disease Monograph

NAME OF THE STUDENT:Rawan Sajdi almutiari

STUDENT ID: 439480304

Meningitis

Introduction

Meningitis is an inflammation of the fluid and membranes (meninges) surrounding your brain and
spinal cord.
The swelling from meningitis typically triggers signs and symptoms such as headache, fever and
a stiff neck.
Most cases of meningitis in the United States are caused by a viral infection, but bacterial,
parasitic and fungal infections are other causes. Some cases of meningitis improve without
treatment in a few weeks. Others can be life-threatening and require emergency antibiotic
treatment.

Sign and symptoms

Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop
over several hours or over a few days.
Possible signs and symptoms in anyone older than the age of 2 include:
Sudden high fever
Stiff neck
Severe headache that seems different from normal
Headache with nausea or vomiting
Confusion or difficulty concentrating
Seizures
Sleepiness or difficulty waking
Sensitivity to light
No appetite or thirst
Skin rash (sometimes, such as in meningococcal meningitis)
Newborns and infants may show these signs:
High fever
Constant crying
Excessive sleepiness or irritability
Difficulty waking from sleep
Inactivity or sluggishness
Not waking to eat
Poor feeding
Vomiting
A bulge in the soft spot on top of a baby's head (fontanel)
Stiffness in the body and neck

Causes
Viral infections are the most common cause of meningitis, followed by bacterial infections
and, rarely, fungal and parasitic infections. Because bacterial infections can be life-
threatening, identifying the cause is essential.
Bacterial meningitis
Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial
meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused
by an ear or sinus infection, a skull fracture, or rarely some surgeries.
Several strains of bacteria can cause acute bacterial meningitis, most commonly:
Streptococcus pneumoniae (pneumococcus). This bacterium is the most common
cause of bacterial meningitis in infants, young children and adults in the United States. It
more commonly causes pneumonia or ear or sinus infections.
Neisseria meningitidis (meningococcus). This bacterium is another leading cause of
bacterial meningitis. These bacteria commonly cause an upper respiratory infection but can
cause meningococcal meningitis when they enter the bloodstream. This is a highly
contagious infection that affects mainly teenagers and young adults.
Haemophilus influenzae (haemophilus). Haemophilus influenzae type b (Hib) bacterium
was once the leading cause of bacterial meningitis in children. But new Hib vaccines have
greatly reduced the number of cases of this type of meningitis.
Listeria monocytogenes (listeria). These bacteria can be found in unpasteurized
cheeses, hot dogs and lunchmeats. Pregnant women, newborns, older adults and people with
weakened immune systems are most susceptible. Listeria can cross the placental barrier,
and infections in late pregnancy may be fatal to the baby.
Viral meningitis
Viral meningitis is usually mild and often clears on its own. Most cases in the United States are
caused by a group of viruses known as enteroviruses, which are most common in late summer
and early fall. Viruses such as herpes simplex virus, HIV, mumps virus, West Nile virus and others
also can cause viral meningitis.
Chronic meningitis
Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) that invade the
membranes and fluid surrounding your brain cause chronic meningitis. Chronic meningitis
develops over two weeks or more. The signs and symptoms of chronic meningitis — headache,
fever, vomiting and mental cloudiness — are similar to those of acute meningitis.
Fungal meningitis
Fungal meningitis is relatively uncommon in the United States. It may mimic acute bacterial
meningitis. It's often contracted by breathing in fungal spores that may be found in soil, decaying
wood and bird droppings. Fungal meningitis isn't contagious from person to person. Cryptococcal
meningitis is a common fungal form of the disease that affects people with immune deficiencies,
such as AIDS. It's life-threatening if not treated with an antifungal medication. Even with
treatment, fungal meningitis may recur.
Parasitic meningitis
Parasites can cause a rare type of meningitis called eosinophilic meningitis. Parasitic meningitis
can also be caused by a tapeworm infection in the brain (cysticercosis) or cerebral malaria.
Amoebic meningitis is a rare type that is sometimes contracted through swimming in fresh water
and can quickly become life-threatening. The main parasites that cause meningitis typically
infect animals. People are usually infected by eating foods contaminated with these parasites.
Parasitic meningitis isn't spread between people.
Other meningitis causes
Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies,
some types of cancer and inflammatory diseases such as sarcoidosis.
 Risk factors
Risk factors for meningitis include:
Skipping vaccinations. Risk rises for anyone who hasn't completed the recommended
childhood or adult vaccination schedule.
Age. Most cases of viral meningitis occur in children younger than age 5. Bacterial
meningitis is common in those under age 20.
Living in a community setting. College students living in dormitories, personnel on
military bases, and children in boarding schools and child care facilities are at greater risk
of meningococcal meningitis. This is probably because the bacterium is spread through the
respiratory route, and spreads quickly through large groups.
Pregnancy. Pregnancy increases the risk of listeriosis — an infection caused by listeria
bacteria, which may also cause meningitis. Listeriosis increases the risk of miscarriage,
stillbirth and premature delivery.
Compromised immune system. AIDS, alcoholism, diabetes, use of immunosuppressant
drugs and other factors that affect your immune system also make you more susceptible to
meningitis. Having your spleen removed also increases your risk, and anyone without a
spleen should get vaccinated to minimize that risk.

