MENINGITIS

MENINGITE

Synonym: Brain  infection

What is it?

Meningitis (MGT) is an infection of the membranes (meninges) that envelop the brain by pathological agents such as: viruses, bacteria, fungi or protozoa. Where there is simultaneous commitment of the brain tissue, it can be denominated meningoencephalitis.

How is it acquired?

This infection is related to the type of germ associated to it. Generally, it can be associated to an either viral or bacterial respiratory infectious setting: otitis (ear infection, tonsillitis (throat infection), cranioencephalic trauma (colonizing germs of the nasal cavity can enter the cranial cavity and contaminate the meninges). Conditions of immunosuppression, like those triggered by HIV infection, can make the individual become more vulnerable to this kind of disease, especially when meningitis is triggered by fungi or protozoa.

What does one feel?

The clinical scenario of MGT (meningitis) is characterized by: intense headache, nauseas, vomiting and a certain degree of mental confusion. Also there are general signs of an infectious setting, including high fever, malaise and even a psychomotor agitation.

Additionally, we can also observe the traditional neck rigidity, a sign of meningeal irritation. With children, the diagnosis can prove more difficult, especially the younger ones, for there is no complaint of headache and the signs of meningeal irritation can be absent. The most frequent findings in children are: fever, irritability, prostration, vomiting, convulsions and even sunken fontanelles.

How does the physician make the diagnosis?

The diagnosis is done through the anamnesis and a thourough, physical examination of the patient. The confirmation of the diagnosis is done through the liquor test, which is collected through a lumbar puncture (in order to collect spinal fluid). Image tests, mainly the tomography of the skull, are not the choice tests for the diagnosis of meningitis, but are indicated where there is focal alteration in the neurological test, or where there are signs of intracranial hipertension (headache, vomiting and mental confusion), or convulsive crises, at the onset of the disease, without general infectious signs.

How do we treat it?

The treatment of acute meningitis is considered an emergency, especially when the etiologic suspicion is bacterial. It should be started as soon as possible and with antibiotics to be administered intravenously, because there is risk to patient's life and to develop severe sequels in these cases. When the suspicion falls on chronic meningitis, like the one provoked by tuberculosis, the treatment can be administered orally be prolonged for weeks.

How to prevent it?

The prevention is possible in the cases diagnosed and when the disease is absolutely certain. The use of masks and the prophylaxis with antibiotic can prevent the spread of meningitis to people that are in close contact with an infected patient.

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