Meningitis
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Meningitis

Meningitis is an infection of the meningitis (cover of the brain) which surround the brain and the spinal cord. 


Viruses and bacteria can cause meningitis. It is important to know the cause since the outcome is very different for different causes. Viral Meningitis is generally less severe and resolves without specific treatment unlike bacterial meningitis which requires antibiotic treatment for the specific bacterium causing it. Bacterial meningitis, if the appropriate treatment is not given, can lead to blindness, deafness, paralysis, mental retardation and death.


Signs and Symptoms
  • High fever
  • Headache
  • Stiff neck

Early diagnosis of meningitis is very important so that when symptoms arise the patient should contact the doctor immediately. The diagnosis is usually made by lumbar puncture to test the spinal fluid for culture and sensitivity to identify the causative agent and give antibiotics accordingly.

Meningitis is very contagious. Rapid person to person transmission. Children are very commonly effected. Common in overcrowding. Reservoir for micro-organism is man. It is spread by droplet infection; micro-organisms lodged in the posterior nasopharynx or by transfer of infected blood e.g. Blood transfusion, organ transplant and contaminated syringes.


Control and Prevention

Haemophilus Meningitis:
Rifampicin should be given to;

  • All household members irrespective of age where there is an index case of haemophilus disease, and a child less than 3 years, except pregnant women, breastfeeding women, any person with severe impairment of hepatic function and children under the age of 3 months.
  • All room contacts where two or more cases of Hib disease have occurred in a play group, nursery or cresche within 120 days (exceptions as above).
  • Index cases of Hib disease prior to discharge from hospital, except children under the age of 3 months.

Meningococcal Meningitis:
Rifampicin/Ciprofloxacin should given as prophylaxis to:

  • Eliminate carriage of meningococci in household members and other close contacts; thereby in turn reduce transmission to susceptible individuals who are not carriers.
  • Prevent susceptible contacts from acquiring infection by directly inhibiting colonisation but it could only be effective for 2 days of prophylaxis.
  • Treat the newly acquired nasopharyngeal or blood borne infection in contacts who are non-immune and may be incubating the disease.

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