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Meningitis: Patients
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Meningitis can produce mild symptoms — such as headache, low-grade fever and tiredness lasting two to three days — in some patients. In other patients, the symptoms can be severe and begin suddenly with fever, headache and stiff neck accompanied by some combination of other symptoms: decreased appetite, nausea, vomiting, sensitivity to bright light, confusion and sleepiness.
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Viruses are the major causes of aseptic meningitis syndrome, an illness that is reported to occur with an incidence rate of 10.9 cases per 100,000 person-years. If appropriate diagnostic methods are performed, a specific viral etiology is identified in 55-70% of cases of aseptic meningitis. Of these, enteroviruses account for 90% of cases. HSV accounts for 0.5-3% of cases of aseptic meningitis and is most commonly associated with primary genital infection and is less likely during recurrences. Mumps is the most common cause of aseptic meningitis in unimmunized populations, occurring in 30% of all patients with mumps. It affects males 2-5 times more often than females.
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Antioxidants have ... attracted attention among meningitis researchers. Studies have found that patients with meningitis have oxidative stress caused by reactive nitrogen species in bacterial meningitis (Kastenbauer S et al 2002). In a mouse model of bacterial meningitis, the internal antioxidant superoxide dismutase (SOD) was studied for its ability to limit oxidative stress that caused damage to the ears. SOD, given by injection, was found to significantly reduce damage to the cochlea (Ge NN et al 2004).
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Distinguishing acute, subacute, and chronic meningitis helps identify the pathogen. Approximately 25% of patients with bacterial meningitis present acutely within 24 hours of onset of symptoms. Other patients with bacterial meningitis and most patients with viral meningitis present with subacute neurologic symptoms developing over 1-7 days. Chronic symptoms lasting longer than 1 week suggest meningitis caused by some viruses as well as tuberculosis, syphilis, fungi (especially cryptococci), and carcinomatous meningitis.
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A very young infant may not show the classic signs of meningitis. Early in infancy, a baby's immune system is not yet developed enough to mount a fever in response to infection, so fever may be absent. However, checking an infant's temperature to see if it is high or low could be an indication. Some infants with meningitis have seizures as their only identifiable symptom. Similarly, debilitated elderly patients may not have fever or other identifiable symptoms of meningitis.
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Viral meningitis can usually be treated at home, with full recovery anywhere from two days to two weeks. While there are no medications that cure viral meningitis, you can relieve discomfort with acetaminophen or ibuprofen. Your doctor will ... recommend bed rest and drinking plenty of fluids. Because viral meningitis is contagious, patients should not resume normal activities until they have approval from their doctor.
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