Un­der­stand­ing the Panic

Wellness Update - - Meningitis -

This past sum­mer cre­ated wide­spread panic when con­tam­i­nated steroid in­jec­tions ex­posed 14,000 peo­ple across 23 states to vi­ral menin­gi­tis. The medicine was re­spon­si­ble for 720 vi­ral menin­gi­tis cases and 48 deaths.

If there is any com­fort, the menin­gi­tis in this case was the Fun­gal va­ri­ety and un­less you were un­for­tu­nate enough to re­ceive the con­tam­i­nated medicine, you weren’t at risk.

That doesn’t make menin­gi­tis any less dan­ger­ous be­cause there are five type of the disease – it can be con­ta­gious and deadly. There is a great deal of con­fu­sion about menin­gi­tis and meningo­coc­cal menin­gi­tis disease. There is a dif­fer­ence – a deadly dif­fer­ence. Per­haps the great­est mis­take made by peo­ple to­day is con­fus­ing menin­gi­tis with the flu and not get­ting med­i­cal help fast enough to avoid po­ten­tially se­ri­ous com­pli­ca­tions from the disease.

Ac­cord­ing to the Na­tional Menin­gi­tis As­so­ci­a­tion: In the United States, ap­prox­i­mately 1,500 peo­ple will be di­ag­nosed with Meningo­coc­cal Menin­gi­tis and 11 per­cent will die. 2. Ado­les­cents and young adults are at greater risk for meningo­coc­cal disease than most, ac­count­ing for 15 per­cent of all cases. One out of seven who get the disease will die. 3. Among those who sur­vive, ap­prox­i­mately 20 per­cent live with per­ma­nent dis­abil­i­ties, such as brain dam­age, hear­ing loss, loss of kid­ney func­tion or limb am­pu­ta­tions. 4. Meningo­coc­cal disease is of­ten mis­di­ag­nosed be­cause

its early symp­toms are much like those of the flu.

Types of Menin­gi­tis

Vi­ral menin­gi­tis, also called asep­tic menin­gi­tis, is the most com­mon type. It is rarely fa­tal and usu­ally re­solves with treat­ment. Menin­gi­tis de­vel­ops in fewer than 1 in 1000 peo­ple who are in­fected with one of the viruses as­so­ci­ated with the con­di­tion. Bac­te­rial menin­gi­tis is of­ten se­vere and is con­sid­ered a po­ten­tial med­i­cal emer­gency. If left un­treated, bac­te­rial menin­gi­tis may be fa­tal or cause se­ri­ous longterm com­pli­ca­tions. Be­cause bac­te­rial menin­gi­tis can progress rapidly, it is im­por­tant to iden­tify the bac­te­ria and be­gin an­tibi­otic treat­ment as soon as pos­si­ble. Bac­te­rial in­fec­tion in the ears, mouth, or si­nuses can spread di­rectly to the brain and spinal cord. Some types of bac­te­ria are trans­mit­ted from per­son to per­son through se­cre­tions from the mouth and nose. Bac­te­rial menin­gi­tis is usu­ally se­vere. While most peo­ple with menin­gi­tis re­cover, it can cause se­ri­ous com­pli­ca­tions, such as brain dam­age, hear­ing loss, or learn­ing dis­abil­i­ties. There are sev­eral pathogens (types of germs) that can cause bac­te­rial menin­gi­tis. Some of the lead­ing causes of bac­te­rial menin­gi­tis in the United States in­clude Haemophilus in­fluen­zae (most of­ten caused by type b, Hib), Strep­to­coc­cus pneu­mo­niae, group B Strep­to­coc­cus, Lis­te­ria mono­cy­to­genes, and Neis­se­ria menin­gi­tidis. Fun­gal menin­gi­tis de­vel­ops in pa­tients with con­di­tions that com­pro­mise the ef­fec­tive­ness of their im­mune sys­tems (e.g., HIV/AIDS, lu­pus, di­a­betes). Fun­gal menin­gi­tis oc­curs in 10% of pa­tients with AIDS. Cry­to­coc­cus ne­o­for­mans and Can­dida al­bi­cans are com­monly in­volved in fun­gal menin­gi­tis. Par­a­sitic menin­gi­tis is more com­mon in un­der­de­vel­oped coun­tries and usu­ally is caused by par­a­sites found in con­tam­i­nated water, food, and soil. Non­in­fec­tious menin­gi­tis may de­velop as a com­pli­ca­tion of an­other ill­ness (e.g., mumps, tu­ber­cu­lo­sis, syphilis). A break in the skin and/or bones in the face or skull (caused by birth de­fect, brain surgery, head in­jury) can al­low bac­te­ria to en­ter the body.

What Causes Menin­gi­tis?

Viruses and bac­te­ria that spread to or di­rectly in­fect the cen­tral ner­vous sys­tem cause most cases of in­fec­tious menin­gi­tis.

