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Meningitis is often described as the disease most feared by parents, as it can strike otherwise healthy children and kill them within just four hours. One in ten victims of Meningitis B will die, and one in four survivors will be left with severe after-effects, including loss of limbs, scarring, loss of hearing and brain damage. Meningitis UK want the newly approved vaccine for Meningitis B to be included to in the NHS childhood immunisation schedule. The new vaccine is the first to be licensed specifically for Meningitis B, one of the deadliest and most common strains of the disease.
Meningitis Symptoms Rash Pictures PicturePin Meningitis Symptoms Rash Pictures cake picture for pinterest and other social networks. The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Nuchal rigidity occurs in 70% of adult cases of bacterial meningitis.[6] Other signs of meningism include the presence of positive Kernig's sign or Brudzinski's sign. Meningitis caused by the bacterium Neisseria meningitidis (known as "meningococcal meningitis") can be differentiated from meningitis with other causes by a rapidly spreading petechial rash which may precede other symptoms.[7] The rash consists of numerous small, irregular purple or red spots ("petechiae") on the trunk, lower extremities, mucous membranes, conjuctiva, and (occasionally) the palms of the hands or soles of the feet. A severe case of meningococcal meningitis in which the petechial rash progressed to gangrene and required amputation of all limbs. People with meningitis may develop additional problems in the early stages of their illness. The brain tissue may swell, with increasing pressure inside the skull and a risk of swollen brain tissue causing herniation. Recent trauma to the skull gives bacteria in the nasal cavity the potential to enter the meningeal space.
Recurrent bacterial meningitis may be caused by persisting anatomical defects, either congenital or acquired, or by disorders of the immune system.[14] Anatomical defects allow continuity between the external environment and the nervous system.
The term aseptic meningitis refers loosely to all cases of meningitis in which no bacterial infection can be demonstrated.
A parasitic cause is often assumed when there is a predominance of eosinophils (a type of white blood cell) in the CSF. The meninges comprise three membranes that, together with the cerebrospinal fluid, enclose and protect the brain and spinal cord (the central nervous system).
In bacterial meningitis, bacteria reach the meninges by one of two main routes: through the bloodstream or through direct contact between the meninges and either the nasal cavity or the skin. The large-scale inflammation that occurs in the subarachnoid space during meningitis is not a direct result of bacterial infection but can rather largely be attributed to the response of the immune system to the entrance of bacteria into the central nervous system.
It is recognized that administration of antibiotics may initially worsen the process outlined above, by increasing the amount of bacterial cell membrane products released through the destruction of bacteria.
In someone suspected of having meningitis, blood tests are performed for markers of inflammation (e.g. The most important test in identifying or ruling out meningitis is analysis of the cerebrospinal fluid through lumbar puncture (LP, spinal tap).[20] However, lumbar puncture is contraindicated if there is a mass in the brain (tumor or abscess) or the intracranial pressure (ICP) is elevated, as it may lead to brain herniation. A lumbar puncture is done by positioning the patient, usually lying on the side, applying local anesthetic, and inserting a needle into the dural sac (a sac around the spinal cord) to collect cerebrospinal fluid (CSF). Various more specialized tests may be used to distinguish between various types of meningitis. A diagnostic and therapeutic conundrum is the "partially treated meningitis", where there are meningitis symptoms after receiving antibiotics (such as for presumptive sinusitis).
Histopathology of bacterial meningitis: autopsy case of a patient with pneumococcal meningitis showing inflammatory infiltrates of the pia mater consisting of neutrophil granulocytes (inset, higher magnification).


