Download What is Meningitis? Cerebrospinal fluid protects the brain and spinal

MENINGITIS
What is Meningitis?
Cerebrospinal fluid protects the brain and spinal cord
with the help of the meninges. Meninges are
membranes that cover the brain and spinal cord.
MENINGitis is an infection of the meninges. There
are two kinds of infections: Viral and Bacterial!
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the “MENINGITIS BELT”,
an area of endemic diffusion of meningococcus infection
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Bacterial Meningitis is very serious, can be contagious and requires
hospitalization during treatment. Bacterial meningitis may result in brain
damage, hearing loss, learning disability, and even death. For bacterial
meningitis, it is important to know which type of bacteria is causing the
meningitis because antibiotics like CHLORAMPHENICOL can prevent
some types from spreading and infecting other people. Neisseria
meningitidis is the common cause of bacterial meningitis. There are 4
known types, and there are vaccines. Unfortunately the vaccine is not
always effective in young children.
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Symptoms:
A very bad headache that won't go away
Neck Stiffness
Back Stiffness
Eye Pain or irritation when exposed to light
Nausea or being sick to the stomach
Vomiting or throwing up
Body aches
Fever
Feeling very sleepy or unable to fully wake
up
Feeling very confused or out of it
*Symptoms can come on very quickly or take
a couple of days to appear.
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Diagnosis:
A spinal tap is performed to collect cerebrospinal fluid that surrounds
the spinal cord for examination under the microscope. The doctor
will numb an area along the spine and then insert a needle between
two vertebras to collect a sample for testing. Treatment depends on
the type of meningitis. If bacterial meningitis is suspected the
diagnosis is usually made by growing bacteria from a sample of spinal
fluid.
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Causes of raised intracranial pressure in a patient with bacterial
meningitis.
(A) Diffuse swelling of the brain. (B) Hydrocephalus results from basal
obstruction of the cerebrospinal fluid. (C) Infarcts are caused by
inflammatory occlusion of arteries. (D) Thrombosis of the cerebral veins
and sinuses.
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Chloramphenicol B.P.
Suspension
Composition:
Each 5ml (teaspoonful) of homogenous suspension contains Chloramphenicol palmitate
equivalent of 125mg Chloramphenicol B.P.
Indications:
Typhoid and paratyphoid fevers caused by S. typhi and S. paratyphi and other Salmonella
infections, meningitis caused by Haemophilus influenza, Reckettsial infections and epidemic
typhus, chronic infection of urinary tract caused by Proteus vulgaris which does not respond to
treatment with other antibiotics.
Side Effects:
Agranulocytosis, aplastic anaemia, thrombocytopenic purpura and bone marrow depression may
occur in long term therapy . Other side effects include renal toxicity, optic neuritis, jaundice,
dryness of the mouth, nausea, vomiting diarrhoea, skin rashes, increase growth of Candida
albicans or other fungi on the mucous membrane may occur causing stomatitis, sore tongue and
rectal or vaginal irritation, and haemolytic anaemia in some patients with a genetic deficiency of
glucose – 6-phosphate dehydrogenase activity . Large doses on infant may lead to “the grey
syndrome characterized by ashen colour of the skin; irregular respiration, perspiration,
progressive pallid cyanosis, circulatory collapse and eventually death. Prolonged administration
may induce bleeding, either by bone marrow depression or by reduction of intestinal flora which
leads to inhibition of vitamin K, hence high prothrombin time.
Special Precautions:
Avoid long-term treatment (not more than 10 days) and in hepatic renal impairment regular
blood cell count should be performed. Chloramphenicol should not be given during active
immunization.
Drugs interaction:
Avoid concomitant use with anticoagulants; antidiabetic agents etc. discontinue the treatment if
serum iron level is high, avoid use in newly born babies. Systemic half-life is enhanced by drugs
that inhibit liver oxidative enzymes; such rifampicin, paracetamol, phenobarbitone, phenytoin.
This is important in cases of poor liver function, mild toxicity to Chloramphenicol and low full
blood count.
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Chloramphenicol has excellent oral bioavailability:
The concentration achieved in brain and
cerebrospinal fluid (CSF) is around 30 to 50% even
when the meninges are not inflamed; this increases
to as high as 89% when the meninges are inflamed.
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Gray (or Grey) baby syndrome
causata da insufficiente capacità metabolica
del neonato
(scarsa glicuronazione + insufficiente escrezione del
farmaco non coniugato)
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