Meningitis: Bacterial or Viral?

Meningitis, according to World Health Organization, is inflammation of the meninges (the covering of the brain and spinal cord). This life-threatening condition is most often caused by infection (bacterial or viral), but it can also be produced by chemical irritation, subarachnoid hemorrhage, cancer, and other conditions. Below are bacterial and viral cases.

1. Meningococcal Meningitis
Meningococcal meningitis is a bacterial form of meningitis; it is a serious infection of the meninges that affects the brain membrane. Bacterial meningitis causes brain damage, hearing loss, or a learning disability in 10% to 20% of survivors and is fatal if left untreated. Even when the disease is diagnosed early and adequate treatment is started, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms. Meningococcal disease should always be viewed as a medical emergency and admission to a hospital is necessary.

Neisseria meningitidis is the common cause of meningococcal meningitis. Neisseria meningitidis are opportunistic pathogens that colonize the nasopharynges and oropharynges of asymptomatic carriers. When a person’s immunity is compromised they proliferate and eventually gain access to the blood, and subsequent crossing to the cerebrospinal fluid causes septicemia to the meninges.

The bacteria are easily transmitted from person to person through droplets of respiratory or throat secretions. Close and prolonged contact with an infected person easily spreads the disease.

The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. The average incubation period is four days, but it can range between two and 10 days.

Initial diagnosis of meningococcal meningitis can be made by clinical examination. The gold standard is a lumbar puncture wherein the spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal can be collected. The diagnosis is confirmed by growing the bacteria by agglutination tests or polymerase chain reaction (PCR). Identification of the type of bacteria responsible is important for proper and effective selection of antibiotics.

Appropriate antibiotic treatment must be started as soon as possible, ideally after the lumbar puncture has been carried out. If treatment is started prior to the lumbar puncture it may be difficult to grow the bacteria from the spinal fluid and confirm the diagnosis. A range of antibiotics can treat the infection, including penicillin, ampicillin, chloramphenicol and ceftriaxone.

2. Viral Meningitis
Viral meningitis has similar symptoms to bacterial meningitis, but is neither as deadly nor as debilitating. According to the Centers for Disease Control, there is no specific treatment available for viral meningitis like most viral illness patients recover on their own. Once diagnosis reveals viral meningitis, treatment is mostly supportive.

3. Tuberculosis (TB) Meningitis
When a tuberculosis bacterium (Mycobacterium Tuberculosis) invades the spinal fluid membranes and the meninges surrounding the brain and spinal cord, tuberculosis (TB) meningitis occurs. The infection usually begins elsewhere in the body, usually in the lungs, and then travels through the bloodstream to the meninges where small abscesses (called microtubercles) are formed. When these abscesses burst, TB meningitis is the result.

Vaccinations can protect children against some diseases that can lead to meningitis. The risk of meningococcal vaccine causing serious harm is extremely small. Ask your health care provider for more information regarding meningitis vaccine.

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