Complications

Meningitis complications can be severe. The longer you or your child has the disease
without treatment, the greater the risk of seizures and permanent neurological
damage, including:
Hearing loss
Memory difficulty
Learning disabilities
Brain damage
Gait problems
Seizures
Kidney failure
Shock
Death

 Preventions

Common bacteria or viruses that can cause meningitis can spread through coughing,
sneezing, , or sharing eating utensils, a toothbrush or a cigarette.
These steps can help prevent meningitis:
Wash your hands. Careful hand-washing helps prevent the spread of germs.
Practice good hygiene. Don't share drinks, foods, straws, eating utensils, lip balms or
toothbrushes with anyone else. Teach children and teens to avoid sharing these items too.
Stay healthy. Maintain your immune system by getting enough rest, exercising regularly,
and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.
Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and
nose.
If you're pregnant, take care with food.
Vaccinations
Some forms of bacterial meningitis are preventable with the following vaccinations:
Haemophilus influenzae type b (Hib) vaccine.
Pneumococcal conjugate vaccine (PCV13). This vaccine also is part of the WHO and
CDC recommended routine vaccination schedule for children younger than 2 years.
Additional doses are recommended for children between the ages of 2 and 5 who are at high
risk of pneumococcal disease, including children who have chronic heart or lung disease or
cancer.
Pneumococcal polysaccharide vaccine (PPSV23). Older children and adults who need
protection from pneumococcal bacteria may receive this vaccine. The CDC recommends the
PPSV23 vaccine for all adults older than 65; for younger adults and children age 2 and older
who have weak immune systems or chronic illnesses such as heart disease, diabetes or
sickle cell anemia; and for anyone who doesn't have a spleen.
Meningococcal conjugate vaccine. The CDC recommends that a single dose be given to
children ages 11 to 12, with a booster shot given at age 16. If the vaccine is first given
between ages 13 and 15, the booster is recommended between ages 16 and 18. If the first
shot is given at age 16 or older, no booster is necessary.
This vaccine can also be given to children between the ages of 2 months and 10 years who
are at high risk of bacterial meningitis or who have been exposed to someone with the
disease. It's also used to vaccinate healthy but previously unvaccinated people who have
been exposed in outbreaks.
 Treatments
Treatment in hospital
Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can
cause serious problems and requires close monitoring.
Severe viral meningitis may also be treated in hospital.
Treatments include:
antibiotics given directly into a vein
fluids given directly into a vein to prevent dehydration
oxygen through a face mask if there are any breathing difficulties
steroid medication to help reduce any swelling around the brain, in some cases
People with meningitis may need to stay in hospital for a few days, and in certain cases
treatment may be needed for several weeks.
Treatment at home
Patient usually be able to go home from hospital if you or your child has mild meningitis and
tests show it's being caused by a viral infection.
This type of meningitis will usually get better on its own without causing any serious problems.
Most people feel better within 7 to 10 days.
In the meantime, you may be advised to:
get plenty of rest
take painkillers for a headache or general aches
take anti-sickness medicine for any nausea or vomiting

Patient Education:
The nurse should educate the parents on ensuring that the children are vaccinated against N.
meningitides. The pharmacist should also educate the family about the need for prophylaxis
when there is a family member with Neisseria meningitis. All contacts should be educated about
the signs and symptoms of the infection and when to return to the emergency department.
Educate family members to provide a nutritional diet that contains more antioxidants, omega 3
fatty acids, and probiotics which allow for better nutritional absorption and citrus fruits to boost
the immune system.
Encourage to maintain the personal hygiene of the patient.
Never leave the patient alone to prevent any fall injury due to seizure.
Patients should avoid driving vehicles, if instructed to do so by the doctor, as some of them may
have blurred vision
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