“Whenever man comes up with a better mousetrap, nature comes up with a better mouse”
Definition
Inflammatory response to bacterial infection of the Pia-arachnoid and the Cerebrospinal fluid.
Prognosis
Good if the diagnosis is made early and therapy instituted, but overall case fatality still around 10%, with strep. Pneumonia meningitis causing 25% mortality.
General Measures
Maintenance of fluid and electrolyte balance, intubating the comatose patient, control of seizures and Glucocorticoids.
Advice to Patient
Nil specific
Follow Up
Depending on course in hospital. Usually adults after ayear, children after 6 months to detect sequelae.
Inadequate Response
Possibility of resistant organisms, brain abscess, subdural empyema, etc.,
Prevention
Prompt medical treatment for infections. Strict asespsis, and comprehensive antibiotic treatment when treating patients with head injuriesFor close contacts of patients with Meningococcal meningitis (house hold contacts, nursing personnel, and doctors who have performed after CPR on a patient, Rifampin (600mgs bid) for 2 days. If organism sensitive to Sulfa, Sulfadiazine (1.0 gm bid) for 2 days. The patient has to be isolated for 24 hours after start of therapy.Meningococcal vaccine against Groups A and C, 0.5 ml IM or SC, immunity for 3 years, immunity takes 5 days to develop, and as this is more than the average incubation period for the disease, is of no use to persons exposed to a case. Vaccine is given during epidemics.
