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Case Summary
1.
"Meningitis is an infection of the fluid of a person's
spinal cord and the fluid that surrounds the brain. People
sometimes refer to it as spinal meningitis. Meningitis is usually
caused by a viral or bacterial infection. Knowing whether
meningitis is caused by a virus or bacterium is important because
the severity of illness and the treatment differ. Viral
meningitis is generally less severe and resolves without specific
treatment, while bacterial meningitis can be quite severe and may
result in brain damage, hearing loss, or learning disability"
(CDC Meningococcal Disease).
2.
"High fever, headache, and stiff neck are common symptoms of
meningitis in anyone over the age of 2 years. These symptoms can
develop over several hours, or they may take 1 to 2 days. Other
symptoms may include nausea, vomiting, discomfort looking into
bright lights, confusion, and sleepiness. As the disease
progresses, patients of any age may have seizures"
(CDC Meningococcal Disease). In this case, the patient
showed the effects of a meningiococcal septicemia due to the
petechial rash present on examination.
3.
Diagnosis was made from the CBC and spinal fluid analysis.
In bacterial meningitis, the WBC is elevated. The spinal
fluid showed a gram negative diplococcus bacteria, an elevated
protein level, and decreased glucose level, indicative of a
bacterial meningitis. The presence of cellular material and
bacteria in the spinal fluid increases the protein level.
The bacteria are utilizing glucose as an energy source, therefore
the total spinal fluid glucose is decreased. An XRay and
CAT scan were ordered to detect the pressure on the brain from
the meningitis. Increased cranial pressure can be very
dangerous, leading to seizures and brain damage.
4.
"Urgent treatment with antibiotics is essential for someone
with bacterial meningitis. The sooner someone with bacterial
meningitis is diagnosed and
treated, the greater chance there
is they will make a full recovery" (Meningitis Foundation of
America). Appropriate treatment with antibiotics reduces
the risk of dying to below 15%. Anti-seizure medication
(steroids) is used to alleviate intracranial pressure.
5.
Meningococcal meningitis occurs predominantly in males.
Epidemics occurs in about 10-year cycles. Most cases of
meningitis are isolated and not related to other cases.
"Bacterial meningitis is fairly uncommon, but can be
extremely serious. It is fatal in one in 10 cases and one
in 7 survivors is left with severe handicap, such as deafness or
brain injury" (Meningitis Foundation of America).
6.
There are vaccines against many of the strains of bacteria that
cause meningitis. The Hib vaccine has been very effective
in reducing the rate of childhood meningtitis. Pneumococcal
vaccine works against the strain of bacteria causing meningitis
primarily in elderly people. Other vaccines may be utilized
to control outbreaks. Since meningitis is a reportable,
communicable disease, the medical teams must promptly notify
state and county public health officials. These individuals then
follow the protocols for notifying persons who may have had
direct contact with the patient.
7.
Many healthcare workers interacted in this case to diagnose and
effectively treat the patient. Physicians ordered key
tests, made the diagnosis, and ordered treatment. Nursing
personnel worked around the clock monitoring vital signs, giving
intravenous antibiotics and fluids, and administering steroid
medications. Clinical laboratory scientists provided key
information for the diagnosis in the form of a CBC, and spinal
fluid results. Radiologic technologists performed Xrays and
a CAT scan to detect the level of intracranial pressure.
Radiologists read and interpreted the images. Public Health
officials played a key role in containing a communicable
disease. They alerted individuals that had been in close
contact with the patient to watch for symptoms that might
indicate meningitis. These individuals were advised to
notify a physician immediately at the appearance of any possible
symptoms.
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