Meningitis
Brooke Hildt and Jim Hutchins
Overview
Pathophysiology
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Viral vs Bacterial Meningitis
There are two main types of meningitis: Viral meningitis and bacterial meningitis. Viral meningitis is the most common type and is almost never life-threatening. It is often caused by enteroviruses, herpes simplex virus, or the varicella zoster virus. Bacterial meningitis while less common can become fatal within 24 hours and commonly occurs alongside sepsis. It is often caused by bacterial meningococcal, pneumococcal, or haemophilus influenzae.
Signs & Symptoms
- Neck stiffness
- Fever
- Non-blanching rash (bacterial)
- Altered mental status/ confusion
- Headache
- Nausea/ vomiting
Diagnosis
The easiest at home test for meningitis is the ‘glass test’. To preform the test, take a clear glass and press it firmly against the skin over the rash. Observe whether the rash fades or “blanches” (lightens in color) when you apply pressure. If the rash remains visible and does not fade when pressure is applied, it is considered a non-blanching rash, which accommodated by a fever could indicate bacterial meningitis and you should seek medical attention immediately. To confirm the diagnosis of meningitis, imaging, blood cultures, and a spinal tap are of best practice. Imaging including a Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) will show a white spot indicating edema, manifested by an autoimmune attack on the myelin sheath of individual axons upon a positive diagnosis. Blood cultures are obtained to test for bacterial growth and sepsis. Patients positive for meningitis will present with increased white blood cell (WBC) count and increased protein in their cerebrospinal fluid (CSP) along with low sugar levels in their spinal tap.
Treatment
Prompt treatment including intravenous antibiotics, intravenous fluids, steroid medications, and oxygen if indicated is of best practice.