Meningitis symptoms
Meningitis symptoms may vary as the disease may be caused by various micro-organisms like bacteria, virus, fungi and also can be due to reactions to medicines or environmental toxins. Bacterial meningitis treatment should be started immediately on occurrence of the meningitis symptoms.
Meningitis symptoms
Delay in onset of meningitis treatment due to error in diagnosis can result in coma or, even, death. The most critical form of meningitis, bacterial meningitis, attacks about 5,000-7,000 people in America every year. African-Americans have been found to be more prone to meningitis than people of other races.
In bacterial and fungal meningitis, monitoring of the patient is required and stay at hospital is mandatory till the meningitis symptoms subside. Meningitis caused by virus shows gradual onset of symptoms and is mostly self-limiting with the meningitis symptoms subsiding within 7-10 days. The incubation period may vary depending upon the cause of infection.
Some strains, especially N. meningococcus of bacterial meningitis, are fatal. It can attack healthy individuals,infants and young children.
The typical meningitis symptoms may be missing in newly-born children, infants or adults who also suffer from other medical conditions.
Meningitis Symptoms in adults
The onset is mostly abrupt with fever, headache, malaise and vomiting. The temperature rises up to 102-103°F. The headache is severely throbbing in character and is mostly in the occipital area. Fear of lights (photophobia) is quite usual. The vomiting is frequent and sometimes projectile. The patient looks irritable all the time and may be delirious.
Bacterial meningitis, especially of the meningococcal variety, can result in the patient becoming critical in the developed untreated cases. As the disease can turn critical, immediate hospitalization is required if the the patient experiences the meningitis symptoms described above.
On examination
The patient prefers to lie with his back towards the light. If left undisturbed, the patient remains quiet but any disturbance leads to resentment. It becomes difficult or sometimes impossible for the patient to turn on to the back and is an evidence of cerebral irritation.
Marked stiffness (nuchal rigidity) in the neck is observed in 50% of the cases because of the rigidity of the posterior cervical muscles and the patient is unable to flex the head forward. Nuchal rigidity is assessed with the patient lying supine and both the hips and knees flexed. If pain is elicited when the knees are passively extended (Kerning`s sign), this indicates nuchal rigidity and meningitis. Back flexing is also severely limited as is straight leg raising due to protective spasm limiting the movement of the inflamed meninges.
If there is neurological involvement then facial nerve paralysis can occur.
Meningitis symptoms in neonatals and infants
The younger the child, the less typical is the illness. Symptoms may be absent in infants below 6 months and few symptoms are prevalent in 6-8 months of age. The very first sign may be convulsions which may be repeated. Marked irritability is seen in infants and the child refuses to take milk. The child vomits quite often and mostly the vomiting is projectile. The cry of the baby is high pitched and its body temperature may be normal or raised. The child, when lying, is quiet and cries on picking, as this leads to irritation of the meninges. Child on examination, looks pale and the breathing rate is high. Neck stiffness is not observed and Kerning`s sign is often absent. The 'soft spot' (anterior fontanelle) is usually tense and bulging.This sign can be absent if there is dehydration due to excessive vomiting. Bacterial meningitis may result in brain damage, hearing loss or learning inefficiency.
If the progress of the meningitis symptoms progresses steadily for between 24-48 hours, even in the face of disease management, it has been observed that between 5 - 10 % of the patients invariably die.
