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Spinal Meningitis
Phillip Wyatt
Course
Prof. Valella
April 18, 2012
Introduction:
There are two main types of meningitis, and they are bacterial spinal meningitis and viral
spinal meningitis. It is a somewhat rare neurological disease that affects the lining of the brain
and spinal cord. It is caused by several types of pathogens with Streptococcus pneumonia and
Neisseria meningitides being the most common types. Other things that can cause spinal
meningitis are fungal infections, some cancers, severe spine or neck injury, inflammatory
diseases like lupus, or adverse reactions to certain medicines or medical treatments. I chose this
disease to write about because I had it when I was only two years old. I was diagnosed on
Christmas Eve in 1988 with bacterial spinal meningitis and my case was considered severe
because I was only two and the infection had already set in. It was something that I don’t
remember much of other than the painful shots that I had to get to rid me of the infection, but it
was something that defined my strong will to live at an early age.
Clinical Features:
Common signs and symptoms of spinal meningitis are headaches, seizures, fever, neck
stiffness, nausea or vomiting, profuse vomiting, numbness of extremities, difficulty speaking
swallowing or walking, and sleepiness or confusion. Signs do not usually show up until the
infection has set in the spinal fluid. Newborns or small children that are not yet talking can be
hard to detect the disease in until it is too late because they only appear to be sluggish and
irritable. Infants cannot tell you that they are in pain so it is often overlooked until the problem
becomes severe, and it is usually to late by then.
Diagnosis:
Rapid evaluation of anyone entering a hospital showing signs of spinal meningitis is
preformed. When someone is suspected of being infected with spinal meningitis they are
immediately placed in an isolation room with a mask on over their nose and mouth so that the
risk of spreading the infection is lessened. The doctor will then check the patients pulse, heart
rate, and temperature to make sure that everything is normal and no measures need to be taken to
make everything normal. If the doctor suspects bacterial spinal meningitis they will sometimes
give the patient antibiotics to see how they react to them, because if they have viral the
antibiotics will not help. CT scans are often done to see if the brain or spinal cord is abscessed or
infected. Blood is drawn to check the white and red blood cell counts. Chest x-rays can be done
to check for pneumonia and fluids in the lungs. Spinal taps or lumbar punctures are used to pull
spinal fluid from the spinal cord to check for things like the presence of white and red blood cells
and protein and glucose.
Therapy:
Hospitalization of people with spinal meningitis is based on the type of meningitis. Viral
spinal meningitis is not a cause for hospitalization and is treated with pain medications like
acetaminophen (Tylenol). Antibiotics are not used because they are not affective against viral
spinal meningitis. Bacterial spinal meningitis is a cause for hospitalization however. This type of
meningitis is much more aggressive and dangerous so the patient is usually admitted to intensive
care for a period for observation. This period of observation can increase if the infection
becomes worsened. Care of bacterial meningitis begins by ensuring that your breathing and
blood pressure are adequate. An IV line is inserted usually into a brachial artery to give fluids or
intravenous antibiotics, and sometimes a larger IV is inserted into the groin chest or neck to
administer medications for seizures or blood pressure. The patient is placed on a heart monitor.
Steroids are sometimes given to decrease the severity of swelling caused by the infection. A
breathing tube may be inserted if the patient is having trouble breathing on their own. A catheter
is sometimes placed in the urinary bladder to check the patient’s hydration.
Prognosis:
A person with a fast onset of spinal meningitis or a case of the very aggressive bacterial
meningitis the mortality rate is nearly 90 percent. Even if the person survives, long term
disabilities can occur such as deafness, seizures, paralysis, blindness, or loss of limbs. Patients
with less severe cases of spinal meningitis have a mortality rate of 25 percent. Long term
disabilities are less common, but are still a possibility. The patient may need extended stay in the
hospital for rehabilitation. A patient with viral spinal meningitis with proper treatment and rest
can be fully recovered in as little as seven to ten weeks.
References Cited
vam de Beek, D., de Gans, J., Spanjaard, L., Weisfelt, M., Reitsma, J.B., and Vermeulen, M.,
2004, Clinical Features and Prognostic Factors in Adults with Bacterial Meningitis, The New
England Journal of Medicine, http://www.nejm.org/doi/pdf/10.1056/NEJMoa040845, (April 17,
2012 )
Schoenstadt, A., 2009, Spinal Meningitis, EMed TV Health Information Brought to Life,
http://nervous-system.emedtv.com/spinal-meningitis/spinal-meningitis.html,(April 17, 2012)
Kacprowicz, R., 2012, Meningitis in Adults, eMedicine Health experts for everyday
emergencies, http://www.emedicinehealth.com/meningitis_in_adults/article_em.htm,(April 17,
2012)
Baraff, L.J., Lee, S.I., Schriger, D.L., 1993, Outcomes of bacterial meningitis in children: a
meta-analysis, The Pediatric Infectious Disease Journal,
http://ukpmc.ac.uk/abstract/MED/8327300/reload=0;jsessionid=UDYd9ZgZ7y4QECwR9bsw.4,
(April 17, 2012)
Wong, V.K., Wright, H.T. Jr., Ross, L.A., Mason, W.H., Inderlied, C.B., Kim, K.S., 1991,
Imipenem/cilastatin treatment of bacterial meningitis in children, The Pediatric Infectious
Disease Journal, http://ukpmc.ac.uk/abstract/MED/2062603,(April 17, 2012)
Bonsu, B.K., Harper, M.B., 2004, Differentiating Acute Bacterial Meningitis From Acute Viral
Meningitis Among Children With Cerebrospinal Fluid Pleocytosis: A Multivariable Regression
Model, The Pediatric Infectious Disease Journal,
http://journals.lww.com/pidj/Abstract/2004/06000/Differentiating_Acute_Bacterial_Meningitis_
From.6.aspx,(April 17, 2012)