Meningitis%20-%20acute,%20bacterial Signs and Symptoms

Signs and Symptoms

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

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

Alternative Causes of Meningitis

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

Signs and Symptoms

Classic triad: Fever, neck stiffness and an altered level of consciousness is present in <50% of cases and some may have severe headache (especially in children) or any of the other symptoms:
- Chills
- Myalgia
- Photophobia
- 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

An uncommon cause of hyperthyroidism

Dr. Rose Zhao-Wei Ting, 16 Nov 2016

A 55-year-old man presented with almost one year history of heat intolerance, mild palpitation and significant weight loss. Free T3 and T4 were elevated with normal TSH. Patient had suboptimal response to carbimazole therapy.

Hypertension and cholesterol lowering interventions do not reduce cognitive decline

Roshini Claire Anthony, 22 Nov 2016

Blood pressure lowering medications and statins do not prevent cognitive and functional decline in elderly patients, according to results of the HOPE-3 trial* presented at the Scientific Sessions of the American Heart Association (AHA 2016) held recently in New Orleans, Louisiana, US.

Shifting paradigms in MS management: Early, optimized interventions improve patient outcomes

04 May 2018

Multiple sclerosis (MS) is one of the most common neurological disorders – affecting over 2.3 million people globally – and it is the leading cause of nontraumatic disability in young adults. However,the availability of supportive resources and services for people with MS is scarce in many regions of the world. In Malaysia, the prevalence of MS is estimated at 2-3/100,000; the current Malaysian clinical practice guidelines on the management of MS recommend disease modifying agents, such as interferon-β and teriflunomide, as first-line therapeutic agents. In this article, Dr Singer - in partnership with Sanofi and the Malaysian Society of Neurosciences - shares his insights into managing MS dynamically, highlighting the importance of early intervention in improving patient outcomes.