Prophylactic antibiotics
When faced with a case of meningitis, there is always great social alarm, and people around them wonder what to do to prevent transmission and new cases of the disease. Only in cases of meningitis and meningitis is it necessary to locate contacts and take preventive measures such as antibiotic prophylaxis. In all other cases of meningitis this is not necessary.
antibiotic prophylaxis consists of giving antibiotics to the people who have been in contact with the patient to minimize the risk of new cases and eradicate nasopharyngeal carriers of meningococcus. In the case of menigococcal meningitis, antibiotic prophylaxis is performed with the rifampicin antibiotic for 2 days. As meningitis is a notifiable disease to the health authorities, they and the medical staff will indicate the guidelines and people who should receive antibiotic prophylaxis. Usually it is indicated in the following contacts:
- People who live in the same address.
- Person with direct exposure to nasopharyngeal drops or secretions (kisses with exchange of saliva, but not kisses on the cheek).
- If the affected person is a small child, in the nursery or kindergarten the prophylaxis of his classmates and educators is indicated. Center-wide prophylaxis is not indicated.
- In the case of primary school courses or older children, prophylaxis can be assessed for colleagues who have more frequent contact with the affected person or the closest friends.
In general, antibiotic prophylaxis is not indicated in co-workers or friends without a close relationship, nor in people who have attended the same social event, nor in people who have traveled in the seat next to it on public transport. When in doubt, it is best to go to the doctor. It has a 24-hour Medical Guidance service where all doubts will be clarified.
Internal Medicine specialist Advance Medical Consultant Physician
(Updated at Apr 14 / 2024)