Meningitis: symptoms and treatment

In itself, meningitis is not a disease, but a symptom, which warns us of an ongoing pathology. Often very dangerous: let’s see how to recognize and control it.

Meningitis is an inflammation of the meninges, membranes that line the brain and spinal cord with the task of protecting the nervous system. It is therefore not in itself a disease but a symptom, even if often the term implies the epidemic form due to meningococcus.

It would also be more correct to speak of meningitis, as the causes can be quite heterogeneous: microorganisms (viruses, bacteria, fungi), which are the most important responsible factor (bacteria rank first), but also trauma and head tumors.

Due to inflammation, they swell the membranes creating a strong unusual pressure that, together with the spread of inflammation, can damage brain areas and impair their functionality.

Bacterial meningitis

There are several forms of meningitis, depending on the infectious agent. Generally, the viral form is less feared, while the bacterial form can have much more serious effects. And it is the latter that we will deal with.

Among the causes of bacterial meningitis, the most common pathogens are Haemophilus influenzae type B (HBV), most relevant in the first year of life, meningococcus (Neisseria meningitidis) and an airway pathogen: pneumococcus (Streptococcus pneumoniae).

In particular, meningococcal disease in recent years has become the most common cause of meningitis among children and young adults. This bacterium differs into various strains, and the most common worldwide are five: A, B, C, W135 and Y. In Italy, as in Europe, the most common are only serogroups B and C are responsible for all cases of meningococcal disease.

It is widespread and can survive in the nose and throat of healthy individuals: about 10-25% of the population is a carrier without, therefore, presenting particular signs or symptoms of infection.

Attending public environments such as schools, gyms, discos, barracks or being near an infected person who coughs can represent an opportunity for contagion.

The incubation period of infection is 2-10 days, but only a few people develop full-blown disease after exposure.

Diagnosis

At its onset, bacterial meningitis can present the same generic symptoms as colds and influenza. Considering that most cases of meningitis occur in the winter months, it is understandable how difficult it is to diagnose it early.

Fever, general exhaustion, nausea and vomiting, diarrhea, irritability and loss of appetite are the most common initial disorders. There are also more characteristic symptoms of the disease.

In particular, in children, the most vulnerable to infection with meningococcal meningitis, it is good to pay attention to severe headaches, neck stiffness (inability to touch the chest with the chin), intolerance to light (photophobia), drowsiness and pain in the joints or muscles, spasms and, more generally, confusion and disorientation.

In infants and very young children, in addition to fever, vomiting and refusal of food, other characteristic symptoms may occur, such as crying with a high-pitched voice, empty expression, numbness and fixity of the gaze, pale complexion and the appearance of red skin spots, which do not disappear under pressure.

In some cases it is evident the sluggishness, the difficulty in waking up and also a certain irritability that the child manifests to physical contact.

Finally, precisely because of inflammation of the meninges, a tension or swelling of the fontanelle, the tender point on the top of the head, can occur in very young children.

Treatment and prevention

Once diagnosed in time, it is possible to treat bacterial meningitis through therapies based on specific intravenous antibiotics, performed in the hospital. However, if the disease is not recognized, it can evolve and have very serious consequences.

The winning strategy, however, consists in prevention, currently possible thanks to vaccines against Haemophilus influenzae type b, pneumococcus (the latest preparation for children released contains 13 strains) and meningococcus (strains A, C, Y and W135; different vaccines are used below and above 2 years of age).

With regard to the latter, it should be remembered that individuals at risk (cohabitants, other subjects who have come into contact with the affected person) must be given antibiotic prophylaxis within 48 hours: two days of therapy are sufficient to avert the danger.