Overview Of The Causes And Complications Of Meningitis
Meningitis is a condition in which the membranes covering the brain and spinal cord become inflamed. It can develop due to viral, bacterial, or fungal causes, and it is sometimes fatal. While vaccines are available to prevent certain types of this condition, patients are encouraged to become familiar with the symptoms associated with various types of meningitis. Patients with this condition may experience a headache, fever, stiff neck, sensitivity to light, nausea, and loss of appetite. These symptoms normally develop rapidly, and emergency hospital treatment is often necessary. To diagnose meningitis, doctors perform a physical examination, blood tests, imaging studies, and a spinal tap (lumbar puncture). Treatment for the condition typically consists of intravenous antibiotics, corticosteroids, and rest. Patients who develop seizures as a result of meningitis will also be treated with anticonvulsants.
Some of the most common types of meningitis and their causes and complications are described below.
Viral Meningitis
Viral meningitis is often a mild form of the condition, and it is frequently caused by enteroviruses, a group of viruses that are especially common over the late summer and early fall in the United States. Mumps, West Nile virus, HIV, and the herpes simplex virus can also lead to viral meningitis. Although viral meningitis cannot be treated with antibiotics, most patients completely recover without treatment within a couple of weeks. If treatment is required, doctors normally begin by recommending bed rest and over-the-counter pain medications to alleviate fever and muscle aches. If necessary, corticosteroids might be prescribed to reduce swelling of the brain, and patients who have had seizures will be given an anticonvulsant. If the patient's viral meningitis is caused by the herpes virus, effective antiviral medication is available for treatment.
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Bacterial Meningitis
Bacterial meningitis is one of the most serious forms of the condition. The infection can develop if certain bacteria enter the bloodstream. Some of the recognized groups of bacteria associated with bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitides, Haemophilus influenzae, and Listeria monocytogenes. Vaccines are available to protect against the first three of these bacteria groups. Listeria monocytogenes are found in hot dogs, lunch meats, and unpasteurized cheese. The symptoms associated with bacterial meningitis have a very rapid onset, and they can become serious or even life-threatening within a few hours. Patients may notice a severe, persistent headache, and they may also have vomiting, nausea, high fever, confusion, and a stiff neck. New skin rashes could also develop very quickly. To reduce the risk of serious complications, patients with any of these symptoms should be taken to an emergency room immediately. If bacterial meningitis is confirmed, high doses of strong intravenous antibiotics will be administered, and the patient will likely need to be placed in the intensive care unit.
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Fungal Meningitis
Fungal meningitis is rare in the United States, though it's important to note patients with compromised immune systems, including those with cancer or HIV, are at a higher risk for this type of infection. A fungus known as Cryptococcus is the most common cause of fungal meningitis. Symptoms of this condition are similar to those of bacterial meningitis, and patients might experience a fever, confusion, sensitivity to light, nausea, and vomiting. To treat this form of meningitis, doctors provide high doses of intravenous antifungal medications over an extended period. Patients with fungal meningitis who have weakened immune systems will need to have treatment over a longer period than other patients. While there are no particular activities known to cause this condition, patients can reduce their risk of fungal meningitis by avoiding soil and other areas where the fungus is likely to be present. Experts also suggest individuals avoid bird droppings, and individuals with weakened immune systems might want to consider avoiding activities involving dust or digging in the dirt. This is particularly advisable for patients who live in regions where Cryptococcus, Histoplasma, or Blastomyces are known to exist.
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Brain Damage
Brain damage is serious complication most often associated with bacterial meningitis, although it can occur with other forms of the disease. Even if treatment is started promptly, some patients who have survived bacterial meningitis may still have lingering neurological issues that could range from mild to severe. For example, survivors of meningitis might have trouble with walking, and learning difficulties may also occur. Some patients could experience hearing loss, and difficulties with memory have been observed too. Individuals who experience lasting neurological complications due to meningitis will likely be treated by a neurologist and other specialists. Depending on the severity of the complications, patients may need to have physical therapy, speech therapy, and occupational therapy, and medications might be beneficial in some instances. Physical therapy could help patients with building the strength and coordination necessary for walking, and speech and occupational therapy could assist individuals in learning or re-learning skills for daily tasks. Therapists can suggest modifications to movements that may make walking and daily tasks easier for patients with neurological considerations. Hearing aids or other audiology treatments may be appropriate for patients who experience hearing loss after meningitis.
