3-2. MENINGITIS

a. Definition of Meningitis. This CNS disease is an acute inflammation of the meninges of the brain or the spinal cord. All three meningeal membranes--the dura mater, the arachnoid, and the pia mater--may be affected.

b. Cause of Meningitis. The inflammation may be caused by any one of the following: pyrogenic bacteria, mycobacteria, fungi, spirochetes, or viruses. Sometimes an upper respiratory infection (URI) is the primary cause of the illness.

c. Sign/Symptoms of Meningitis. Signs and symptoms are similar to those of an upper respiratory infection. Included are the following:

(1) Headache.

(2) Back pain.

(3) Stiff neck.

(4) Chills.

(5) Irregular fever.

(6) Anorexia (loss of appetite).

(7) Confusion.

(8) Drowsiness.

(9) Stupor.

(10) Coma may develop as the illness progresses.

(11) Brudzinski's sign. The abrupt neck flexion in the supine patient causes involuntary flexion of the knees. When passive flexion of the lower limb on one side is made, a similar movement is seen in the opposite limb. Another name for Brudzinski's sign is contralateral sign.

d. Treatment of Meningitis. Treat the symptoms and perform necessary life-supporting measures. Usually, the patient is treated as follows:

(1) Usually, antibiotics are given intravenously for a period of time (often two weeks). Oral antibiotics are given after these medications. Appropriate oral antibiotics include penicillin, tetracycline, or erythromycin.

NOTE: If there is intracranial pressure (ICP), mannitol may be given. This medication should relieve pressure on the brain.

(2) Other medications which can be given include anticonvulsants if needed or a sedative to reduce restlessness. Aspirin or acetaminophen can be given to relieve headache and fever.

(3) Supportive measures include bed rest, lowering of body temperature, and measures to prevent dehydration.

(4) If the patient's nasal cultures are positive, isolate him.

(5) Treat any other conditions such as endocarditis or pneumonia.