The most severe cases of meningitis are caused by bacteria, which in adults cause characteristic symptoms that can make diagnosis easier.
Concern over recent cases of meningitis in Italy has resulted in an increase in requests for vaccinations. “The number of cases is constant (a thousand a year) and there is no epidemic,” points out Fabrizio Pregliasco, professor of Hygiene at the University of Milan. “But the race to vaccinate is still positive to reduce the percentage of healthy carriers (currently 1 in 10) in younger generations.”
“The word meningitis includes a series of diseases with different causes, viruses or bacteria, and with different severity depending on the strain causing the infection,” continues the virologist. “But even the most aggressive bacterium, meningococcal C, in our country in the last four years has caused 36 deaths, compared to 3,500 deaths per year from road accidents”. In 2016, 178 cases of meningococcal meningitis were reported, a slight increase compared to 2012-14, but a decrease compared to 2015.
What is meningitis
Meningitis is an infectious disease that causes inflammation of the membranes that surround the brain and spinal cord (meninges): bacteria and viruses, with the lowering of the immune defenses, can spread from the blood to the meninges, passing through the liquid that protects the brain and spinal cord.
Viral meningitis is quite common: sometimes not even recognized because its symptoms are similar to those of a flu. More serious are bacterial meningitis, caused:
- Haemophilus influenzae type B
- Streptococcus or Diplococcus pneumoniae (pneumococcus), which can cause pneumonia, upper respiratory tract infections, otitis
- from meningococcus or Neisseria meningitidis, the most dangerous: five serogroups of this bacterium (A, B, C, Y, W135, against which vaccines are available) are capable of causing serious diseases and epidemics.
Healthy carriers
About 30% of the healthy population can be considered carriers of meningococci (in the nasopharyngeal tract) without symptoms. When the bacterium passes from the nasopharyngeal tract to other regions of the body, the disease can be triggered:
- meningococcal meningitis, if it reaches the meninges through the circulatory system
- sepsis, if the bacterium spreads to tissues and organs outside the central nervous system.
According to the Higher Institute of Health (ISS) this last form causes death in 8-14% of patients who are affected.
Symptoms
Diagnosis of meningitis is not simple, but in adults there are characteristic signs:
- difficulty waking up
- irritability
- photophobia
- spasms
- wryneck
- Rashes
- vomit
- Seizures.
Neck stiffness, in particular, occurs in 70% of cases of bacterial meningitis type B.
Two other typical symptoms are:
- the sign of Kernig
- Brudzinski’s sign.
Let’s see what it is:
Sign of Kernig | It occurs when the patient cannot hold his legs while sitting extended due to intense pain and lying down he cannot flex them on the basin |
Brudzinski’s sign | It manifests itself with spontaneous flexion of the hips and knee bending the head forward |
Sepsis, one of the possible complications, can occur fulminantly: sudden high fever, rashes with or without bleeding, headache, lactic acidosis, petechiae, etc.
Diagnosis and treatment
In case a suspicion arises, confirmation comes from specific tests: the taking of a sample of cerebrospinal fluid with a lumbar puncture, molecular analysis to identify traces of DNA of the bacterium in the body, culture examination.
The treatment in the hospital consists of taking antibiotics, to which corticosteroids can be added to reduce inflammation of the meninges, liquids to rehydrate the body and analgesics to relieve symptoms.
Particular attention is also given to people who have come into close contact with the patient, who must follow a preventive drug therapy based on antibiotics.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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