CEREBROSPINAL MENINGITIS

BY

DR AFUYE OLUBUNMI OLUSOLA

MB;BS (ILORIN)

19TH APRIL, 2017

INTRODUCTION

Cerebrospinal meningitis (CSM)

is also known as Meningococcal

disease or Cerebrospinal fever.

It is an infectious disease

resulting in the inflammation of

the meninges {the thin

membranes covering the brain

and spinal cord} of both brain

DISEASE’ NAME

This disease called

Cerebrospinal meningitis was so

named in 1873.

CAUSATIVE ORGANISM

•The only organism responsible for

CSM is Neisseria meningitides

(also called Diplococcus

intracellularis meningitides or

Meningococus)

•This organism has preference for

cerebral membranes

•It is common and naturally

widely distributed but usually

harmless. It’s found in the nose

and throat of man, this can

overwhelm the body immune

system to cause meningitis and

systemic disease to a susceptible

individual.

•It has a very short incubation

EPIDEMIOLOGY

•It occurs worldwide as endemic

and epidemic (seasonal) forms

•It is common in Asia and sub-

Sahara Africa called the “Meningitis

belt”. Countries involved includes:

Burkina Faso, Benin Republic,

Cameroon, Chad, Ivory Coast,

Ethiopia, Gambia, Ghana, Mali,

Mauritania, Niger, Nigeria, Senegal,

Sudan and Togo.

•There is presently an outbreak in

Burkina Faso, Mali, Niger and Nigeria

(involving states like Bauchi, Jigawa,

Kano, Katsina and Yobe with more

than 156 people reported deaths)

• It is a major cause of bacterial

meningitis in children and young

adults.

• It has a rapid progression and can be

fatal resulting in about 5-10% of

SYMPTOMS

In Babies and Young

Children

•Fever

•Vomiting

• Irritability

•Refusal to feed

•High pitched,

inconsolable or

moaning cry

•Pale shin

•Bulging or tensed

fontanel

In older children and

adults

•Severe Headache

•Stiff neck

•Fever

•photophobia

•vomiting

•altered consciousness

or coma

• features of septicaemia

like: rash, cold hands

and feet, joint and

muscle aches, stomach

INVESTIGATIONS

•Rapid diagnostic test to help

make rapid and correct diagnosis

of cases

•Blood cerebrospinal fluid tests to

identify the organism and body

response to the infection

TREATMENT

•Suspicion of meningitis is a

medical emergency

•Seek medical attention quickly if

you observe the following

symptoms: sudden fever, severe

headache and neck stiffness

•Early treatment can help prevent

serious complications.

•Drugs used in treatment of CSM

includes: Ceftriaxone, Penicillin G,

Chloramphenicol, corticosteroids

like dexamethasone. The

physician will determine the

appropriate medication and

dosage for the individual.

•Rehydration and oxygen may be

required.

PREVENTION

Vaccination: routine

immunization is recommended

for adolescents (11-18 years).

However, this is not practicable

in African meningitis belt as the

vaccine only offers protection for

3-5years. Thus vaccine are

offered to involved areas on

outbreak of the disease.

Proper hygiene i.e Hand washing

Avoid direct contact with

secretions from infected person

Covering of mouth and nose

when sneezing or coughing

Avoid overcrowding

Provide adequate ventilation in

houses

MODE OF SPREAD•CSM spread through droplets

(saliva and respiratory secretions)

•Prolong close contact with

infected person

•Coughing

•Sneezing

•Kissing

•Sharing of eating and drinking

utensils

RISK FACTORSAge

Skipping of vaccinations

Dry weather

Dusty winds

Cold nights

Large population/overcrowding

Resent travel to states in meningitis

belt (In Nigeria they are Benue, Kaduna,

Kano, Katsina, Niger, Sokoto, Zamfara

etc.)

Weak immune system resulting

from AIDS, diabetes, alcoholism,

immunosuppressive drugs

Spleen removal

Respiratory infections

Smoking

Complement deficiencies

PROPHYLAXIS

People who have close

contacts with infected

individuals should be placed

on either of the following

drugs:

Rifampicin

Azithromycin

Ceftriaxone

LONG TERM EFFECTS OF CSMHearing loss

Blinndess

Learning impairment

Epilepsy

Behavioral, emotional and psychological problems

Abnormal Gait

Amputation

Skin Scarring

Bone and joint damage

Kidney failure

CONCLUSION

Cerebrospinal meningitis is a

disease that calls for immediate

intervention in other to secure

the lives of the general

populace.