The Lack Of Understanding By Some Of The Healthcare Professionals She Saw Was Really Frustrating For Jane One Reason Why Shes Sharing Her Viral Meningitis Story
A lack of understanding
I woke up at about 5am on March 9th 2012 with a severe headache in the back of my neck. I thought I had woken up too early and tried to get back to sleep. By 7.30am I was feeling sick and had pins and needles in my arms. Two weeks previously I had had a bad dose of flu, probably the worst I have ever had, and was off work for a week.
As there was no one at home I called a friend as I just didn’t know what to do, and she told me to call an ambulance. An emergency car arrived within five minutes, but the medic didn’t seem too concerned, thought I was having a migraine and told me the pins and needles in my arms were due to me hyper-ventilating. The ambulance arrived a few minutes later and took me to hospital. On arrival they tried to give me painkiller tablets but I felt too sick to take them, and was given morphine in liquid form. Within an hour of being in hospital I had had a brain scan.
Meningitis had not crossed my mind
Meningitis had not crossed my mind at this point. I thought perhaps it was ‘only’ a migraine, but my worst fear was a stroke due to the pins and needles and strange sensations in my arms. Throughout the morning I was kept in A&E with a string of doctors performing various tests on me. I think they all shone a torch in my eyes and asked me if the light affected me. I think, meningitis or not, if you are feeling that ill with a severe headache, a torch shone in your eyes would be uncomfortable.
Told to go home and rest
Clinical Tests For Meningeal Inflammation May Not Help
If the patient history raises suspicions for meningitis—such as neck stiffness, severe headache, and/or living in close quarters where infections easily spread—clinical tests might be performed in the doctor’s office to help gauge whether the meninges are potentially inflamed. These tests could include:
- Nuchal rigidity. When the neck cannot flex forward all the way, nuchal rigidity is present. This could possibly be due to neck muscles stiffening to avoid painful movements of the meninges within the cervical spine.
- Brudzinski’s sign. With the patient in a supine position , the head is gently lifted upward. If the hips and knees flex as a result, Brudzinski’s sign is positive. In theory, moving the neck upward causes the inflamed meninges surrounding the spinal cord to stretch, and the hips and knees reflexively move upward to compensate and reduce the tension.
- Kernig’s sign. With the patient in a supine position, the knee is lifted and then the leg is gradually extended. If pain results and the movement to straighten the leg is resisted, Kernig’s sign is considered positive.
- Jolt accentuation. A patient with headache and fever turns the head side to side two or three times per second. If the headache worsens, the test is considered positive. Jolt accentuation is typically done for someone reporting headache but not neck stiffness.
What Are The Risk Factors For Bacterial Meningitis
- Having been in close contact with someone who has bacterial meningitis .
- Having a compromised immune system.
- Having traveled to an area of the world where meningitis is widespread .
While some forms of bacterial meningitis are contagious, especially meningococcus, none is transmitted as easily as the common cold or the flu. However, bacterial meningitis can be spread through the exchange of respiratory and throat secretions, such as:
- coughing or sneezing
What Are The Symptoms Of Meningitis In A Child
The symptoms of meningitis vary depending on what causes the infection. The symptoms may start several days after your child has had a cold and runny nose, or diarrhea and vomiting. Symptoms can occur a bit differently in each child. Symptoms may appear suddenly. Or they may develop over several days.
In babies, symptoms may include:
A purple-red splotchy rash
The symptoms of meningitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
When To See A Doctor About Meningitis Symptoms
You should see your GP if your child:
- has an unexplained fever and is generally unwell
- complains of a persistent headache or sore neck
- says bright light hurts her eyes.
If you think your child has meningitis, he must see a doctor as soon as possible. If you’re in any doubt, take your child to the emergency department at your nearest hospital.
How Meningitis Causes Neck Pain And Stiffness
While most stiff necks result from minor muscle strains or ligament sprains, a stiff neck caused by meningitis is a vastly different process that stems from a potentially life-threatening infection. This page examines why neck stiffness is present in some cases of meningitis.
How Can I Help Prevent Meningitis In My Child
Several vaccines are available to prevent some of the bacterial infections that can cause meningitis. These include:
H. influenzae type b vaccine . This is given as a 3- or 4-part series during your child’s routine vaccines starting at 2 months old.
PCV13 pneumococcal vaccine. The American Academy of Pediatrics recommends this vaccine for all healthy children younger than age 2. PCV13 can be given along with other childhood vaccines. It is recommended at ages 2 months, 4 months, 6 months, and 12 to 15 months. One dose is also advised for older children who did not get the 4-dose series, and for those at high risk for pneumococcal disease.
PPSV23pneumococcal vaccine. This vaccine is also recommended for older children at high risk for pneumococcal disease.
