Meningitis
What is it?
Meningitis is an inflammation of the meninges and cerebrospinal fluid, cause by bacterial and viral infections.
What causes it?
Meningococcal meningitis (spinal meningitis) is caused by Neisseria meningitidis and is known to be the most serious form of meningitis. Haemophilus influenzae type B had been the cause in children up to 3 years old, but a vaccination against this strand was found in 1981. Viruses and other microorganisms have also been known to cause meningitis.
Transmission factors
N. meningitidis is transmitted by respiratory droplets after the upper respiratory tract has been colonized by the virus in healthy individuals. Every human has probably been a carrier of N. meningitidis at some point in their life. The disease is known to peak in the winter months when temperature and humidity is low. Meningococcal meningitis is more common in certain parts of the United States and world. The reason for those specific locations is unknown. Transmission factors for N. meningitidis are contact of oral secretions (kissing, sharing food or drink), crowding, close contact and smoking.
Clinical Presentation
Incubation period is usually 2-4 days but may last up to 10 days. Symptoms may present rapidly anywhere within hours to days of exposure. As with most bacterial infections, signs and symptoms may include fever, chills, headache, lethargy, malaise, altered mental status, vomiting and seizures. The disease may be caused from an upper respiratory or ear infection. Meningitis patients also develop a characteristic rash that may turn into hemorrhagic spots. Ten percent of patients may develop septic shock. Adrenal insufficiency, disseminated intravascular coagulation (DIC), and coma are other consequences. Death can occur in 6- 8 hours.
Newborns/Infants – Slow, inactive, vomiting, irritability, poor feeding habits, fever, bulging spot on their soft spot, body stiffness and may cry when being held.
Older children – Flu like symptoms, difficulty breathing, cough, stiff neck, confusion, headache
Adults – Symptoms vary due to medical history, but most adults will experience headache, dizziness, lethargy, body aches, fever, confusion, skin rash.
Check for Brudzinki’s and Kernig’s signs in patients
Brudzinki’s signs – A physical exam finding in which flexion of the neck causes flexion of the hips and knees
Kernig’s signs – A physical exam finding in which the patient is unable to fully extend the knees with hips flexed.
Immunizations
There are several serotypes for N. meningitidis (A, B, C, X, Y, Z, 29-E, W-135) with B and C causing most outbreaks in the USA. A vaccine has been developed against A, C, Y and W-135. People who do not have a spleen, are traveling to endemic areas and children under the age of two are candidates for this vaccination.
Sources:
Brady Paramedic Care: Medical Emergencies (pages 571–573)
http://www.webmd.com/a-to-z-guides/meningitis-topic-overview