About 90% of cases of vi­ral menin­gi­tis are caused by one of the en­teroviruses (e.g., cox­sack­ievirus, echovirus, po­liovirus). Mumps, her­pesvirus, and ar­boviruses (trans­mit­ted by in­sect bites) also may cause vi­ral menin­gi­tis. About 30% of mumps cases in peo­ple not vac­ci­nated for the disease de­velop menin­gi­tis.

Com­mon causes of bac­te­rial menin­gi­tis in­clude Strep­to­coc­cus pneu­mo­niae, Neis­se­ria menin­gi­tides, Sta­phy­lo­coc­cus aureus, Escherichia coli, and Sta­phy­lo­coc­cus epi­der­midis. Prior to the 1990s, Haemophilus in­fluen­zae type b was the pri­mary cause, but wide­spread vac­ci­na­tion (Hib vac­cine) has greatly re­duced the in­ci­dence of this in­fec­tion.

Non­in­fec­tious Menin­gi­tis Causes

There are other, non­in­fec­tious ways to get menin­gi­tis. Th­ese in­clude: * Car­ci­no­mato­sis (wide­spread metastatic can­cer) * Con­tam­i­nated water (may con­tain par­a­sites) * Head in­jury, birth de­fect of the skull, brain surgery (may

re­sult in in­fec­tion of the meninges or cere­brospinal fluid) * Med­i­ca­tions such as non­s­teroidal anti-in­flam­ma­to­ries

(e.g., ibupro­fen, naproxen) and an­tibi­otics.

Know the Signs and Symp­toms of Menin­gi­tis

Symp­toms of bac­te­rial menin­gi­tis are usu­ally acute, de­vel­op­ing within a few hours and last 2 to 3 weeks. It is im­por­tant to get med­i­cal at­ten­tion as soon as the symp­toms oc­cur, be­cause acute bac­te­rial menin­gi­tis can be fa­tal within hours.

Vi­ral menin­gi­tis can de­velop sud­denly or within days or weeks, de­pend­ing on the virus and the over­all health of the pa­tient. The most com­mon symp­toms of both vi­ral and bac­te­rial menin­gi­tis are stiff neck, headache, and fever. The symp­toms can de­velop over the course of a few hours (acute bac­te­rial menin­gi­tis) or a few days. Some pa­tients ex­pe­ri­ence cough, runny nose, and con­ges­tion prior to de­vel­op­ing other symp­toms.

Other signs and symp­toms of menin­gi­tis can in­clude: * Con­fu­sion * Drowsi­ness * Joint pain * Lethargy * Nau­sea and vom­it­ing * Seizures * Sen­si­tiv­ity to light (pho­to­pho­bia) * Skin rash (com­monly near the armpits

and on the hands and feet)

Symp­toms in In­fants.

Menin­gi­tis symp­toms in in­fants can be dif­fi­cult to de­tect and in­clude: * Bulging of the soft spots (fontanels) in the head

caused by in­creased in­tracra­nial pres­sure * De­creased ac­tiv­ity * Dif­fi­culty nurs­ing or eat­ing * Ex­ces­sive sleep­ing * High-pitched cry * In­creased cry­ing and ir­ri­tabil­ity * Vom­it­ing

Treat­ment for Menin­gi­tis

Treat­ment for menin­gi­tis is de­ter­mined by the type of menin­gi­tis and the or­gan­ism caus­ing the disease.

Vi­ral menin­gi­tis usu­ally re­quires bed rest, in­creased fluid in­take to pre­vent de­hy­dra­tion, and anal­gesics (e.g., as­pirin, ac­etaminophen) to re­duce fever and re­lieve body aches.

Menin­gi­tis caused by her­pesvirus can be treated us­ing antiviral med­i­ca­tion

Bac­te­rial menin­gi­tis re­quires prompt in­tra­venous (IV) an­tibi­otic treat­ment in the hospi­tal to pre­vent se­ri­ous com­pli­ca­tions and neu­ro­log­i­cal dam­age. If symp­toms are se­vere, IV treat­ment may be ini­ti­ated be­fore the lum­bar punc­ture is per­formed.

Se­verely ill pa­tients are treated im­me­di­ately with a com­bi­na­tion of an­tibi­otics. Peni­cillin com­bined with other med­i­ca­tions is com­monly used.

There are spe­cific med­i­ca­tions that are ef­fec­tive against fun­gal menin­gi­tis and Par­a­sitic menin­gi­tis usu­ally is treated with a ben­z­im­i­da­zole de­riv­a­tive or other an­ti­helminthic agent.

Menin­gi­tis can strike quickly. When in doubt, seek med­i­cal ad­vice. It could be more than the flu. -This in­for­ma­tion pro­vided courtesy of the Na­tional Menin­gi­tis As­so­ci­a­tion

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