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Revision as of 00:35, 21 May 2004 by Alex.tan (talk | contribs) (copyedits)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)Meningitis is inflammation of the sheaths and membranes (meninges) covering the brain and the spinal cord. Although the most common causes are infection (either bacterial or viral), chemical agents and even tumor cells may cause meningitis. Encephalitis and brain abscess can complicate infective meningitis.
Major bacteria that cause meningitis are Streptococcus pneumoniae, Haemophilus influenzae, staphylococcus and meningococcus.
The classical symptoms of meningitis are headache, neck stiffness and photophobia (the trio are called "meningism"). An altered level of consciousness or other neurological deficits may be present depending on the severity of the disease. A lumbar puncture to obtain cerebrospinal fluid is usually indicated to determine the cause and direct appropriate treatment.
Meningitis is a medical emergency with high levels of fatality and the cause is usually bacterial strains sensitive to antibiotics. Patients with suspected meningitis should optimally have a lumbar puncture procedure after a CT scan (which will help rule out a possible raised intracranial pressure that may cause a serious or fatal 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 raised intracranial pressure (likely due to edema or concomitant brain abscess), a broad spectrum intravenous antibiotic should be started anyway which can later be replaced with more specific antibiotics depending on the results of blood and cerebrospinal fluid culture and sensitivity studies.
Infection of the meninges usually originates through spread from infection of the neighbouring structures (which include the sinuses and mastoid cells of ear). These should be investigated when diagnosis of meningitis is confirmed or suspected.
Convulsions are a known complication of meningitis and are treated with appropriate anti-seizure drugs such as phenytoin.