The invasion of the meninges by any of the offending bacteria or
viruses brings about an inflammatory response leading to the formation
of purulent matter. The bacterial invasion causes meningeal hyperaemia
and infiltration by polymorphonuclear leucocytes into the spinal fluid.
The infiltration causes vasculitis with congestion and reduced cerebral blood flow. Purulent exudation is produced. Cerebral oedema occurs as a result of the infection and vasculitis thereby leading to impaired perfusion.
This subsequently results in impaired cerebral tissue metabolism and increased intracranial pressure which is responsible for nausea, vomiting and confusion.
Irritation of the meninges brings about neck pain and stiffness, severe headache, fever, etc. Photophobia, back pain and myalgia may also accompany above symptoms.
Irritation of the motor centre causes abnormal impulses resulting in muscle spasm, causing the back to arch and the head to retract with great rigidity of the muscles.
Clinical features
1. Stiffness of the neck
2. Severe headache
3. Vomiting
4. Photophobia (fear of light)
5. Fever
6. Irritability
7. Delirium
8. Convulsion
9. Muscular pain
10. Malaise
11. Positive Kernig's sign (when the thigh is supported at right angles to the trunk, the patient is unable to straighten his leg at the knee joint).
Diagnosis
1. Lumbar puncture: This produces pressurized cerebrospinal fluid which is turbid in nature (normal pressure is 120-130mm)
2. Cerebrospinal fluid gram stain and culture helps to identify the offending organisms.
3. Cytological examination of Cerebrospinal fluid shows an increase in white blood cells count.
4. Counter current immunoelectrophoresis of the cerebrospinal fluid helps to detect bacterial antigen.
5. Kernig's sign is usually positive
6. The classical triad (headache, stiffness of the neck and vomiting) is to some extent diagnostic.
Predisposing factors
1. Head injury
2. Otitis media
3. Upper respiratory tract infection
4. Poliomyelitis
5. Neuro-surgery
6. Lumbar puncture
7. Mastoiditis
8. Poor sanitation.
Complications of meningitis
a. Hydrocephalus
b. Blindness
c. Deafness
d. Paralysis
e. Urine retention
f. Cardiac arrest
g. Bronchopneumonia
In order to arrive at a more accurate diagnosis of this condition, you need to understand the basic signs and symptom, and also conduct the necessary laboratory tests. When the test result is analyzed against the presenting features, a proper diagnosis can be then be made.
The infiltration causes vasculitis with congestion and reduced cerebral blood flow. Purulent exudation is produced. Cerebral oedema occurs as a result of the infection and vasculitis thereby leading to impaired perfusion.
This subsequently results in impaired cerebral tissue metabolism and increased intracranial pressure which is responsible for nausea, vomiting and confusion.
Irritation of the meninges brings about neck pain and stiffness, severe headache, fever, etc. Photophobia, back pain and myalgia may also accompany above symptoms.
Irritation of the motor centre causes abnormal impulses resulting in muscle spasm, causing the back to arch and the head to retract with great rigidity of the muscles.
Clinical features
1. Stiffness of the neck
2. Severe headache
3. Vomiting
4. Photophobia (fear of light)
5. Fever
6. Irritability
7. Delirium
8. Convulsion
9. Muscular pain
10. Malaise
11. Positive Kernig's sign (when the thigh is supported at right angles to the trunk, the patient is unable to straighten his leg at the knee joint).
Diagnosis
1. Lumbar puncture: This produces pressurized cerebrospinal fluid which is turbid in nature (normal pressure is 120-130mm)
2. Cerebrospinal fluid gram stain and culture helps to identify the offending organisms.
3. Cytological examination of Cerebrospinal fluid shows an increase in white blood cells count.
4. Counter current immunoelectrophoresis of the cerebrospinal fluid helps to detect bacterial antigen.
5. Kernig's sign is usually positive
6. The classical triad (headache, stiffness of the neck and vomiting) is to some extent diagnostic.
Predisposing factors
1. Head injury
2. Otitis media
3. Upper respiratory tract infection
4. Poliomyelitis
5. Neuro-surgery
6. Lumbar puncture
7. Mastoiditis
8. Poor sanitation.
Complications of meningitis
a. Hydrocephalus
b. Blindness
c. Deafness
d. Paralysis
e. Urine retention
f. Cardiac arrest
g. Bronchopneumonia
In order to arrive at a more accurate diagnosis of this condition, you need to understand the basic signs and symptom, and also conduct the necessary laboratory tests. When the test result is analyzed against the presenting features, a proper diagnosis can be then be made.
Joseph Ezie Efoghor is a Registered Nurse with several years of
practical experience. He has touched many lives through his style of
writing. To get more of his articles, visit http://www.africannursesforum.com/blog
Article Source:
http://EzineArticles.com/?expert=Joseph_Ezie_Efoghor
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