Meningococcal vaccine. This vaccine is part of the routine vaccine schedule. It is given to children ages 11 to 12, with a booster given at age 16. It is given to teens entering high school if they were not vaccinated at age 11 or 12. A booster is also given at age 16 to 18, or up to 5 years later. Babies and young children at increased risk may also have this vaccine. Ask your child’s healthcare provider about the number of doses and when they should be given.
Vaccines that protect against viruses such as measles, mumps, chickenpox, and the flu can prevent viral meningitis.
Talk with your child’s healthcare provider if you have questions about the vaccines.
Meningitis: Far More Than A Pain In The Neck
Meningitis has been very topical recently for a variety of reasons so I thought I’d write a little about it. Firstly, there was the saddening coroner’s report indicating that an emergency service call handler caused a treatment delay for a 5 year old who ultimately had meningitis. Secondly was the news that the combined meningitis A,C,W and Y vaccine is to be offered to teenagers and university-goers this September, and incorporated into the UK vaccination schedule as standard from January 2016. Finally, there was the not so recent news that the meningitis B vaccine is also to be incorporated into the UK schedule from September 2015. It won’t be available to everyone though – only those babies aged 4 months or under at the time of its rollout – but its inclusion is a really positive step forward.
She had a temperature of 38.3C when I examined her, but there was little else to find, and notably, no rash.
This was a rather sobering patient for me for a number of reasons, mainly: a) she was not a child and b) she had so few of the “classic” signs and symptoms we are all taught about.
So what is meningitis?
What are those signs and symptoms?
A lot of the signs and symptoms of meningitis, when taken individually, might not seem of much significance and happen with almost any other illness. But when present in certain combinations they may indicate the possibility of meningitis:
· A severe headache
· Notable sensitivity to bright light
Stiff Neck And Neck Pain Signs Of Meningitis
Neck pain. Although neck pain can have multiple causes, the most common being the wrong position and muscle strains, there are situations when it can be a sign of meningitis.
Meningitis occurs when the membranes or meninges around the spinal cord and brain become inflamed.
Four types of meningitis are possible:
Bacterial:the most severe life-threatening form of meningitis. This type can be fatal if not treated immediately with antibiotics to prevent the spread of the infection and additional complications.Viral: the most common cause of a meningitis infection. Usually, this type is not as severe as bacterial meningitis and often disappears without the need for treatment.Fungus: this unusual type Meningitis is caused by a fungus that enters the spinal cord from the bloodstream.Parasitic: This much less common form of meningitis is caused by parasites.
You do not always need treatment for non-bacterial meningitis. The infection can go away on its own. Meningitis can be confused with the flu, dehydration or gastroenteritis. It can also be overlooked, as the symptoms may be mild or not always apparent.
What Are The Signs & Symptoms Of Meningitis
Meningitis symptoms vary, depending on the person’s age and the cause of the infection. The first symptoms can come on quickly or start several days after someone has had a cold, diarrhea, vomiting, or other signs of an infection.
Common symptoms include:
- skin rash
Meningitis in Infants
Infants with meningitis might have different symptoms. Babies might be cranky, feed poorly, and be sleepy or hard to wake up. It may be hard to comfort them, even when they’re picked up and rocked. They also may have a fever or bulging fontanelle .
Other symptoms of meningitis in babies can include:
- stiffness of the body and neck
- a lower-than-normal temperature
- a high-pitched cry
How To Recognize Spinal Meningitis Symptoms
This article was medically reviewed by Mandolin S. Ziadie, MD. Dr. Ziadie is a board certified Pathologist in South Florida specializing in Anatomic and Clinical Pathology. She earned her medical degree from the University of Miami School of Medicine in 2004 and completed her fellowship in Pediatric Pathology at Children’s Medical Center in 2010.There are 13 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 88% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 356,417 times.
Meningitis, sometimes referred to as spinal meningitis, is an inflammation of the membranes surrounding the brain and spinal cord. Meningitis is usually caused by a viral infection, but it can also be caused by a bacterial or fungal infection. Depending on the type of infection, meningitis can be easily curable or potentially life threatening.
Where Does Your Neck Hurt With Meningitis
Meningitis is characterized by a number of symptoms, and each case varies. The classic symptoms include distinctive skin rash, more sensitive to light, fontanel , or even seizures. Sometimes it may also hurt your neck, leading to neck pain and stiffness. These discomforts can interfere with you daily activities. Even the disease could turn into serious if left untreated, this is especially true for bacterial meningitis.
The Anatomy And Function Of The Meninges
The meninges are the protective layers covering the brain and spinal cord. The cranial meninges cover the brain and cushion it from the skull; the spinal meninges cover the spinal cord and protect it from direct contact with the cervical spine and thoracic spine .
In addition to protecting the brain and spinal cord, the meninges also help direct the flow of blood to the skull and brain, as well as transport cerebrospinal fluid. Cerebrospinal fluid is formed in the brain and flows freely through the cranial meninges and into the spinal meninges.
