What is meningitis?

Meningitis is an inflammation of the meninges: three membranes that surround the brain and protect the brain, spinal cord, and other parts of the nervous system. It is mainly caused by bacteria or viruses, but can also be triggered by parasites, fungi, or the Koch bacillus, the bacterium that causes tuberculosis.

Symptoms

Symptoms of meningitis can vary depending on the cause of the infection (bacterial, viral, fungal, parasitic) and the age of the affected person. However, there are some common associated symptoms. The most common include:

high fever: most people with meningitis present this symptom, especially in bacterial infections
intense headache: usually severe and persistent
neck stiffness: one of the classic symptoms of meningitis. The patient may have difficulty touching the chin to the chest due to neck muscle stiffness
sensitivity to light: people with meningitis often have difficulty tolerating bright light and may prefer dark environments
vomiting: the person may experience nausea and vomiting, often without relief
skin spots: in meningococcal meningitis (a type of the disease caused by the bacterium Neisseria meningitidis), red or purple spots may appear on the skin, called petechiae

Causes

Meningitis can be caused by various infectious agents such as bacteria, viruses, fungi, or parasites, as well as other non-infectious conditions. The main causes include:

bacterial meningitis: caused by bacteria such as Streptococcus pneumoniae. It is a serious and potentially fatal condition that requires immediate medical treatment
viral meningitis: caused by viruses such as herpes. It is generally less severe than bacterial meningitis
fungal meningitis: caused by fungi, usually in people with weakened immune systems. It can be a serious condition and requires treatment
parasitic meningitis: caused by parasites such as those that cause malaria. This form is less common but can be serious
non-infectious meningitis: in addition to infections, meningitis can also be caused by non-infectious factors such as autoimmune diseases, reactions or allergies to medications, cancer, head injuries, and surgeries in the head and neck region

Diagnóstico

O diagnóstico de meningite deve ser feito com agilidade, principalmente naquela causada por bactérias, que requer tratamento médico imediato. Os passos típicos envolvidos no diagnóstico da meningite são:

histórico médico: o profissional da saúde deve começar fazendo perguntas sobre os sintomas e o histórico médico do paciente. É importante informar ao profissional da saúde sobre quaisquer sintomas específicos, como febre alta, dor de cabeça intensa, rigidez no pescoço e sensibilidade à luz
exame físico: visa avaliar os sinais vitais, como a temperatura, a pressão arterial e os batimentos cardíacos
exame de líquido cefalorraquidiano (LCR): esse é um procedimento onde o profissional da saúde colhe uma amostra do LCR, um líquido que envolve as meninges, para analisar o caso com maior profundidade
exames de sangue: podem ser realizados para ajudar a identificar a causa da meningite

Treatment

Meningitis treatment should follow several steps:

empirical initial treatment: when meningitis is highly suspected, this treatment is started before laboratory test results are obtained due to the urgency of the case
identification of the infectious agent: after collecting cerebrospinal fluid (CSF) samples, laboratory tests are done to identify the cause of the infection. These results guide specific treatment
targeted treatment: once the cause of the infection is identified, treatment is adjusted accordingly:
bacterial meningitis: treatment is administered intravenously and is often maintained for a specific period depending on the bacteria and severity of the infection
viral meningitis: usually resolves on its own with rest and symptom management such as pain and fever. In some severe cases or specific situations, antiviral medications may be administered
fungal or parasitic meningitis: targeted treatment involves administering antifungal medications as necessary

Prevention

Meningitis prevention involves several strategies depending on the cause of the infection. Some preventive measures that can help reduce the risk of contracting the disease include:

vaccination: one of the most effective ways to prevent the disease. There are different vaccines available to prevent the most common forms of bacterial meningitis. A healthcare professional should be consulted to determine which vaccines are recommended and when to take them
hygiene practices: regularly washing hands with soap and water helps prevent the spread of infections that can lead to meningitis
safe sex practices: using condoms during vaginal, anal, and oral sex can reduce the risk of contracting infections that may also lead to meningitis

References

Meningitis - Health Department

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By Einstein Editorial Board