Some Of The Signs And Symptoms Of Meningitis

By Claire Bolton


Meningitis is a condition in which the protective membranes of the brain or meninges become inflamed. This may be due to an infection or any other factor that causes physical or chemical trauma to the membranes. Infecting organisms may be bacteria, protozoa, viruses or fungi. Whenever the meninges are inflamed, there is a risk of spinal cord or brain involvement with possible loss in neurological function. The signs and symptoms of meningitis may not be picked up very easily in the initial stages if the attending physician is not well experienced.

The symptomatology is mainly dependent on the stage of the disease. Earlier stages are usually characterised with subtle signs and symptoms that are suggestive of flu. As the disease progresses the presentation becomes clearer. Another factor that determines the initial and subsequent presentation is the causative agent. Symptoms usually develop within hours or days. Viral disease progresses faster than disease caused by other factors.

Different age groups are susceptible to different organisms known to cause meningitis. Newborns and infants are most commonly affected by the organisms belonging to group B streptococci acquired from the birth canal at birth. Other organisms include Listeria monocytogenes and E. Coli. As they grow older, cases of Neisseria meningitidis and Haemophilus influenzae (specifically type B) become more common. Adults are most likely to be affected by Streptococcus pneumoniae.

Severe disease often leads to systemic involvement. A small amount of organisms in the blood stream results in a condition known as bacteraemia. If the amount is large enough to infect organs, the condition is referred to as septicaemia. When septicaemia is caused by Neisseria meningitidis, it is known as meningococcemia. It is a condition that affects blood vessels and causes widespread bleeding particularly beneath the skin.

The classic triad of symptoms includes fever, neck rigidity and altered mental status. This combination will be seen in about 45% of patients with bacterial meningitis. If none of these signs is present, then the probability that the condition in question is meningitis is very low. Neck stiffness occurs due to increased muscle tone. It occurs in 70% of the cases. Headache is present in about 90% of the cases.

Other common symptoms that may be observed include drowsiness, irritability when exposed to bright light (photophobia) and loss of appetite. In severe cases, patients may start to convulse and even become comatose. A lot of expertise is required in make a diagnosis in newborns and young infants since their presentation is not straight forward. 30% of them will have convulsions. Other signs include fever, lethargy, diarrhoea, irritability and poor feeding.

Meningococcal diseases results in distinct signs. There is often a change in colour of the skin. The colour becomes darker due to bleeding taking place underneath. There have also been reports of skin rashes, cold extremities, myalgia (muscle pain), joint pain (arthralgia), chills and increased rate of breathing.

When any of any of the signs and symptoms of meningitis is seen, one should seek medical attention immediately. This will ensure that treatment is started in a timely manner. Depending on the offending organism, one may receive a course of antibacterial, antiviral or antiprotozoal agents. It is common for corticosteroids to be administered concomitantly. If not treated, the condition may cause a number of complications such as epilepsy, cognitive deficits, hydrocephalus and deafness.




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