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.
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