Meningitis
Risk factors
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INFECTIOUS DISEASE |
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Bacterial
Illnesses
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Meningitis is an infection and inflammation of
the membranes (meninges) and fluid (cerebrospinal
fluid) surrounding your brain and spinal cord.
Meningitis is most often caused by bacteria or
viruses. Bacterial meningitis is usually much more
serious than viral meningitis. Most cases of
meningitis occur when bacteria from an infection in
another part of your body travel through your
bloodstream to your brain and spinal cord. But
bacteria can also spread directly to your brain or
spine from a severe head injury or from an infection
in your ear, nose or teeth.
Some types of meningitis are contagious. You may
be exposed to the bacteria when someone with
meningitis coughs or sneezes. The bacteria can also
spread through kissing or sharing eating utensils, a
toothbrush or a cigarette. You're also at increased
risk if you live or work with someone with the
disease.
Meningitis strikes suddenly, usually with a high
fever, severe
headache and vomiting. As the disease
progresses, the brain swells and may begin to bleed.
Meningitis is fatal in about 10 percent of cases.
Unfortunately, many of those who survive an attack
may have serious long-term neurologic complications,
such as deafness, blindness, speech loss or brain
damage.
Seventy percent of meningitis cases occur in
children under age 5, but the incidence of the
disease is increasing among young people between the
ages of 15 and 24. Older adults also tend to have a
high incidence of meningitis.
Meningitis is a medical emergency. How well you
recover depends on how quickly you receive
treatment. If you suspect that you or someone in
your family has symptoms of meningitis, seek medical
care right away.
Risk factors
Children under age 5, young people ages 18 to 24 and older adults are
more likely to develop meningitis than the rest of the population.
Black, Eskimo and American Indian children are especially at risk of
meningitis caused by the bacteria H. influenzae and
Streptococcus pneumoniae. People with weakened or suppressed immune
systems also are at higher risk.
College students living in dormitories, personnel on military bases and
children in boarding schools and child-care facilities are at increased
risk of meningococcal meningitis, mainly because infectious diseases
tend to spread quickly wherever large groups of people congregate.
If you're pregnant, you're 20 times more likely to contract listeriosis,
an infection that may cause meningitis. If you have listeriosis, your
unborn baby is at risk too. Also at higher risk of listeriosis are
people who work with domestic animals, including dairy farmers and
ranchers.
Some studies have linked increased risk to smoking and drinking alcohol,
which may suppress your body's immune system. Other factors that may
compromise your immune system — including AIDS, diabetes and use of
immunosuppressant drugs — also make you more susceptible to meningitis.
Removal of your spleen, an important part of your immune system, may
also increase your risk.
When to seek medical advice
The sooner you're treated for acute bacterial meningitis, the better are
the chances that you'll recover without serious complications. But the
disease can make you sick very quickly. If you or someone in your family
has symptoms of meningitis — such as fever, severe headache, vomiting
and stiff neck — get medical care right away.
If a family member or someone you work with has meningitis, talk to your
doctor about medications that can help prevent you from getting sick.
Screening and diagnosis
Your doctor will likely diagnose meningitis based on your medical
history, a physical exam and certain diagnostic tests. During the exam,
your doctor may check for signs of infection around your head, ears,
throat and the skin along your spine.
You may also have a throat culture to check for the bacteria that cause
meningitis, perhaps X-rays or a computerized tomography (CT) scan of
your chest, skull or sinuses. A CT scan is a diagnostic imaging
procedure that uses a series of very thin computer-generated X-rays to
reveal two-dimensional "slices" of your body.
The definitive diagnosis of meningitis, however, is often made by
analyzing a sample of your cerebrospinal fluid (CSF), which is extracted
during a procedure known as a spinal tap (lumbar puncture). After you've
received a local anesthetic, your doctor inserts a thin, hollow needle
between two vertebrae in your lower back (lumbar area) and into your
spinal canal. He or she then removes some cerebrospinal fluid for
laboratory analysis. One of the signs of meningitis is a low sugar
(glucose) level along with an increased white blood cell count in the
fluid. CSF analysis may also help your doctor identify the exact
bacteria that's causing your illness.
The entire procedure takes from less than 10 to about 30 minutes. You
may have a feeling of pressure while the fluid is being extracted and a
headache afterward because of a drop in CSF pressure. A lumbar puncture
also carries a small risk of infection.
If your doctor suspects you have viral meningitis, he or she may order a
test known as a polymerase chain reaction (PCR) amplification to check
for the presence of certain viruses. If you have chronic meningitis
caused by cancer or an inflammatory illness, you may need other tests.
In all cases, however, your doctor's goal will be to make an accurate
diagnosis and start treatment as soon as possible.
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