Meningitis

My cousin, Ate Libet, a stewardess of Cathay Pacific visited us today. She had a Sydney flight yesterday. She had dinner with the family. On the course of our chit-chat, she mentioned that her son, Kevin had Viral Meningitis and was confined at the Makati Med for 9 days. Here is some of the things you should know about Meningitis....

Meningitis is a viral or bacterial infection of the meninges (membranes that surround the brain and spinal cord) that enters through the bloodstream from other parts of the body. The meninges have no host defenses to fight off invading bacteria. Meningeal inflammation of the brain or spinal cord can also be of noninfectious origin.

One of the most important things to determine when meningitis is suspected is whether it is bacterial (meningococcal) or viral. If a bacterial pathogen is the culprit, it is essential to identify the specific causative agent so that the appropriate antibiotics can be prescribed immediately. If left untreated, bacterial meningitis can lead to severe complications such as brain damage, hearing loss, epilepsy, and even death. Viral meningitis is generally less severe and typically resolves on its own.

The classic presentations of meningitis are fever, headache, meningismus (nuchal rigidity), and signs of cerebral dysfunction such as confusion, delirium, or impaired consciousness. However, in the vast majority of cases, only 1 or 2 of these symptoms will be present, so the diagnosis is not always so clear-cut. Only two thirds of patients with bacterial meningitis will present with all 3 classic symptoms of fever, nuchal rigidity, and change in mental status.[4] However, the diagnosis of meningitis can be ruled out, with 99% to 100% sensitivity, by the absence of at least one of the classic symptoms of fever, neck stiffness, and altered mental status.

Additional presenting symptoms include nausea, confusion, sleepiness, stupor, visual discomfort, and seizure activity. All of the above-mentioned characteristics are harder to detect in infants -- signs to look for in the very young include lethargy, irritability, vomiting, and poor appetite. Symptoms may have a sudden onset, whereby the patient becomes severely ill within a matter of hours, or they may develop more gradually (over the course of 1 to 2 days).