Meningitis

What Is Meningitis?

Meningitis is an infection of the central nervous system- specifically an infection of the meninges that line the brain and spinal cord. Meningitis can either be bacterial, viral, fungal or parasitic. Meningitis can also be acute or chronic.

Bacterial meningitis is most often caused by Streptococcus pneumonia or Neisseria meningitides. Tuberculosis can also lead to meningitis, especially in individuals with weakened immunity such as HIV/AIDS patients or patients with leukaemia. Haemophilus influenza B causes infections in children under six years. Staphylococcus aureus causes meningeal infection, often secondary to trauma or from surrounding nasal or oral passages. Meningococcus meningitis has the highest mortality rate of bacterial meningitis, and annual outbreaks occur in endemic areas, such as the meningitis belt in sub-Saharan Africa.

Viral meningitis is most often caused by herpes simplex virus, mumps virus and varicella zoster. Viral meningitis is often referred to as aseptic meningitis.

Cryptococcal meningitis is an opportunistic fungal infection that occurs commonly in patients with a decreased immune system such as patients suffering from HIV/AIDS. A quarter of cases of HIV related deaths in Africa occurs due to cryptococcal meningitis.

Meningitis is a severe condition and urgent treatment is warranted. Consequences of untreated or delayed treatment of HIV include deafness, blindness, brain abscess, impaired cognition and in severe cases, death.

Bacterial meningitis is treated with intravenous antibiotics, while viral meningitis is often only treated symptomatically. Immunocompromised patients with cryptococcal meningitis need intravenous anti-fungal treatment, followed by daily oral antifungals, life-long.

Diagnosis of meningitis is made on clinical examination, with a diagnostic lumbar puncture and cerebrospinal fluid analysis. The glucose, protein, white blood cell counts give an indication of either viral or bacterial meningitis. Radiology like CT or MRI scans may show features that are suggestive of meningitis. The culture of CSF will give an indication of the causative organism, to assist in treatment with the correct antibiotic or antifungal medication.

What Are The Symptoms Of Meningitis?

Symptoms of meningitis are consistent with symptoms of raised intracranial pressure and irritation of the meninges.

These include:

• A headache(severe)
• Neck stiffness
• Photophobia (pain or inability in looking into light)
• Nausea and/or vomiting
• Fever
• Altered level of consciousness or confusion
• Seizures
• Skin rash (usually maculopapular) may occur in meningococcal or viral meningitis

What Are The Causes Of Meningitis?

• The spread of infective organisms is most often via the bloodstream. This includes bacterial, viral or fungal infections.
• The spread of infective organism from surrounding structures such as the sinuses or inner ear structures.
• Head or scalp injury can predispose to infection, especially if there is any penetrating injury.
• Post-surgical complications of neurosurgery e.g. ventriculoperitoneal shunt insertion in hydrocephalus.

What Are The Things One Should Do To Manage Meningitis?

• Vaccines are available for certain strains of meningitis causing organisms. These include meningococcus, pneumococcus, Haemophilus influenza B and mumps. Vaccines can significantly lower the chances of contracting meningitis, as well as reducing the complications associated with infections should they arise.
• Prophylactic antibiotics are indicated after contact with a carrier or symptomatic individual.
• Undiagnosed acute onset headache with neck stiffness should immediately be investigated, especially if there is associated fever.

What Are The Things One Should Avoid To Manage Meningitis?

• Do not smoke. Smoking increases general systemic inflammation and will delay healing of the meninges.
• Most viral and bacterial meningitis can be contagious. During the recovery period, the risk of infection is significantly decreased but it would be wise to avoid children and pregnant women.

What Are The Best Foods For Meningitis?

• Although meningitis cannot be cured by food, a diet high in nutrients will help to speed up recovery and strengthen the immune system.

Fruits and vegetables high in antioxidants should be consumed. These include:

•  Fruit: Papaya, grapefruit, blueberries, strawberries, citrus fruits
• Vegetables: Red bell peppers, leafy green vegetables, cruciferous vegetables.
• Foods that have antibacterial and antifungal properties: Coconut oil, garlic, lemon, onions, honey, turmeric, pineapple
• High intake of clean, purified water (at least two litres per day)
• Omega 3 is good for central nervous system function. Foods high in omega 3 include fatty fish such as mackerel, tuna, salmon, avocado, coconut oil and almonds. 

What Are The Worst Foods For Meningitis?

• High salt diet/ foods should be avoided due to their hypertensive effect on blood vessels, including the blood vessels in the brain and meninges. However, salt should be used in moderation and not be completely avoided.
• Processed foods contain lots of unsaturated fatty acids and increase inflammation
• Unrefined starches
• Caffeine containing beverages
• Alcohol

What Are The Medicines For Meningitis?

What Are The Tips To Manage Meningitis?

• Strict bed rest during the acute phase of meningitis.
• Mild exercise during the recovery phase may increase the speed of rehabilitation after treatment.