The three layers of the meninges include:
- Dura mater. The outermost layer is the toughest and comprised of dense fibrous tissue, which provides the most protection. The dura mater is the only layer of the meninges that is sensitive to pain.
- Arachnoid mater. The middle layer is filled with elastic tissues and collagen in a spider web-like structure, which is how this layer gets its name. The cerebrospinal fluid runs beneath the arachnoid mater in the subarachnoid space and above the pia mater.
- Pia mater. The innermost layer attaches to and closely lines the spinal cord and brain, unlike the looser-fitting arachnoid mater and dura mater on the outside. The pia mater is the thinnest and most delicate of the three meningeal layers.
Diagnosis Of Acute Bacterial Meningitis
Spinal tap and analysis of cerebrospinal fluid
If a child 2 years old or younger has a fever and a parent senses that the child is inexplicably irritable or sleepy, the parent should see or call a doctor immediately, particularly if symptoms do not resolve after an adequate dose of acetaminophen.
Children require immediate medical attention, usually in an emergency department, if they do any of the following:
Become increasingly irritable or unusually sleepy
Have a low body temperature
Refuse to eat
Rash with a fever or stiff neck
During the physical examination, doctors look for telltale signs of meningitis, particularly a stiff neck. They also look for a rash, especially in children, adolescents, and young adults, and for other symptoms, which may suggest a cause. Doctors may strongly suspect bacterial meningitis based on symptoms and results of the examination, but tests are needed to confirm the diagnosis and to identify the specific bacteria causing it.
As soon as doctors suspect bacterial meningitis, they first take a sample of blood to be grown in a laboratory and analyzed. Then they start treatment with antibiotics and corticosteroids immediately, without waiting for test results, because meningitis can progress rapidly.
Treatment Of Acute Bacterial Meningitis
Seizures: Antiseizure drugs are given.
Shock: Additional fluids and sometimes drugs are given to increase blood pressure and treat shock, as may occur in Waterhouse-Friderichsen syndrome.
Coma: Mechanical ventilation may need to be used.
Dangerously increased pressure within the skull : The head of the bed is elevated, and corticosteroids are used to reduce pressure within the skull. If pressure must be lowered quickly, mechanical ventilation is used. Mechanical ventilation decreases the amount of carbon dioxide in the blood and thus quickly but briefly reduces pressure in the cerebrospinal fluid. Also, mannitol may be given intravenously. Mannitol causes fluids in the brain to move into the bloodstream and thus reduces pressure within the skull. Pressure within the skull may be monitored with a small tube connected to a gauge. The catheter is inserted through a tiny opening drilled through the skull. The catheter can also be used to remove cerebrospinal fluid and thus reduce pressure when necessary.
Subdural empyema: A surgeon may have to drain the pus to ensure a successful recovery.
Prognosis Of Acute Bacterial Meningitis
If treated early, most people with meningitis recover well. But when treatment is delayed, permanent brain or nerve damage or death is more likely, especially in very young children and people over 60. Mortality rates are
For children under 19 years: As low as 3% but often higher
For adults < 60 years: About 17%
For adults over 60 years: Up to 37%
For people with meningitis that is due to Staphylococcus aureus and not acquired in a hospital : About 43%
In some people, seizures that result from meningitis require lifelong treatment.
People who have had meningitis may have problems such as permanent mental impairment, problems with memory or concentration, learning disabilities, behavioral problems, paralysis, double vision, and partial or complete loss of hearing.
Prevention After Exposure To Meningitis
Family members, medical personnel, and others in close contact with people who have meningococcal meningitis should be given an antibiotic as a preventive measure.
Whether children under 2 years old need preventive antibiotics after exposure at day care to someone with meningitis due to Haemophilus influenzae is unclear.
Preventive antibiotics are usually needed only for meningococcal meningitis and meningitis due to Haemophilus influenzae.
When Neck Stiffness May Mean Meningitis
Meningitis is a serious condition that occurs when the meninges—protective membranes covering the brain and spinal cord—become infected and inflamed. Early symptoms can be similar to the flu. However, having a stiff neck in addition to flu-like symptoms could be a key clue that meningitis is the problem and should be checked by a doctor.
Patients should seek immediate medical attention if a stiff neck is accompanied by a fever, headache and/or nausea. SeeWhen Is a Stiff Neck Serious?
There are several types of meningitis, but this article focuses on the two most common ones: viral and bacterial. In cases where someone has contracted bacterial meningitis, finding medical attention immediately can be the difference between making a full recovery and permanent disability or death.
Key Points About Meningitis In Children
Meningitis is an inflammation of the thin membranes that cover the brain and the spinal cord.
It is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid. A fungus or parasite may also cause meningitis.
Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis is usually more severe and may lead to long-term complications or death.
