Meningitis

What is Meningitis?

Meningitis is an infection of the brain, more specifically an infection of  a layer that covers the brain and spinal cord.

Meningitis can be caused by viruses, bacteria and even fungi.

Over the last 30 years Meningitis cases have reduced in number . However there is still each year 1 case for every 100,000 people in Europe.

Who Gets Meningitis?

Anyone can get meningitis. Children under 5, Teenagers and Young adults  are more at risk of getting meningitis.

Types of Meningitis

meningitis rash
Viral Meningits

This is the most common type of meningitis.

Mumps, chickenpox, influenza  and many other  viruses can cause  meningitis.

Generally speaking viral meningitis is milder than the bacterial infection.

Bacterial Meningitis

This is generally a more serious infection.

There are 3 main causes of  bacterial meningitis in the UK.

Neiserria Meningitidis (meningococcal meningitis)

This is a common bacteria that 10% of people carry, harmlessly, in their upper respiratory tract-(nose, mouth and throat). It can be passed to other  people by close contact- coughing, sneezing and even kissing

It doesn’t usually make people poorly for 2 main reasons : 1. The bacteria cannot survive long outside the body; 2, most of us already have been in contact with this infection at some times in our life, and have some immunity to it

There are several types of Meningococcus  type A, B, C.W and Y

Streptococcal Pneumococcus  ( Pneumococcal meningitis)

As the name suggests this bacteria usually causes  ear, nose, throat and  chest infections. Rarely it can cause septicaemia and meningitis. For this to happen the  infection must spread from the site of the infection, into the blood and onto the  brain

Haemophilus Infuenza  (Hib)

This used to be the commonest type of meningitis  in young children  but since  vaccination to Hib was introduced in the infant vaccination it has become a rare infection – a real success story.

Symptoms  Of Meningitis

Most people are aware of the rash that we all look for but the truth is that this may never occur, or may do so only when the infection has become widespread and serious.

Early symptoms

Pale skin especially in the face and around the lips which may have a blue tinge.

Cold  peripheries. Despite having a high temperature the hands and feet may seem quite cold.

Limb pain. The person may not be able to walk around or wven stand up. The pain can be very intense.

Rash

this is associated with meningococcal meningitis . it can occur early in the disease but often only occurs  when the infection has progressed.

It has a characteristic  purply red colour and  doesn’t fade when you press the spost and let go . many other  viral infection can cause a rash but this rash fades if you press it.

Other symptoms

Babies
  • Raised  Temperature
  • Pale skin. May be blotchy and feel cold despite the temperature
  • Crying at rest and this may get worse when the baby is lifted up
  • Drowsiness – it may be hard to wake
  • Breathing- this may be too fast or seem
  • laboured and difficult
  • Poor Feeds-  may not take feeds
  • Bulging soft spot. The fontanelle or soft spot on the skull may be bulging outwards
  • Vomiting
Older Children and Adults
  • Raised  Temperature
  • Pale skin. May be blotchy and feel cold despite the temperature
  • Aches – joints, muscles – this can be so bad that they cannot stand or walk
  • It can also involve the neck making it stiff  especially when trying to bend it forward
  • Drowsiness – it may be hard to wake
  • Bright lights- these may cause pain or distress
  • Confusion from mild to severe may appear vacant or may seem to hallucinate
  • Vomiting
  • Breathing- this may be too fast or seem laboured and difficult
The symptoms can occur very rapidly or over a few days  and early on you may think that it is just a normal virus  but be aware of meningitis and if you suspect meningitis  SEE YOUR DOCTOR IMMEDIATELY either  call to the GP and insist on being seen immediately. This may require a GP to visit. If you suspect meningitis TELL THE GP RECEPTIONIST. They will prioritise your appointment or visit.

If the GP suspects meningitis, they will immediately refer you to hospital. They will call an ambulance to get you there asap.

While waiting for the ambulance, they will usually give you an injection of antibiotics, to get the treatment started asap.

Once in hospital the patients will be seen immediately and started on a drip giving fluids and very strong antibiotics. The doctors will carry out blood tests and a lumbar puncture- drawing fluid from the spine to see what bacteria are causing the infection.

After recovery

Most people who get meningitis survive but can have a range of problems , short term and long term and  some that can cause severe disability.

These include:

  • Persisting headaches
  • Fits and seizures
  • Weakness, paralysis, arthritis
  • Scarring
  • Amputations  of fingers and occasionally whole limbs
  • Visison, speech and memory problems

Prevention

Vaccination  Children have routine vaccination against  Meningitis B and C, Hib and Pneumococcus.

University students are offered  a vaccine against  Meningitis A, C.W any Y.

Contact

If someone is diagnosed with meningococcal infection, people who they have been in close contact with are offered a course of antibiotics  In this case contacts refers to  members of the household and people they may have kissed  in the last 7 days.

Author Info

Adam Simon

Adam Simon

Dr Simon is an extremely well qualified general practice doctor with considerable expert knowledge and a truly engaging patient approach.

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