meningitis%20-%20acute,%20bacterial
MENINGITIS - ACUTE, BACTERIAL

Acute meningitis is the infection of the subarachnoid space and cerebrospinal fluid by bacteria that may cause local and systemic inflammatory response.
There is the classic triad of symptoms of fever, neck stiffness and altered level of consciousness.
Other symptoms include chills, myalgia, photophobia, severe headache, focal neurologic symptoms, nausea, vomiting, seizures and some patients may present with rash.

 

Definition

  • Meningitis is the infection of the meninges and subarachnoid space that is usually caused by bacteria results in high mortality and morbidity throughout the world

Etiology

  • H influenza type B, N meningitidis and S pneumoniae 
  • Causative agents depend on the age of the patient and predisposing factors
  • The introduction of conjugated vaccines have caused decline in the incidence of bacterial meningitis in children thus majority of cases are now present in the adult population

Other causes of acute meningitis include the following:

  • Spirochetes eg Treponema pallidum
  • Mycobacteria eg Mycobacterium tuberculosis
  • Fungi eg Cryptococcus, Coccidioides, Sporothrix
  • Viruses eg herpes simplex virus (HSV), varicella zoster, cytomegalovirus (CMV), enterovirus
  • Protozoa and helminths

Signs and Symptoms

  • Classic triad: Fever, neck stiffness and an altered level of consciousness
  • Other symptoms:
    • Chills
    • Myalgia
    • Photophobia
    • Severe headache
    • Focal neurologic symptoms (eg cranial nerve palsies, ataxia, dilated/unequal and poorly reacting pupils - late sign)
    • Nausea/vomiting
    • Seizures (late sign)
    • Some patients may present with petechial rash
    • Some patients may not present with the classic signs (eg alcoholics, patients who are immunocompromised and who had meningitis after neurosurgery)
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Radha Chitale, 25 Apr 2016
Two kinds of oral bacteria were associated with an increased risk of pancreatic cancer, according to research presented at the 2016 meeting of the American Association for Cancer Research (AACR), held recently in New Orleans, Louisiana, US.
24 Dec 2017
Patients with fluoroquinolone-resistant rectal vault flora appear to have higher odds of developing infectious complications following transrectal ultrasound-guided prostate needle biopsy despite targeted prophylaxis, a study has found.
31 Mar 2016
Lymphoid-resistant commensal bacteria (LRCs) colonize the interstitial lymphoid tissues of healthy mammals.
Pearl Toh, 03 Nov 2017
Increasing daily water intake by 1.5 L can half the risk of recurrent acute uncomplicated cystitis (rAUC) in women, suggests a study presented at the recent Infectious Disease Week (IDWeek) in San Diego, California, US.