For some causes of meningitis, prophylaxis can be provided in the long term with vaccine, or in the short term with antibiotics.
Since the 1980s, many countries have included immunization against Haemophilus influenzae type B in their routine childhood vaccination schemes.
Short-term antibiotic prophylaxis is also a method of prevention, particularly of meningococcal meningitis.
Mechanical ventilation may be needed if the level of consciousness is very low, or if there is evidence of respiratory failure. Structural formula of ceftriaxone, one of the third-generation cefalosporin antibiotics recommended for the initial treatment of bacterial meningitis. Empiric antibiotics (treatment without exact diagnosis) must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. A 2010 analysis of previous studies has shown that the benefit from steroids may not be as significant as previously found. Viral meningitis typically requires supportive therapy only; most viruses responsible for causing meningitis are not amenable to specific treatment.
In children there are several potential disabilities which result from damage to the nervous system.
1,870 of these cases will be Meningitis B, one of the most common forms of the deadly disease.
Meningitis is an inflammation of the brain lining, whilst Septicaemia is an infection of the blood. Sometimes, especially in small children, only nonspecific symptoms may be present, such as irritability and drowsiness. This involves inserting a needle into the spinal canal to extract a sample of cerebrospinal fluid (CSF), the fluid that envelops the brain and spinal cord.
Kernig's sign is assessed with the patient lying supine, with the hip and knee flexed to 90 degrees.
The rash is typically non-blanching: the redness does not disappear when pressed with a finger or a glass tumbler. The patient, Charlotte Cleverley-Bisman, survived the disease and became a poster child for a meningitis vaccination campaign in New Zealand. These may require specific treatment, and sometimes indicate severe illness or worse prognosis. In premature babies and newborns up to three months old, common causes are group B streptococci (subtypes III which normally inhabit the vagina and are mainly a cause during the first week of life) and those that normally inhabit the digestive tract such as Escherichia coli (carrying K1 antigen). Similarly, individuals with a cerebral shunt or related device (such as an extraventricular drain or Ommaya reservoir) are at increased risk of infection through those devices.
This is usually due to viruses, but it may be due to bacterial infection that has already been partially treated, with disappearance of the bacteria from the meninges, or by infection in a space adjacent to the meninges (e.g. The pia mater is a very delicate impermeable membrane that firmly adheres to the surface of the brain, following all the minor contours. In most cases, meningitis follows invasion of the bloodstream by organisms that live upon mucous surfaces such as the nasal cavity.
When components of the bacterial cell membrane are identified by the immune cells of the brain (astrocytes and microglia), they respond by releasing large amounts of cytokines, hormone-like mediators that recruit other immune cells and stimulate other tissues to participate in an immune response. When this has been achieved, the "opening pressure" of the CSF is measured using a manometer. In bacterial meningitis it is typically lower; the CSF glucose level is therefore divided by the blood glucose (CSF glucose to serum glucose ratio).


A latex agglutination test may be positive in meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci; its routine use is not encouraged as it rarely leads to changes in treatment, but it may be used if other tests are not diagnostic.
When this happens, CSF findings may resemble those of viral meningitis, but antibiotic treatment may need to be continued until there is definitive positive evidence of a viral cause (e.g. The findings from a post mortem are usually a widespread inflammation of the pia mater and arachnoid layers of the meninges covering the brain and spinal cord. This has practically eliminated this pathogen as a cause of meningitis in young children in those countries. In cases of meningococcal meningitis, prophylactic treatment of close contacts with antibiotics (e.g.
The choice of initial treatment depends largely on the kind of bacteria that cause meningitis in a particular place. The CSF is then examined in a medical laboratory.[3] The usual treatment for meningitis is the prompt application of antibiotics and sometimes antiviral drugs. The infection may trigger sepsis, a systemic inflammatory response syndrome of falling blood pressure, fast heart rate, high or abnormally low temperature and rapid breathing. The arachnoid mater (so named because of its spider-web-like appearance) is a loosely fitting sac on top of the pia mater. This is often in turn preceded by viral infections, which break down the normal barrier provided by the mucous surfaces.
The blood-brain barrier becomes more permeable, leading to "vasogenic" cerebral edema (swelling of the brain due to fluid leakage from blood vessels). Most of the antibiotics used in meningitis have not been tested directly on meningitis patients in clinical trials. With treatment, mortality (risk of death) from bacterial meningitis depends on the age of the patient and the underlying cause.
A positive Brudzinski's sign occurs when flexion of the neck causes involuntary flexion of the knee and hip.
Older children are more commonly affected by Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (serotypes 6, 9, 14, 18 and 23) and those under five by Haemophilus influenzae type B (in countries that do not offer vaccination, see below).[1][3] In adults, N.
Endocarditis (infection of the heart valves with spread of small clusters of bacteria through the bloodstream) may cause aseptic meningitis. The subarachnoid space separates the arachnoid and pia mater membranes, and is filled with cerebrospinal fluid. Once bacteria have entered the bloodstream, they enter the subarachnoid space in places where the blood-brain barrier is vulnerable—such as the choroid plexus.
Large numbers of white blood cells enter the CSF, causing inflammation of the meninges, and leading to "interstitial" edema (swelling due to fluid between the cells).
Thus, corticosteroids are recommended in the treatment of pediatric meningitis if the cause is H.
Aseptic meningitis may also result from infection with spirochetes, a type of bacteria that includes Treponema pallidum (the cause of syphilis) and Borrelia burgdorferi (known for causing Lyme disease).
The outermost membrane, the dura mater, is a thick durable membrane, which is attached to both the arachnoid membrane and the skull. In addition, the walls of the blood vessels themselves become inflamed (cerebral vasculitis), which leads to a decreased blood flow and a third type of edema, "cytotoxic" edema.



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