Meningitis is a disease caused by an inflammation of the meninges, the membranes that surround the brain. The inflammation is usually caused by infection of the fluid surrounding the brain and spinal cord. Of the two types of meningitis, the viral form is more common but seldom life threatening. Bacterial meningitis, however, although rare may be fatal. Among the main causes of viral meningitis are different viruses spread between people by coughing or sneezing, or through poor hygiene. Causative germs may originate in sewage polluted water as well. On rare occasions, certain insects, such as mosquitos and ticks, are thought to pass on these viruses. The organism that causes the bacterial version of the disease may be spread through the exchange of respiratory and throat secretions, such as coughing and kissing. In all four different types of bacteria are known to cause the disease. Infection could take several routes to the brain: the bloodstream from another infected part of the body, through the bones of the skull from infected sinuses or inner ears, or from a head injury, such as a fractured skull or penetrating wound.
In addition to a complete medical history and physical examination, doctors at BRAINS use blood tests and a number of modern diagnostic tools to diagnose and treat the disease among them CT scans and Lumbar puncture (see Technology & Procedures).
Specific treatment for meningitis will be determined by a specialist based on the following factors: Your age, overall health, and medical history; extent of the disease; the organism that is causing the infection; your tolerance for specific medications, procedures or therapies; expectations for the course of the disease and your opinion or preference.
Treatment may include:
Bacterial meningitis: Treatment for bacterial meningitis usually involves intravenous (IV) antibiotics. The earlier the treatment is initiated, the better the outcome.
While steroid administration has been shown to be helpful in treating bacterial meningitis in infants and children, this treatment is used less frequently in adults. Dexamethasone, a type of steroid, may be given in more acute cases of bacterial meningitis, to decrease the inflammatory response caused by the bacteria.
Viral meningitis: Treatment for viral meningitis is usually supportive (aimed at relieving symptoms). With the exception of the herpes simplex virus, there are no specific medications to treat the organisms that cause viral meningitis. Sometimes antiviral medications are used to combat some other specific types of viruses, with variable benefit.
Fungal meningitis: An intravenous anti-fungal medication may be administered to treat fungal meningitis.
Tuberculous (TB) meningitis: A long course (one year) of medications is recommended for people who develop TB meningitis. The therapy usually involves treatment with several different medications for the first few months, followed by other medications.
New diagnostic techniques, drugs and interventions are continually being introduced into neurology and brain and spine specialists at BRAINS are at the forefront of these advances. Currently the following technology tools are being used at the hospital in the diagnosis of meningitis in addition to blood tests and comprehensive clinical evaluation:
Lumbar puncture (also called spinal tap): A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.
Computed tomography scan (also called a CT or CAT scan): A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Muralimohan S, Pande A, Vasudevan MC, Ramamurthi R. Invasive rhino-cerebral fungal granuloma. Neurol India. 2010.58(2):270-6