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What is Meningitis?

Funny you should ask …

From Wikipedia:

Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. While some forms of meningitis are mild and resolve on their own, meningitis is a potentially life-threatening condition due to the proximity of the inflammation to the brain and spinal cord.

Most cases of meningitis are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, that spread into the blood and into the cerebrospinal fluid (CSF).[9] The most common cause of meningitis is viral [the kind Kelsey had], and often runs its course within a few days. Bacterial meningitis is the second most frequent type and can be serious and life-threatening.

Severe headache is the most common symptom of meningitis (87 percent) followed by nuchal rigidity (“neck stiffness”, found in 83%). Other signs commonly associated with meningitis are photophobia (inability to tolerate bright light), phonophobia (inability to tolerate loud noises), irritability and delirium (in small children) and seizures (in 20-40% of cases).

Glad it was viral and bacterial so that this did not happen:

Meninigitis can be diagnosed after death has occurred.

Kelsey’s symptoms included severe headache (um, yeah, you could call it that), neck stiffness, high fever (earlier in the week), photophobia, dizziness, nausea, etc. This all led to an early Saturday morning visit to the ER, where she briefly passed out/collapsed in the waiting room. They they gave her strong pain medicine, steroids and antibiotics and did this:

Investigations include blood tests (electrolytes, liver and kidney function, inflammatory markers and a complete blood count). The most important test in identifying or ruling out meningitis is analysis of the cerebrospinal fluid (fluid that envelops the brain and the spinal cord) through lumbar puncture (LP).

And this:

Computed tomography (CT) is a medical imaging method employing tomography. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation. The word “tomography” is derived from the Greek tomos (slice) and graphein (to write).

And then there was this problem:

The cerebrospinal fluid (CSF) sample is examined for white blood cells (and which subtypes), red blood cells, protein content and glucose level. Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis; microbiological culture of the sample may still yield a causative organism. The type of white blood cell predominantly present predicts whether meningitis is due to bacterial or viral infection.

Cultures are often negative if CSF is taken after the administration of antibiotics.

Kelsey had been on antibiotics for a sinus infection. So they had to let the cultures grow for 48 hours to make sure bacteria were not present. While they did that, she had to be in the hospital. Because there was a chance her meningitis was bacterial and not just viral, we had to do this:

Isolation practices can include placement in a private room or with a select roommate, the use of protective barriers such as masks, gowns and gloves, a special emphasis on handwashing (which is always very important), and special handling of contaminated articles. Because of the differences among infectious diseases, more than one of these precautions may be necessary to prevent spread of some diseases but may not be necessary for others.

Patient care items, such as a stethoscope, that are used for a patient in Contact Precautions should not be shared with other patients unless they are properly cleaned and disinfected before reuse.

The lumbar puncture also led to this:

A headache that is persistent despite a long period of bedrest and occurs only when sitting up may be indicative of a CSF leak from the lumbar puncture site. It can be treated by more bedrest, or by an epidural blood patch, where the patient’s own blood is injected back into the site of leakage to cause a clot to form and seal off the leak.

And then we came home.

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