Meningitis

Meningitis is the infection of the sheaths and membranes (meninges) covering the brain and the spinal cord. Although the most common causes are bacteria, certain viral, chemical agents and even tumor cells may cause meningitis. Encephalitis and brain abscess can accompany meningitis as a complication (due to spreading of bacteria to neighbouring brain structures).

Major bacteria that cause meningitis are streptococcus, Haemophilus influenzae[?], staphylococcus and meningococcus.

The symptoms and diagnostic methods are similar to those of encephalitis. Additionally, the culture of the cerebrospinal fluid and blood is crucial to determine the causative agent.

Since meningitis is a severe medical emergency with high levels of fatality and the cause is usually a bacteria strain that is highly treatable by antibiotics, patients with suspected meningitis should immediately undergo a lumbar puncture[?] procedure after a CT scan (which will eliminate a possible brain swelling that may cause a brain herniation during lumbar puncture) and broad spectrum antibiotics should be urgently started before the culture studies are completed. If lumbar puncture can not be performed because of brain swelling or a possible concomitant brain abscess, a broad spectrum antibiotic is started anyway and later it can be replaced with a more specific antibiotic depending on the results of blood culture studies.

Meningitis is usually caused by the infectious disorders of the neighbouring structures (sinuses, mastoid cells of ear etc.). Diagnostic tests should be run to find and treat these possible sources of infection, as well. Convulsions are frequently encountered during the course of meningitis and are treated with appropriate anti-seizure drugs like phenytoin.