Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) were found to be a biomarker in cerebrospinal fluid during the presence of bacterial meningitis; however, it is not yet recommended for clinical practice (Brouwer et al., 2010). Blood cultures and skin biopsy have been used to detect causative pathogens in patients when cerebrospinal fluid cultures are negative or unavailable, but these tests are not definitive enough to be used as the standard diagnostic method (Brouwer et al., 2010). Improvements to blood culture and skin biopsy testing could result in a quicker, more cost effective diagnostic technique that is also safer for the patient.
Treatment Modalities
There are a variety of antibiotic regimens and therapies used for children with bacterial meningitis. Selecting the necessary antibiotic for treatment requires the assessment of its activity against the causative pathogen, its ability to penetrate the cerebrospinal fluid, and to determine the minimum antibiotic concentration for effective results (Chavez-Bueno et al., 2005). The compromised nature of the blood-brain barrier caused by meningitis also increases the permeability of most antibiotics, and must be considered when evaluating treatment dosage. Empirical therapy treatments are selected for children based on the most probable causative pathogen for the patient's age and the susceptibility patterns in the patient's geographical location (Yogev et al., 2005). Once the bacterial pathogen is known, or assumed, treatment providers will base the antibacterial regimen based on penicillin resistance and ?-Lactam allergy. The antibacterial treatments of choice for N. meningitidis are ceftriaxone or cefotaxime; Hib is cefotaxime or ceftriaxone; S. pneumoniae is cefotaxime or ceftriaxone plus vancomycin (Yogev et al., 2005). Peniciliin G. Or ampicillin is also considered standard therapies for susceptible (non-resistant) strains of N. meningitidis and S. pneumoniae (Chavez-Bueno et al., 2005). Antibiotic pretreatment of bacterial meningitis (treatment prior to lumbar puncture) is also employed in a significant number of childhood cases of bacterial meningitis, and is known to affect cerebrospinal fluid glucose and protein levels (Nigrovic et al., 2008).
One of the damaging effects of the inflammatory processes associated with bacterial meningitis causes permanent neurological sequelae, and most commonly, hearing loss (Yogev et al., 2005). Corticosteroid treatment, namely dexamethasone, is used (either before or with antibiotic treatment) to reduce hearing loss in children (Mongelluzzo et al., 2008). There are concerns with corticosteroid treatment due to the potential decrease in cerebrospinal fluid penetration of antibiotics; as well as side effects, such as gastrointestinal bleeding and prevention of secondary fever which indicates antimicrobial failure (Mongelluzzo et al., 2008). Anticonvulsant medications such as benzodiazepines and phenobarbital are recommended to prevent and control seizures (Chavez-Bueno et al., 2005).
Non-pharmacological strategies used to reduce the intracranial pressure caused by inflammation include the avoidances of vigorous procedures such as intubation, 30? head elevation, and short-term hyperventilation (Chavez-Bueno et al., 2005). Complications from treatment and bacterial meningitis include seizures, subdural effusions, brain abscesses, persistent fever, and fatality (Chavez-Bueno et al., 2005). The cost of treatment is relatively small due to lack of surgical intervention needed for bacterial meningitis. The majority of costs relevant to the patient concern the cost of vaccinations, antibiotics, and costs associated with hospital care. Costs of referral treatments must also be considered. From a research and development perspective, the greatest cost is vaccine development; the cost of which drives vaccination policies (Ceyhan et al., 2008).
Education
Educating parents on the signs and risk factors for bacterial meningitis is critical in order for children to receive appropriate medical care as quickly as possible. Although symptoms such as fever and vomiting are not obvious signs of meningitis, educating parents on the risk of penetrating head injuries, and any immunosuppressive states (such as HIV infection), greatly increase the likelihood of acquiring bacterial meningitis (Chavez-Bueno et al., 2005). Children who undergo cochlear implants are also at a high risk of acquiring bacterial meningitis; the rate of which is 30 times greater than children in the general U.S. population (Biernath et al., 2006). Once a child is recovering from bacterial meningitis, parents and the patient must also be educated on potential lifestyle changes. Etiology, patient age, concentration of bacteria, and cerebrospinal fluid findings at the time of diagnosis can all impact the outcome of bacterial meningitis (Chavez-Bueno et al., 2005). The most common outcome in children is hearing loss, in which some measure of hearing loss occurs in 25% to 35% of patients; there is also risk of neuromotor, speech, and learning disabilities in children, in which approximately 10% of children will develop (Chavez-Bueno et al., 2005).
Follow-up and Referral
Hearing loss, learning disabilities, speech difficulties, behavioral problems, and neuromotor impairment are all known consequences of bacterial...
Bacterial meningitis is a rare infection that attacks the meninges that shroud the brain/spinal cord. It is a potentially deadly infection and one that can be contagious as well. It is caused by a bacterial infection, as the name implies, that started somewhere in the body, for example in the sinuses, and made its way to the brain through the bloodstream (Understanding Meningitis -- The Basics, 2015). Thus, in the
Bacterial Meningitis) Namani, S. A., Koci, R. A., Qehaja-BuAaj, E., Ajazaj-Berisha, L., & Mehmeti, M. (2014). The epidemiology of bacterial meningitis in Kosovo. The Journal of Infection in Developing Countries, 8(07), 823-830. The article aims to present bacterial meningitis epidemiologic features presented in Kosovo, a developing country. The epidemiological data in question was analyzed with patient observation and chart review at the University Clinical Center of Kosovo for two years. The
Meningitis is an inflammation of the coverings of spinal cord and brain. Meningitis results from an infection to the cerebrospinal fluid in the spaces that surround the brain and spinal cord (Centers for Disease Control and Prevention [CDC], 2012). Either infections from viruses or from bacteria can cause meningitis; however, the viral form of meningitis is often significantly less severe than its bacterial counterpart and usually resolves without much treatment
Carriers might pass on the disease, but they may not suffer from it for days, months, years or even indefinitely. The cause of susceptibility, other than the obvious -- a weakened immune -- system is not known. People who come in close contact, such as members of a family, children and youngsters at school of day care, those that are sexually or otherwise intimate will transmit the disease. These individuals
It can be quite contagious. Fungal meningitis generally occurs in patients who are immune compromised. The symptoms are similar to viral and bacterial meningitis. As with many opportunistic fungal infections of immune compromised patients, it can be quite serious, and treatment is difficult or impossible. Diagnosis and Treatment The biggest question for physicians treating patients with suspected meningitis is: "is it viral or is it bacterial?" Rapid tests for Neisseria meningitidis (meningococcus)
Introduction Meningitis infects the meninges, the delicate membranes that house the spinal cord and the brain. It is a rare infection that can affect adults and children alike. The disease manifests in several types such as through viral, bacterial and fungal varieties. Bacterial meningitis is the most dangerous and infectious variety. It is a life threatening disease. It infects people in physical contact. Incidentally, viral meningitis is not as severe as
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