Failure To Diagnose Meningitis
The types of bacteria that cause meningitis depend upon the age group. For newborns, the most common bacterial agents are group B streptococci (which may inhabit the vagina and pass to a baby during childbirth), Escherichia coli and Lysteria monocytogenes. Older children and adults are more often affected by Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae.
Aseptic meningitis is a diagnosis attached to a meningeal infection that cannot be attributed to a bacteria. Cases of aseptic meningitis are usually caused by a virus, or a bacterial condition that has partially resolved. Viruses known to cause meningitis include: enteroviruses, herpes simplex type 2, varicella zoster, mumps and HIV. Endocarditis may also cause aseptic meningitis. Other potential causes for meningitis include trauma that enables organisms to invade the bloodstream, head trauma that puts the meninges into direct contact with the nasal cavity or skin, and parasites in the cerebral spinal fluid.
In adults, signs and symptoms of meningitis include:
- severe headache;
- neck stiffness (nuchal rigidity);
- high fever (rapid onset);
- altered mental status;
- positive Kernig's sign; and
- positive Brudzinski's sign.
- bulging fontanel;
- high fever;
- abnormal skin color;
- seizure activity;
- inconsolable crying; and
- high-pitched shriek.
Treatment for meningitis depends on the type of inflammation. Generally, viral meningitis does not respond to specific treatments. It is commonly treated at home with fluid and bed rest. Whereas, bacterial meningitis is treated by empiric antibiotics (e.g. cefalosporin, cefotaxime, vancomycin) and adjuvant treatment with corticosteroids (e.g., dexamathasone) to mitigate inflammation.
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