Anonymous asked: brain meningitis symptoms & how to find out whether the patient is recovering with the current medication or not?
I haven’t had to deal with patients with, or suspected of, meningitis for a very long while, so I had to scratch my own meninges and ponder this one.
First, realize that there are 5 possible causes of meningitis (bacterial, viral, fungal, parasitic and non-infectious [such as cancer or systemic conditions]) but the most common are viral and bacterial, in that order. Both are contagious, and there can be a viral infection that leads further to a bacterial infection.
Symptoms tend to be milder for viral meningitis, and depending on the infecting virus are treated conservatively with bed rest, maintaining hydration and nutrition and prescription or OTC medications for pain. Determining recovery is determined by symptom resolution. Some viral infections require antiviral treatment.
Symptoms in a patient >2 years old:
Sudden high fever
Severe headache that isn’t easily confused with other types of headache
Vomiting or nausea with headache
Confusion or difficulty concentrating
Sleepiness or difficulty waking up
Sensitivity to light and/or sound
Lack of interest in drinking and eating
- Skin rash in some cases, such as meningococcol meningitis
For patients younger than 2 years old:
- High fever
- Constant crying
- Excessive sleepiness or irritability
- Inactivity or sluggishness
- Poor feeding
- A bulge in the soft spot on top of a baby’s head (fontanel)
- Stiffness n a baby’s body and neck
For bacterial meningitis, it is diagnosed by symptom presentation, along with blood work for CBC with diff. and blood cultures. A lumbar puncture may be done, as well as a CT scan to R/O masses of other changes. Antibiotics are chosen based on the infectious agent, and the patient’s medical history; initial treatment is 7-21 days, dependent on the antibiotic.
In regards to recovery, you’ll be looking for reduction and/or absence of fever, reduction in neurological symptoms (including reduction and/or control of seizures, return to baseline LOC, return of motor planning and function, tolerance of stimuli, etc.) and ability to take food and fluids by mouth. Depending on the age of the patient (<2 has greater mortality and residual effects) the patient may have to be monitored for hearing loss, cognitive impairment and presence/absence of seizures.
This was a somewhat cursory answer; I pulled it from prior experience and a number of resources, which I’ll give here.
(Yes, I tend to read a lot.)