Treatment of Meningitis

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Meningitis is usually caused by infection from viruses or micro-organisms. Meningitis can be diagnosed through blood tests such as blood cultures and blood count. Lumbar puncture analyzes the cerebrospinal fluid; it checks and terminates the herniation of the brain. Prior to lumbar puncture MRI and CT scan is done to check the status.

In severe forms of meningitis monitoring of blood electrolytes is important. Lumbar puncture is done by positioning the patient usually lying on the side and local anesthesia is applied; a needle is injected in the dural sac. The CSF is examined for seeing the types of white blood cells, red blood cells, proteins and glucose level. The white blood cells present indicates whether the meningitis is bacterial or viral. Although in the beginning this indicator is usually not important and does not affect the treatment.

The concentration of glucose in CSF is normally above 40% in blood. In bacterial meningitis it is usually low. Meningitis is usually diagnosed after death that is in postmortem.

The findings from a post mortem are usually widespread inflammation to the pia mater and arachnoids layer. Since 1980’s many countries have included immunization against meningitis and this has worked a lot in countries to prevent this deadly disease. Usually in the childhood the child is immunized with meningitis vaccination before five years of age. Meningitis is usually life threatening and causes high mortality rate if untreated.

Delay in treatment causes deaths and a severe stage of meningitis. If the level of consciousness is low then mechanical ventilation is required to treat it.

Seizures are treated with anticonvuzants. Empiric antibiotics should be started immediately before the results are known lumbar puncture and CSF are performed.

Hydrocephalus may require insertion of a temporary and long term drainage device such as cerebral shunt.

The result of the CSF facto usually takes longer time to be available; Tuberculosis meningitis requires prolonged treatment of antibiotics. Meningitis of all types can be treated at an early stage with antibiotics, preventive vaccinations and even through other medical facilities.



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