Bacterial meningitis involves:
Bacterial Entry: Pathogenic bacteria enter the bloodstream and cross the blood-brain barrier, reaching the cerebrospinal fluid (CSF) and causing inflammation of the meninges (protective membranes surrounding the brain and spinal cord).
Inflammation: Bacterial invasion triggers an immune response, leading to inflammation of the meninges, increased CSF pressure, and potential impairment of blood flow to the brain.
Toxin Production: Some bacteria release toxins that contribute to tissue damage and systemic symptoms.
Complications: Without prompt treatment, bacterial meningitis can lead to brain damage, hearing loss, seizures, septic shock, and death.
Clinical Evaluation
Symptoms: Assessment of symptoms such as sudden onset of fever, severe headache, neck stiffness, sensitivity to light (photophobia), nausea, vomiting, and altered mental status (confusion or delirium).
Physical Examination: Examination findings may include signs of meningeal irritation (Kernig's sign, Brudzinski's sign), altered level of consciousness, and neurological deficits.
Diagnostic Tests: Lumbar puncture (spinal tap) to analyze CSF for white blood cells, protein levels, and bacterial culture, blood tests to identify causative bacteria, and imaging studies (CT or MRI) to assess for complications.
Sudden onset of high fever and chills.
Severe headache, often described as "the worst headache of my life".
Neck stiffness and pain when trying to touch the chin to the chest (meningeal irritation).
Sensitivity to light (photophobia) and sound.
Nausea, vomiting, and in infants, poor feeding and irritability.
Altered mental status, confusion, seizures, and coma in severe cases.
Prompt treatment is essential to reduce complications and improve outcomes:
Antibiotics: Immediate administration of broad-spectrum antibiotics to target common pathogens (e.g., Streptococcus pneumoniae, Neisseria meningitidis).
Supportive Care: Intravenous fluids to maintain hydration, medications to reduce fever and manage symptoms like headache and nausea.
Monitoring: Continuous monitoring of vital signs, neurological status, and response to treatment.
Vaccination: Vaccination against common bacterial pathogens that cause meningitis, such as meningococcus and pneumococcus, to prevent infection.