Overview

What is meningitis

Meningitis is a state defined by swelling of the protective tissues enclosing the brain and spine (meninges). It is occasionally referred to as spinal meningitis. The meninges shield your brain and spinal cord, preventing injury and offering structural support. Nerves, blood vessels, and protective fluid (cerebrospinal fluid) are present within them. Meningitis can be caused by infectious diseases such as viruses and bacteria, as well as non-infectious conditions like cancer or head injuries.¹

Types of meningitis

There are six types of meningitis:² 

Bacterial meningitis

Different types of bacteria can typically be transmitted from one person to another, causing bacterial meningitis. The bacteria can exist inside or on the bodies of children and adults. This does not guarantee they will get sick, but they can still transmit the bacteria to other people. It is crucial to seek immediate medical assistance for bacterial meningitis, as it can be fatal.

Viral meningitis

The majority of meningitis cases are the result of viral infections. Viral meningitis can be mild, but it is commonly more severe in infants under three months old and in other at-risk children. Some viruses, like herpes simplex, can trigger serious instances of viral meningitis, even in older children and adults.

Amoebic meningitis

Naegleria fowleri is the amoeba that leads to the development of amebic meningitis. When the amoeba enters the brain through the nose, it can infect people. It is not transmitted between individuals. Amoebas can be found in freshwater lakes and rivers with warm temperatures where people go swimming. Naegleria fowleri may also be present in tainted pools and splash pads, tap water, and soil. Individuals can't contract an infection by consuming water that is contaminated with the amoeba.

Parasitic meningitis

Parasitic meningitis is not as prevalent as viral and bacterial meningitis. Parasites are predominantly located in animals. People become infected by consuming contaminated food or by ingesting soil tainted with faeces from infected animals.

Fungal meningitis

Various kinds of fungi that reside in the environment, specifically in the soil, are responsible for fungal meningitis. If infection control practices are not adhered to, patients can also contract this infection during medical procedures.

Drug-induced aseptic meningitis

Occasionally, specific medications can lead to drug-induced aseptic meningitis (DIAM). DIAM is most commonly caused by non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics.¹

Pediatric parasitic meningitis

Meningitis caused by parasites is an uncommon type of meningitis illness. A parasite is a living being that resides within or on another organism. This entity functions as its host, while the parasite relies on its host for sustenance to survive. Parasites are tiny creatures that cannot be seen by the naked eye and can develop into lengthy worms as they become more powerful by feeding on their host and reproducing. The parasite in and of itself is not an illness; however, it has the potential to induce and transmit diseases like meningitis.³

Three varieties of parasites can impact humans, including:

1. Protozoa are organisms consisting of a single cell that can reproduce within human beings. These parasites can be transmitted through tainted food and water, contact between individuals, and insect stings
2. Helminths are parasitic worms that commonly inhabit a person's digestive system. These parasites are unable to reproduce or grow inside the human body and are eventually excreted in the person's faeces
3. Ectoparasites are tiny creatures that reside on the body's surface. Some of them are ticks, fleas, and lice. These particular parasites are not among those that can cause parasitic meningitis. They lead to illnesses like Lyme disease

Causes

Certain parasites can lead to a less common type of meningitis known as eosinophilic meningitis, eosinophilic meningoencephalitis, or EM. Three primary parasites responsible for causing EM in certain individuals are:⁴

1. Angiostrongylus cantonensis, also known as neurologic angiostrongyliasis
2. Baylisascaris procyonis causes baylisascariasis, also known as neural larva migrans
3. Neurognathostomiasis is caused by the parasite Gnathostoma spinigerum

How these parasites spread 

Typically, these parasites infect animals rather than humans. People become infected mainly by consuming infected animals or contaminated food products.⁴

1. A. Cantonensis: Infection can occur in humans through the consumption of raw or undercooked snails or slugs, or contaminated fruits and vegetables
2. B. procyonis: Individuals become infected when they unintentionally consume eggs of the infectious parasite. You can locate these eggs in raccoon droppings and in areas (such as soil) that have been exposed to raccoon droppings
3. G. spinigerum: Infection can occur in individuals who consume raw or undercooked freshwater fish or eels, frogs, poultry, or snakes

Individuals generally do not transmit parasitic meningitis or the parasites responsible for it to others.