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Seizures
Seizures can occur as a complication of fungal and bacterial meningitis, and patients may also develop them in the later stages of the condition. Patients who have survived bacterial meningitis may later develop epilepsy. Focal seizures are the most common seizures in meningitis survivors. These types of seizures affect one part of the brain, and they can occur while a patient is still conscious (simple focal seizure) or while they are unconscious (complex focal seizure). Patients experiencing any type of seizure could notice a sense of fear or anxiety, and some individuals also report a feeling of deja vu. Uncontrolled jerking movements of the arms and legs may occur, and patients will normally be confused after the seizure. Certain types of seizures may cause the patient to appear as if they are simply staring off into the distance with a blank expression. Seizures can be diagnosed with an electroencephalogram and MRI scans, and patients identified as epileptic will typically be treated with a combination of anticonvulsants.
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Hearing Loss
Meningitis is capable of causing hearing loss. In fact, thirty percent of the bacterial meningitis cases recorded in the United States cause some level of hearing loss. More than three percent of young people in the United States with hearing loss had meningitis as children. The level of hearing loss can vary from mild to profound. Because bacterial meningitis increases the risk of hearing loss, patients need to talk to a hearing specialist after they have recovered to determine whether there was any effect. The hearing loss is caused by the loss of the inner ear's hair cells, which are responsible for picking up the vibrations from sound waves. If the damage to the structures of the inner ear becomes more complete, patients might experience profound hearing loss. Some individuals also experience tinnitus following meningitis, which is a ringing or whooshing in the ears. Hearing aids help remedy all but profound hearing loss cases.
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Kidney Failure
Some kinds of bacterial meningitis have the potential to lead to kidney failure. They can also cause long-term kidney damage that continues to need treatment following recovery. Depending on the severity of the condition, patients might be prescribed medications that damage the kidneys. The kidneys are responsible for filtering the blood, and they help remove waste and toxins from the body. Toxins are removed from the blood and sent to the bladder so they can leave the body through urination. When the kidneys are unable to filter the waste out of the blood, this condition is called kidney failure. The kidneys are a vital organ. When they don't work correctly, the patient's body will become overloaded with toxins. If kidney failure isn't treated, it can be life-threatening. There are a variety of symptoms of kidney failure. When patients have bacterial meningitis, their doctor should keep a close eye on their kidney function during the recovery process. Persistent nausea, pressure or pain in the chest, and a reduced amount of urine are all key signs of kidney failure.
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Issues With Memory
Some patients have reported issues with memory following their recovery from meningitis. This can occur when there is brain damage as a result of the illness. Memory problems can take several different forms. The brain has different ways of storing and retrieving memory. Some patients might have problems with their long-term memory and remembering core events. Others might have trouble with short-term recall, which can make it difficult to keep appointment times or remember new facts. The problems with memory sometimes have an impact on a patient's school or work performance, particularly when they interfere with their ability to stick to schedules. The memory issues tend to be worst immediately following recovery from meningitis. In most cases, issues with memory will get better over time. Some patients make a full recovery. It's important to have a neurologist monitor any ongoing cognitive impairments after meningitis. If the memory problems get progressively worse instead of better, there may be factors beyond meningitis at play.
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Learning Disabilities
Some patients who have meningitis may experience learning disabilities as an ongoing complication. This is especially true of those who contract meningitis in infancy or childhood. Meningitis can affect the way the brain develops in young people, which can lead to learning disabilities and cognitive impairment. The learning disabilities may take on a variety of forms depending on the effect of the disease on the brain. A learning disability is a neurological issue that interferes with processing. Some disabilities affect an individual's ability to learn skills like math, writing, and reading. There can also be neurological effects on things like time planning, organization, long and short term memory, attention, concentration, and abstract reasoning. Even though learning disabilities are best known for impeding academic performance, they can also affect an individual's interpersonal relationships and functioning in the workplace. Some problems, like issues with reading and writing and math, can be detected during the school years. Other learning disabilities are more abstract and may be more difficult to diagnose. One example is attention deficit hyperactivity disorder (ADHD), which often goes undiagnosed in children.
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Issues With Gait
Meningitis can cause issues with gait both during the course of the disease and afterward. Balance is controlled in part by the inner ear. The ears and brain work together to help establish a sense of equilibrium. When meningitis causes the brain to swell, this equilibrium is often disrupted, which leads to dizziness and a loss of balance. Some individuals may fall. These cases tend to resolve once the meningitis is treated and the person has recovered. In other cases, there may be more permanent damage to the brain that leads to gait abnormalities. While recovering from meningitis, doctors should keep an eye on a patient's cognitive function and physical function to assess any neurological abnormalities. Issues with gait can include unsteadiness, trouble staying balanced, and difficulty walking in general. Some patients experience vertigo, lightheadedness, and dizziness. Not all problems with gait are neurological, and it's possible to have gait problems that have nothing to do with meningitis. The potential complications from gait abnormalities include trauma, injury, pain, and inflammation.