What is Bacterial Meningitis?

Meningitis results from either a viral or a bacterial infection of the fluid in the spinal cord and the fluid that surrounds the brain. Knowing whether a particular case of meningitis results from a virus or a bacterium is important because of differences in the seriousness of the illnesses and the treatment needed. Viral meningitis, also called aseptic meningitis, is usually relatively mild, clearing up within a week or two without specific treatment. Bacterial meningitis is much more serious. It can cause severe disease that can result in brain damage and even death.

Haemophilus influenzae type b (Hib), Neisseria meningitidis, and Streptococcus pneumoniae are the most common bacterial causes of meningitis. The bacteria often live harmlessly in a person's mouth and throat. In rare instances, however, they can break through the body's immune defenses and travel to the fluid surrounding the brain and spinal cord. There they begin to multiply quickly. The thin membrane that covers the brain and spinal cord (meninges) then becomes swollen and inflamed.

In persons over age two, common symptoms of bacterial meningitis are high fever, headache, and stiff neck. These symptoms can develop over several hours, or may take one to two days to develop. Other symptoms can include nausea, vomiting, sensitivity to light, confusion, and sleepiness. In advanced cases, bruises develop under the skin and spread quickly. In newborns and infants, the typical symptoms of fever, headache, and neck stiffness may be hard to detect. Other signs in babies might be inactivity, irritability, vomiting, and poor feeding. As the disease progresses, patients of any age can have seizures.

Medical professionals make a diagnosis by growing bacteria from a sample of spinal fluid. A doctor obtains the spinal fluid through a spinal tap. A doctor inserts a needle into the lower back and removes some fluid from the spinal canal. Identification of the type of bacteria responsible for the meningitis is important for the selection of correct antibiotic treatment.

Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor right away. Doctors can treat bacterial meningitis with a number of effective antibiotics. It is important, however, that patients begin treatment early. If not detected early, advanced bacterial meningitis can lead to brain damage, coma, and death. Survivors can suffer long-term complications, including hearing loss, mental retardation, paralysis, and seizures.

Anyone can get bacterial meningitis, but it is most common in infants and children. Meningitis is a continuing threat in day-care centers and schools. Healthy children and young adults are susceptible, and death can occur within a few hours of onset. People who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis or Hib can also be at increased risk. This includes people in the same household or day-care center, or anyone with direct contact with discharges from a meningitis patient's mouth or nose.

Doctors can give people who are identified as close contacts of a person with meningitis caused by Neisseria meningitidis antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated. There are vaccines against Hib, some strains of Neisseria meningitidis, and many types of Streptococcus pneumoniae. The vaccines against Hib are very safe and highly effective. By six months of age, every infant should receive at least three doses of an Hib vaccine. A fourth dose (booster) should be given to children between 12 and 18 months of age.

Doctors do not routinely use the vaccine against Neisseria meningitidis (meningococcal vaccine) in civilians in the United States and is relatively ineffective in children under age 2 years. Doctors sometimes use the vaccine to control outbreaks of some types of meningococcal meningitis in the United States. The vaccine against Streptococcal pneumoniae (pneumococcal vaccine) is not effective in persons under age 2 years but is recommended for all persons over age 65 and younger persons with certain medical problems.

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