An infection usually starts in the respiratory tract. In a child, it may first cause a cold, sinus infection, or ear infection. It can then go into the bloodstream and reach the brain and spinal cord.
A lumbar puncture is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal.
Several vaccines are available to prevent some of the bacterial and viral infections that can cause meningitis.
Symptoms Of Acute Bacterial Meningitis
Symptoms of acute bacterial meningitis vary by age.
In newborns and infants, early symptoms usually do not suggest a particular cause. Symptoms most often include
A high or low body temperature
Irritability, such as excessive fussiness or crying that continues or worsens after being comforted and cuddled by the mother or caregiver
Smacking the lips, chewing involuntarily, gazing in different directions, or periodically going limp
Sluggishness or listlessness
A high-pitched crying that is unusual for the baby
Unlike older children and adults, most newborns and infants do not have a stiff neck. If meningitis becomes severe, the soft spots between skull bones , which are present in infants before their skull bones grow together, may bulge because pressure within the skull is increased.
In most children and adults, acute bacterial meningitis begins with symptoms that slowly worsen for 3 to 5 days. These symptoms may include a general feeling of illness, fever, irritability, and vomiting. Some people have a sore throat, cough, and a runny nose. These vague symptoms may resemble those of a viral infection.
Early symptoms that suggest meningitis specifically include
Confusion or decreased alertness
Sensitivity to light
Some people have symptoms of a stroke, including paralysis. Some have seizures.
If bacterial meningitis develops after surgery on the brain or spinal cord, symptoms often take days to develop.
How Is Meningitis Diagnosed In A Child
The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:
Lumbar puncture . This is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain is measured. A small amount of cerebral spinal fluid is removed and sent for testing to see if there is an infection or other problems.
Blood tests. These can help diagnose infections that cause meningitis.
CT scan or MRI. These are tests that show images of the brain. A CT scan is sometimes done to look for other conditions that may cause similar symptoms as meningitis. An MRI may show inflammatory changes in the meninges. These tests give more information. But meningitis can’t be diagnosed using these tests alone.
Nasal, throat, or rectal swabs. These tests help diagnose viral infections that cause meningitis.
How Are Meninges And Neck Are Related
Meninges are located on the outer layer of the spinal cord and the brain. They run from your head to the end of your lower back. The meninges in the neck are the only movable tissues. Thus, inflammation or any kind of infection can lead to pain while moving the neck or tightness and stiffness in the neck. It can also lead to restricted movement and inflexibility.
Meningitis is a curable condition. If you have the signs and symptoms of the condition, you need to consult a doctor on an immediate basis. Book an appointment with a doctor and get some physical examinations done. Your health is the foremost priority, you should give it some attention. Follow the advice of the doctor and let your body heal with some care.
Causes Of Acute Bacterial Meningitis
Different species of bacteria can cause meningitis. The bacteria most likely to be the cause depends on
How old people are
Which bacteria are likely to cause meningitis also depends on what is weakening the immune system and which part of the immune system is weakened, as in the following examples:
AIDS or Hodgkin lymphoma: Listeria monocytogenes, the bacteria that cause tuberculosis, or fungi
Problems producing antibodies or removal of the spleen: Streptococcus pneumoniae or, less often, Neisseria meningitidis, which may cause a rapid, severe form of meningitis
Recent chemotherapy for cancer: Pseudomonas aeruginosa or gram-negative bacteria such as E. coli
In very young infants and older people, certain parts of the immune system may be weak, increasing the risk of meningitis due to Listeria monocytogenes.
When Should I Seek Medical Attention
See your doctor if your child has an unexplained fever, a lasting headache or sore neck, or says that bright lights hurt their eyes.
- a high fever with a severe headache
- stiffness and pain in the neck
- dislike of bright lights
- and a skin rash of red or purple spots that do not turn white when you press on them with a finger
How Is Meningitis Treated In A Child
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment varies by type of meningitis. The treatments by type include:
Bacterial meningitis. Treatment is started as quickly as possible. The healthcare provider will give your child IV antibiotics, which kill bacteria. Your child will also get a corticosteroid medicine. The steroid works by decreasing the swelling and reducing pressure that can build up in the brain. Steroids also reduce the risk for hearing loss and brain damage.
Viral meningitis. Most children get better on their own without treatment. In some cases, treatment may be done to help ease symptoms. There are no medicines to treat the viruses that cause viral meningitis. The only exception is herpes simplex virus, which is treated with IV antiviral medicine. Babies and children with a weakened immune system may need to stay in the hospital.
Fungal meningitis. Your child may get IV antifungal medicine.
Tuberculous meningitis. Your child will be treated with a course of medicines over 1 year. Treatment is done with several medicines for the first few months. This is followed by other medicines for the remaining time.
While your child is recovering from meningitis, he or she may also need:
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.