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$Unique_ID{BRK03993}
$Pretitle{}
$Title{Meningitis}
$Subject{Meningitis Adult Meningitis Infantile Meningitis Neonatal Meningitis
Waterhouse-Friderichsen Syndrome Encephalitis }
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1992 National Organization for Rare Disorders,
Inc.
539:
Meningitis
** IMPORTANT **
It is possible the main title of the article (Meningitis) is not the name
you expected. Please check the SYNONYMS listing on the next page to find
alternate names and disorder subdivisions covered by this article.
Synonyms
DISORDER SUBDIVISIONS:
Adult Meningitis
Infantile Meningitis
Neonatal Meningitis
Includes:
Waterhouse-Friderichsen Syndrome
Information on the following disorder may be found in the Related
Disorders section of this report:
Encephalitis
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Meningitis is characterized by inflammation of the membranes (meninges)
around the brain or spinal cord. The disorder can occur in three different
forms: adult, infantile, and neonatal. This inflammation may be caused by
different types of bacteria, viruses, fungi, or malignant tumors. Chemical
reactions to certain injections into the spinal canal can also cause
Meningitis. This inflammation can begin suddenly (acute) or develop
gradually (subacute). Adult forms of Meningitis are characterized by fever,
headache, and a stiff neck, sometimes with aching muscles. Nausea, vomiting
and other symptoms may occur. Treatment with antibiotics is usually
effective against the infection.
Symptoms
Meningitis in adults and children is often preceded by respiratory illness or
a sore throat. In its acute form, the disorder is characterized by fever,
headache, a stiff neck, and vomiting. Adults may become seriously ill within
24 hours. In children, the course of the infection may be even shorter.
Symptoms among older children and adults may progress from irritability
through confusion, drowsiness, and stupor, possibly leading to coma.
Dehydration often occurs, and collapse of the blood vessels may lead to shock
(Waterhouse-Friderichsen Syndrome), especially when the Meningitis is caused
by meningococcus bacteria which spreads to the blood (septicemia). Paralysis
of one side of the body (hemiparesis) is uncommon early in the course of
Meningitis, but may occur later as a result of tissue death in the brain
(cerebral infarction). Meningitis may recur even after treatment with
antibiotics.
Infantile Meningitis:
The course of the disorder is less predictable among infants between 3
months and 2 years of age. Fever, vomiting, irritability, and convulsions
usually occur. A high-pitched cry, and a bulging or tight soft spot
(fontanel) on the crown of the head (where the parts of the still unhardened
bones join) may also occur. Since the incidence of Meningitis is highest
among this age group, any unexplained fever needs to be closely watched.
Cerebral fluid may accumulate just inside the tough outer membrane covering
the brain (subdural effusions) after several days. Typical signs of
Meningitis include seizures, a persistent fever, and an enlarging head size.
A brain abscess or subdural pus accumulation may also occur. Water
accumulating in the brain (hydrocephalus), deafness and slowed mental and
physical development are possible effects of Meningitis on the central
nervous system.
Neonatal Meningitis:
Meningitis in newborn babies can begin during the first 4 weeks of life.
It may be caused by infections in parts of the body other than the brain or
spine. Some cases may arise from complications occurring at birth. The
disorder is characterized by subtle and non-specific signs such as
jitteriness, interrupted breathing (apnea), vomiting, diarrhea, and a
yellowish skin color (jaundice). Usually signs of infection elsewhere in the
body (e.g. middle ear infection) are also present. The cerebrospinal fluid
can be tested for a definite diagnosis.
Meningitis due to Group B pneumococcus bacteria may be present in the
first 10 days of life, when it frequently accompanies a lung illness.
Usually, however, this form of Meningitis occurs after 10 days of age as an
isolated illness. Neonatal Meningitis is also characterized by symptoms such
as fever, drowsiness, and seizures.
Causes
Meningitis can be caused by different bacteria, viruses and organisms such as
Neisseria meningitis, Hemophilus influenzae b, Streptococcus (Diplococcus)
pneumoniae, Group A Streptococcus, Escherichia coli or other gram-negative
organisms (chiefly Pseudomonas), and Staphylococcus aureus.
Recurrent Meningitis occurs in special situations: 1) When there is a
communication between the brain and the exterior that may be inborn or occur
after an injury; 2) When infection occurs in areas close to the meninges as
in mastoid infection, sinus infection, brain abscess, accumulation of pus
under the outer meninge (subdural empyema), or spinal epidural abscess; 3)
When the patient has impaired immunity against bacteria or other causes of
illness.
Affected Population
Neonatal Meningitis usually occurs during the first 4 weeks of life, and
predominantly affects infants of low birth weight who have had complications
at birth. This form of the disorder occurs in approximately 2 out of 10,000
full-term infants, and in 2 out of 1,000 low birth weight infants. This form
of Meningitis predominantly affects males.
Related Disorders
Symptoms of the following disorders may resemble those of Meningitis.
Comparisons may be useful for a differential diagnosis:
Encephalitis is a brain infection. There are different types of this
disorder which are caused by different types of viruses. Encephalitis may
also be caused by hypersensitivity initiated by a virus or other protein that
is foreign to the body. Symptoms may include headache, drowsiness,
hyperactivity, and/or general weakness. This disorder may have some symptoms
similar to those of Meningitis such as a stiff neck, altered reflexes,
confusion, speech disorders, possible convulsions, paralysis and coma. (For
more information choose "Encephalitis" as your search term in the Rare
Disease Database.)
Therapies: Standard
Meningitis is usually treated with different types of antibiotics used
against the specific bacteria causing the infection. These may include
ampicillin, chloramphenicol, gentamicin, penicillin, moxalactam, nafcillin,
or in tuberculosis cases isoniazid.
Children over 2 years of age can be immunized against Meningitis with the
Haemophilus influenzae type b polysaccharide vaccine.
A vaccine composed of attenuated bacteria with added protein, has been
approved for use in children under two years of age to protect them against
Haemophilus influenzae type B Meningitis
Therapies: Investigational
The orphan product, Amphotericin B Lipid Complex, has been sponsored by the
Bristol-Myers Squibb Co., P.O. Box 4000, Princeton, NJ, 08543, for the
treatment of Cryptococcal Meningitis.
This disease entry is based upon medical information available through
February 1992. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Meningitis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Allergy and Infections Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
Centers for Disease Control (CDC)
1600 Clifton Road, NE
Atlanta, GA 30333
(404) 639-3534
References
INTERNAL MEDICINE, 2nd ed.: Jay H. Stein, et al., eds.; Little Brown, 1987.
Pp. 1494-1502.
PREVENTION OF HAEMOPHILUS INFLUENZAE TYPE B INFECTIONS IN HIGH-RISK
INFANTS TREATED WITH BACTERIAL POLYSACCHARIDE IMMUNE GLOBULIN: M. Santosham,
et al.; New England Journal Med (October 8, 1987: issue 317(15)). Pp. 923-
929.
PROSPECTS FOR PREVENTION OF HAEMOPHILUS INFLUENZAE TYPE B DISEASE BY
IMMUNIZATION: D.M. Granoff, et al.; Journal Infect Dis (March 1986: issue
153(3)). Pp. 448-461.
CAPSULAR POLYSACCHARIDE OF HAEMOPHILUS INFLUENZAE TYPE B AS A VACCINE:
J.C. Parke, Jr.; Pediatr Infect Dis Journal (August 1987: issue 6(8)). Pp.
795-798.