Sign and symptoms

The signs of meningitis can differ based on the underlying cause of the infection. The signs could begin a few days following your child's experience with a cold and sniffles, or stomach issues like diarrhoea and vomiting. Symptoms may vary slightly from one child to another. Symptoms can occur abruptly. Alternatively, they could progress for several days.

Symptoms in infants can consist of:⁵

Symptoms in babies can be hard to identify.

1. Irritability
2. High body temperature
3. Getting extra sleep
4. Inadequate nutrition.
5. A loud, sharp scream
6. Bending backwards
7. Weeps while being lifted or embraced
8. uncontrollable sobbing
9. Swollen fontanelle (soft spot on a baby's head)
10. Distinct disposition
11. A rash with patches of purple and red colour

For children older than one year old:

1. Pain in the neck and back
2. Pain in the head
3. Feeling drowsy
4. Disorientation
5. Being easily annoyed or frustrated.
6. High body temperature
7. Rejecting food
8. Diminished state of awareness
9. Epileptic fits
10. Light sensitivity, also known as photophobia.
11. Feeling sick and throwing up
12. Stiffness in the neck
13. A rash with purple-red splotches

A couple of days after your child has a cold and runny nose, or diarrhoea and vomiting, they may start showing symptoms of meningitis. Meningitis symptoms may resemble those of different problems or illnesses. Always be sure to consult with your child's doctor for an accurate diagnosis.

Diagnosis

Some tests that help diagnose meningitis:⁶

1. Lumbar puncture: A spinal tap is also known as a lumbar puncture. This test is the only one that can detect meningitis. A needle is inserted into the lower back, specifically into the spinal canal. This is the region surrounding the spinal cord. The measurement of pressure in the spinal canal and brain is taken. A small quantity of cerebrospinal fluid (CSF) is extracted and tested to check for infections or other issues
2. Blood tests: These tests can assist in the diagnosis of infections that lead to meningitis
3. Computed tomography or magnetic resonance imaging: These tests display brain images. Sometimes a CT scan is performed to search for other conditions that might present similar symptoms to meningitis. An MRI can reveal inflammatory modifications in the meninges. These tests provide additional information. However, these tests alone are insufficient for diagnosing meningitis
4. Swabs are taken from the nose, throat, or rectum

Treatment

The doctor will decide on the specific treatment for meningitis based on your child's condition:⁵

1. The age, general health, and past medical conditions of your child
2. The severity of the illness
3. The organism responsible for the infection
4. Your child's ability to handle certain medications, treatments, or therapies
5. Anticipated progression of the illness
6. Your viewpoint or choice
7. The type of treatment given will differ depending on the cause and severity of the disease. Your child might be prescribed oral antiparasitic medication along with corticosteroids

Supportive therapy

While your child is in the process of recovering from meningitis, additional treatments may be started to enhance recovery and well-being and offer relief from symptoms. The following may be included in this list:

1. Resting in bed
2. Encouraging higher liquid consumption (which could mean pushing fluids at home or getting IV fluids in the hospital)
3. Medications are prescribed for lowering fever and relieving headache symptoms
4. If your child gets seriously sick and struggles to breathe, they may need additional oxygen or a respirator for support

Summary

Meningitis is a swelling of the protective membranes around the brain and spinal cord. Infectious diseases like viruses or bacteria, along with non-infectious conditions such as cancer or head injuries, can be the source of the issue. Six different kinds of meningitis exist: bacterial, viral, amoebic, parasitic, fungal, as well as drug-induced aseptic meningitis. Parasitic meningitis in children is a rare form caused by parasites. Symptoms can differ based on age and might consist of elevated body temperature, neck and back discomfort, and light sensitivity.

Diagnosis includes procedures such as lumbar puncture and blood tests. The type of treatment needed varies based on the reason and seriousness of the sickness and could involve antiparasitic drugs along with supportive treatments. Prompt medical intervention is vital for meningitis, as it has the potential to be deadly.