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Meningitis

Meningitis is still with us. It can strike in an instant, but the impact can last a lifetime - Meningitis Now


"Most cases of meningitis are caused by viruses and these infections, while they make you feel really lousy for a week or two, are usually fought off by the body on its own with no residual effects. One specific type of viral meningitis is herpetic viral meningitis and it is treatable with an antiviral drug called acyclovir. CSF evaluation is pretty good at showing whether a case of meningitis is caused by a virus, but really lousy at determining which specific virus is the guilty party.

Because of this many physicians treat all patients who have viral meningitis with acyclovir just in case they happen to have herpetic meningitis, which is a fairly common disease because the herpes viruses (there are lots) are much more prevalent than most folks realized. Remember that herpes viruses don’t only cause the notorious genital disease, the also cause cold sores, which most of us have from time-to-time.

The biggest concern that a doctor has when they are confronted with someone who has meningitis is to determine if the meningitis is cause by bacteria. Bacterial meningitis is bad news because it is fatal about 10% of the time and responsible for brain damage or limb amputations in up to 20% (that’s 1-in-5) of the survivors. Limb amputations? Yep, I said that right. Bacterial meningitis frequently causes shock and DIC, two deadly conditions in which the whole body more or less shuts down in response to an infection.

When this occurs the body tries to shunt its blood supply to its most important organs, namely the heart and the brain, and this comes at the expense of the limbs in particular. Because the limbs no longer are being supplied with an adequate amount of blood they die and the treatment for a necrotic limb is to amputate it before it becomes infected because otherwise the infection of the dead limb is likely to spread to the rest of the body and result in death.

Bacterial meningitis is treated with potent antibiotics, antiepileptic drugs to prevent seizures, and with powerful anti-inflammatory drugs to decrease damage to the brain. With that said, the best treatment for bacterial meningitis is to prevent it in the first place and the medical establishment is actually pretty good at this if people will vaccinate their kids! Pneumococcus and Haemophilus influenza type b were formerly very common causes of very serious cases of bacterial meningitis in young children.

The incidence of meningitis caused by these two nasty bugs has greatly decreased due to the Conjugated Pneumococcal Vaccine (PCV7) and the Hib Vaccine, both of which are routinely given to young children with the first dose of Hib being given at the age of 2 months. In addition, the most notorious cause of meningitis in teenagers and young adults is Meningococcus and we have a pretty good vaccine that covers most strains of this nasty killer and that is now routinely given to children at age 12 (with a booster at age 16), thus saving many otherwise young healthy lives. The take home message is to please vaccinate your children!

There are two other uncommon, but exceedingly nasty, other types of organisms that are potential causes of meningitis: fungi and parasites. Fungal meningitis most commonly afflicts people who are immunocompromised, e.g. people with AIDS and people suffering from cancer. Though usually uncommon in healthy persons, there was an outbreak in 2012 that was spread by contaminated corticosteroid injections (often used for joint injections in people with arthritis) that unnecessarily killed a lot of people.

An even more scary cause of meningitis is the parasite Naegleria fowleri, an ameba that can swim up the nose of people who are swimming in warm fresh water and that causes a form of meningitis that has a 95% mortality (death) rate! Fortunately Naegleria meningitis is rare; unfortunately, when it does strike it is usually in young healthy teenagers because this is the age group that most commonly swims in warm lakes and rivers."

Source: Zippykidcustomer, Excerpt from What is Meningitis? Meningitis 101, The health and Medical Blog with a Personality, October 29, 2013.


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