Bacterial Meningitis: A Dreaded Disease That is Fully Curable
All diseases and infections that affect the brain are invariably dangerous and can potentially kill. Meningitis is the most common of them. Among the different types of Meningitis, the Bacterial Meningitis has historically been the most common, and equally dangerous. It is only in the last fifty years or so that we have become equipped to deal with it.
What is Bacterial Meningitis
Meninges are the membranous coverings which protect the brain and the spinal cord. Bacterial Meningitis, which is sometimes also called the Bacterial Spinal Meningitis is an infection of the Meninges. It is a dreaded disease which can be fatal if not treated immediately. In earlier times, Bacterial Meningitis amounted to a death forecast, but today, we can usually hope to treat it effectively and swiftly with appropriate antibiotics. The treatment requires a lot of intensive care and needs a hospital setting. The patient can usually recover with minimal damage, provided the treatment is initiated timely.
The fall in the mortality rates of patients diagnosed with Bacterial Meningitis is largely a result of availability of highly effectives modern day antibiotics. Today, it is possible for the physicians to identify the exact bacteria causing the diseases and treat it with the antibiotic that is most effective against it. In doing so, timely action can make the difference between life and death.
The causes of Bacterial Meningitis
Bacterial Meningitis is a result of infection by bacteria. The most common causes for this condition are Neisseria Meningitidis, Streptococcus Pneumoniae, and Haemophilus Influenzae. However, many other bacteria can also cause this condition, especially in the old and very young ones, or those who suffer from very low body immunity.
Signs and Symptoms of Bacterial Meningitis
Bacterial Meningitis is characterized by rapid onset and progression of symptoms, and hence usually referred as Acute Bacterial Meningitis. The condition of the patient deteriorates very rapidly, and an unattended person is at a very high risk because consciousness and thinking power is disturbed very quickly during the disease progression.
The onset of the disease is usually associated with innocuous symptoms like headache, fever, nausea and vomiting. However, very soon, the consciousness begins to get disturbed. It often progresses so fast that within a few hours, the patient can begin to behave in an abnormal manner. It begins with the patient becoming more and more restless, confused and irritable. At times, there may be uncontrollable rage, incoherence of speech and gross confusion. As the condition worsens, delirium set in. Sometimes, the attendants describe such behavior as having fits. Gradually, this uncontrollable and occasionally violent behavior begins to get replaced with loss of consciousness. The Delirium is replaced by semi-consciousness, which finally leads to total loss of consciousness and a comatose state.
One of the most characteristic signs, highly suggestive of Meningitis is neck rigidity. A normal person’s neck can be easily bent by the person himself or by others with a little bit of effort. However, in Meningitis, neither the patient herself, nor others can bend her neck, which becomes very rigid, almost like a log. It is a classic sign of Meningitis, which appears early in the disease and is of great help to the physician in diagnosing the condition as Meningitis. Later on, even when the patient is totally unconscious and the whole body is limp, even then, it is not possible to bend the neck because of the neck rigidity, a sign that is highly diagnostic of Meningitis. Another similar and related sign often used by the physicians for diagnosing Meningitis in its early stages, is the Kernig's sign. A patient of Meningitis, when asked to lift the straight foot up, while lying on her back will be unable to do so because of the pain caused by this maneuver.
Challenges in diagnosing Bacterial Meningitis
There are several medical conditions that lead to signs and symptoms, which are very similar to those of Bacterial Meningitis. Meningitis caused by viruses or fungi can also lead to a similar clinical picture. It is very important to distinguish Bacterial Meningitis from them because their treatment is entirely different and losing time with a wrong treatment can drastically reduce the changes of survival. Some cases of Intra-Cerebral vascular accidents can also lead to signs and symptoms that are similar to Bacterial Meningitis, as can be some other diseases and poisonings.
An important tool in the final diagnosis of Bacterial Meningitis is the Laboratory Examination of the Cerebro-Spinal Fluid (CSF), the fluid that fills the space between the Meninges and the brain and spinal cord. It is extracted by the physicians usually by a syringe inserted in the lower back, a procedure called Lumbar Puncture or LP. The Laboratory Examination Report of CSF is usually diagnostic in case of Bacterial Meningitis because of its typical features, consisting of low sugar level, high albumin, high white blood cell counts and no red blood cells.
Treatment of Bacterial Meningitis
A person diagnosed or even suspected of having Bacterial Meningitis must be shifted urgently to a well equipped Hospital with Intensive Medical Care facilities. This is essential in view of the rapid deterioration that can take place and the high rate of mortality if treatment is delayed. The deterioration in consciousness is another reason why a person suspected of Bacterial Meningitis must be immediately admitted to a Hospital.
The treatment of Bacterial Meningitis consists mainly of antibiotics. Because of the deteriorating consciousness level, these antibiotics are often required to be administered intravenously. Immediately after the patient is examined clinically by a physician, the CSF is taken for Laboratory Examination, and the treatment is begun with broad spectrum antibiotics that are effective against the usual bacterial causes. As soon as the Microbiological Reports of CSF become available, the antibiotics to which the bacteria show maximum susceptibility are introduced. Using multiple antibiotics may be preferable at times to counter the possibility of bacterial resistance and ensure hastening of recovery.
During the period of treatment, the patient requires a lot of supportive treatment too. Sometimes a delirious and violent patient may even need to be restrained mechanically. An important part of the treatment regimen is to counter the increased intracranial pressure that results from the infection. For this purpose, intravenous Mannitol and Corticosteroids may need to be used to prevent further complications.
Can Bacterial Meningitis be prevented
There are some measures that can reduce the possibility of Bacterial Meningitis, but whether they need to be adopted or not, is a choice that depends upon the probability of acquiring Bacterial Meningitis. Such decision making is best left to a Medical Expert. The option of vaccination is available against the usual bacterial causes. Generally, if the bacterial infection is endemic, then vaccination against H. Influenzae may be advisable in children. In case of older persons, vaccination against S. Pneumoniae can sometimes be helpful. Generally speaking, a strong body immunity remains our greatest protection to all infections, and Bacterial Meningitis is no exception to this rule.
Fortunately, with the advent of modern antibiotics and antiseptics, the frequency of all bacterial diseases is falling. Bacterial Meningitis has also become much rarer now in developed countries. Unfortunately, in many developing countries, it continues to pose a major challenge for health care.