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Friday, 29 November 2013

Meningitis - The Complications

Meningitis is defined as a condition of inflammation of the protective membranes,  covering the brain and spinal cord (meninges). Meningitis, a life threaten disease, can kill and immediate action can and does save lives.(1) Although bacterial meningitis has become an uncommon disease in the developed world. Unfortunately, because of limited economic resources and poor living conditions, many developing countries are still affected by the devastating consequences of this life-threatening systemic infection(2)
Complications
1. In the study to raise awareness of meningitis and its symptoms and describes some of the practical support that can be offered to sufferers, their families and friends. Doctors at the University of Hertfordshire. indicated that he prognosis and possible complications are described. These include potential problems such as sensorineural deafness, raised intracranial pressure, the need for skin grafting and the amputation of limbs and/or digits.(1)

2. Spectrum of complications 
Systematically central nervous system and systemic complications during the acute phase of adult bacterial meningitis
a. Central nervous system complications
Include brain swelling, hydrocephalus, brain abscess, subdural empyema, or subdural effusion (using computed tomography) and cerebrovascular involvement (using cerebral angiography),
b. Systemic complications
Include septic shock, disseminated intravascular coagulation, adult respiratory distress syndrome, or septic or reactive arthritis(30). Cerebrovascular complications are the most frequent intracranial complications in bacterial meningitis of the adult (37.1%) and are major determinants in the prognosis of this disease(31)

3. Others spectrum of complications
In the analyzing 87 consecutive cases between 1984 and 2002. Meningitis-associated intracranial complications developed in 74.7% and systemic complications in 37.9% of cases. Diffuse brain oedema (28.7%) and hydrocephalus (16.1%) developed more frequently than previously reported. The incidences of arterial (21.8%) and venous (9.2%) cerebrovascular complications were also very high. Furthermore, 9.2% of cases developed spontaneous intracranial haemorrhages (two patients with subarachnoid and two with subarachnoid and intracerebral bleedings, all in association with vasculitis; one subject with intracerebral haemorrhage due to sinus thrombosis; and three cases with intracerebral bleedings of unknown aetiology). Other new findings were the incidence of acute spinal cord dysfunction due to myelitis (2.3%) and that of hearing loss (19.5% of all patients and 25.8% of survivors). The in-hospital mortality was 24.1%. Only 48.3% of the patients had a good outcome at discharge (32)

4. Etc. 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/15284663
(2) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2803%2913693-8/fulltext
(31) http://www.ncbi.nlm.nih.gov/pubmed/1641143
(32) http://www.ncbi.nlm.nih.gov/pubmed/12690042