Meningitis Health Article

Diagnosis

A number of techniques are used when examining a patient suspected of having meningitis to verify the diagnosis. Certain manipulations of the head (lowering the head, chin towards chest, for example) are difficult to perform and painful for a patient with meningitis.

The most important test used to diagnose meningitis is the lumbar puncture (LP), commonly called a spinal tap. Lumbar puncture involves the insertion of a thin needle into a space between the vertebrae in the lower back and the withdrawal of a small amount of CSF. The CSF is then examined under a microscope to look for bacteria or fungi. Normal CSF contains set percentages of glucose and protein. These percentages will vary with bacterial, viral, or other causes of meningitis. For example, bacterial meningitis causes a smaller than normal percentage of glucose to be present in CSF, as the bacteria are essentially "eating" the host's glucose, and using it for their own nutrition and energy production. Normal CSF should contain no infection-fighting cells (white blood cells), so the presence of white blood cells in CSF is another indication of meningitis. Some of the withdrawn CSF is also put into special lab dishes to allow growth of the suspected infecting organism, which can then be identified more easily. Special immunologic and serologic tests may also be used to help identify the infectious agent.

In rare instances, CSF from a lumbar puncture cannot be examined because the amount of swelling within the skull is so great that the pressure within the skull (intracranial pressure) is extremely high. This pressure is always measured immediately upon insertion of the LP needle. If it is found to be very high, no fluid is withdrawn because doing so could cause herniation of the brain stem. Herniation of the brain stem occurs when the part of the brain connecting to the spinal cord is thrust through the opening at the base of the skull into the spinal canal. Such herniation will cause compression of those structures within the brain stem that control the most vital functions of the body (breathing, heart beat, consciousness). Death or permanent debilitation follows herniation of the brain stem.

Treatment

Because meningitis is a potentially deadly condition, doctors should be contacted immediately for diagnosis and treatment. Alternative treatments should be used only to support the recovery process following appropriate antibiotic treatments, or used concurrently with antibiotic treatments.

General recommendations

Patients should be well rested in bed, preferably in a darkened room. They should be given lots of fluids and nutritious foods. Patients should avoid processed foods and those with high fat and sugar content. Fats are difficult to digest in severely ill patients; sugar tends to depress the immune system and impede recovery process. Patients should also take vitamin A (up to 10,000 IU per day), B-complex vitamins (up to 1,500 mg per day), and vitamin C (up to 2 g per day) to help keep the body strong and prevent future infections. Additionally, the patient may consider taking other antioxidants, essential fatty acids (EFAs), and/or participate in therapies, such as massage therapy and movement therapies (e.g., t'ai chi).

Other treatments

Alternative therapies, such as homeopathy, traditional Chinese medicine, and Western herbal medicine may help patients regain their health and build up their immune systems. The recovering individual, under the direction of a professional alternative therapist, may opt to include mushrooms into his or her diet to stimulate immune function. Contact an experienced herbalist or homeopathic practitioner for specific remedies.

Allopathic treatment

Antibiotics are the first line of treatment for bacterial meningitis. In recent years, however, doctors have turned to such newer medications as vancomycin or the fluoroquinolones to treat bacterial meningitis because strains of S. pneumoniae and N. meningitidis have emerged that are resistant to penicillin and the older antibiotics. Because of the effectiveness of the blood-brain barrier in preventing the passage of substances into the brain, medications must be delivered directly into the patient's veins (intravenously) at very high doses. Antiviral drugs (acyclovir) may be helpful in shortening the course of viral meningitis, and antifungal medications are available as well. Patients who develop seizures will require medications to halt the seizures and prevent their return.