Meningitis | Causes, Symptoms, Risk Factors, Prevention & Treatment

Meningitis Treatment Depending On The Actual Cause

Meningitis can be life-threatening, and treatment often starts in an emergency room to manage seizures and other critical symptoms. Treatment plans depend on the actual cause of meningitis:

1. Bacterial meningitis

› Stabilization

In acute cases, the patient’s airways are checked as the first thing to do in order to assess any breathing or circulatory troubles. If any of those problems exist, they need to be managed by an emergency specialist before starting the antibiotic treatment. Intravenous fluids (applied directly into the veins) are preferred during the first 48 hours, and some patients may also need oxygen masks and anti-seizure medications.

› Antibiotic treatment

Bacterial meningitis is usually dangerous, and treatment should start after hospitalization as soon as possible. The patient is kept in a dim-lightened and quiet room to avoid seizures and photo-sensitivity. In most cases, doctors begin antibiotic therapy with broad-spectrum antibiotics once the suspicion is made and the patient is admitted into the hospital.

Still, a more specific antibiotic treatment is the best choice, and it will be determined by a procedure called lumbar puncture or spinal tap. Lumbar puncture should be done before starting antibiotic therapy. In a lumbar puncture, a physician asks the patient to lie on one side, introduces a needle into the spine and draws some of the spinal fluid to check for bacteria or other organisms. Once the causal bacteria are identified and got tested for antibiotic sensitivity, the doctor will choose the best antibiotic accordingly. A typical round of antibiotics takes from 5 days to 3 weeks according to the etiology (causal bacteria) and is applied into the veins for rapid effects (intravenously). Patients who are improving after six days of therapy can receive the rest of the treatment at home with the appropriate care, medical follow up, and under a specialist’s permission.

› Steroids

Steroids are applied into the veins (intravenously), along with or before starting the antibiotic therapy, and should be discontinued after four days in some instances. Steroids prevent brain swelling and help to reduce the risk of complications, especially hearing loss and neurological sequelae.

› Fluids and pain killers

Fluids are essential to prevent dehydration, while pain killers are given to provide analgesia (pain relief) and lower the fever. Both are given into the veins for rapid effects (intravenously).

› Careful observation

It’s essential during the whole course of the disease. A physician regularly checks for any signs of brain affection, seizures or complications. Continuous assessment and evaluation of the blood glucose levels and the mental status via especial scales are required.

› Eliminating the source of infection

In many cases, the source of infection is located in the paranasal sinus or middle ear (otitis media), so an otolaryngologist examines the patient to determine the source and treat its causes. Treatment may involve surgery for drainage of the infected areas. This promotes faster recovery from the current condition and reduces the risk of recurrence.

› Measures for the close contacts

If the bacterial meningitis is caused by a particular bacterial species called meningococcal bacteria, it will be important to give prophylactic antibiotic therapy to anyone who has been in contact with the patient recently in order to avoid their infection.

› Complicated cases, e.g. meningococcal sepsis

Patients receive more intensive antibiotic therapy and are stabilized regarding their blood flow and breathing.