What is bacterial meningitis?
Meningitis is an inflammation of the membranes that covering the brain and spinal cord. Bacterial meningitis is a very serious disease and can be deadly. Death can occur in just a few hours. Although most people with meningitis are cured, permanent disabilities can occur as a result of infections, such as brain damage, hearing loss, and learning difficulties.
There are several types of bacteria that can cause meningitis. Some of the main causes of bacterial meningitis include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.
These bacteria can also be linked to other serious disease, sepsis. Sepsis is the body’s life-threatening response to infections that can lead to tissue damage, organ failure, and death.
Bacterial Meningitis symptoms
Symptoms of bacterial meningitis are similar to those of meningitis in general. Some indications may include:
- Fever.
- Headaches.
- Stiffness in the neck.
There are also other symptoms that become common, such as
- Nausea and vomiting,
- Decreased consciousness,
- Seizures,
- Skin rashes, and
- Decreased appetite.
Bacterial Meningitis Symptoms in Infant
If it occurs in infants under 1 month, the symptoms of bacterial meningitis can be:
- Don’t want to breastfeed.
- The baby looks limp and unenergized.
- Irritation.
- Shortness of breath (apnea).
- Did not show any response (apathy).
- Fever.
- Seizures.
- Jaundice.
- Shock.
How do you get bacterial meningitis?
Bacterial Meningitis Causes
Bacteria can enter blood vessels and flow into the brain and spine, then cause bacterial meningitis. But there is also bacterial meningitis that occurs due to bacteria that attack meninges directly. For example, through ear infections or sinus infections, fractured skull bones, or surgical procedures.
Types of bacteria that cause bacterial meningitis generally include:
Streptococcus pneumoniae
Streptococcus pneumoniae is the most common cause of bacterial meningitis in infants, children, and older persons. These bacteria more often cause pneumonia or ear and sinus infections. Immunization can help prevent infection of this type of bacteria.
Neisseria meningitidis
Neisseria meningitidis is a common cause of upper respiratory tract infections. The amount of this bacteria can also cause meningococcal meningitis when the bacteria enter the blood vessels. Immunization can also be done as a preventive measure.
Learn more about Meningococcal Vaccine: Types, Who Needs It, and Side Effects
Haemophilus influenzae
Haemophilus influenzae type B bacteria are the cause of bacterial meningitis in children. Immunization of HIB can reduce the risk.
Listeria monocytogenes
Listeria monocytogenes can be found in unpasteurized cheeses as well as preserved meats (such as sausages or canned meat). Pregnant women, newborns, people with weakened immune systems are among the most vulnerable to this bacterial infection.
Bacterial Meningitis Diagnosis
Diagnosis of bacterial meningitis often overlaps with viral meningitis. In this case, cerebrospinal fluid examination becomes the key to distinguishing bacterial or viral meningitis.
Anamnesis
Anamnesis in cases of bacterial meningitis in addition to being used to enforce diagnosis, it is also important to choose the appropriate therapy. There are at least 10 important questions to be explored before antibiotic treatment of bacterial meningitis is administered. Do patients have:
- History of drug allergies
- There was exposure to someone with meningitis before
- Moderate infections (especially respiratory or ear infections)
- Using antibiotics in a few days
- New to travel mainly to areas with endemic meningoccal diseases such as sub-Saharan Africa
- History of injectable drug use
- Petechiae or progressive ecchymosis (likely leading to a gonococcal infection)
- History of head trauma
- Otorrhea or rhinorrhea
- HIV infection or having risk factors infected with HIV or other Immunocompromised conditions.
Physical Examination
Suspicion of meningitis relies heavily on early assessments of meningitis syndrome. Research in the Netherlands on older persons, known as the classic triad for bacterial meningitis is fever, stiffness and changes in mental status. Almost all patients (98-100%) bacterial meningitis have at least one of these classic triad.
Laboratory
The main purpose of laboratory examination on bacterial meningitis is to identify the causative bacteria.
The results of analysis of cerebrospinal fluid, can be used to distinguish bacterial meningitis or viral meningitis or chronic bacterial meningitis.
Radiology Examination
LSF screening is very important to confirm the diagnosis and administration of antibiotics as quickly as possible in patients suspected of meningitis. In most patients with acute bacterial meningitis, LP can be done safely without having to undergo a radiological examination first.
There are several circumstances in which a CT-scan must be performed first before the LP is performed, namely:
- Head trauma
- Immunocompromised state
- There have been seizures (in the last 7 days)
- Abnormal level of awareness
- Focal weakness, abnormal speech
- Abnormality of field of view or gaze paresis
- Inability to follow commands or answer questions appropriately
- There is a history of one of the following conditions: mass lesions (SOL), focal infections, or strokes.
The Infectious Disease Society of America (IDSA) (2004) recommended the use of criteria for CT-scan screening in older persons meningitis patients before the lumbar puncture (Recommendation B-II).
