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Friday, 29 November 2013

Meningitis - The Diagnosis

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)
Diagnosis 
1. Spinal tap
After assessing the symptoms and taking the physical exam, the diagnosis is to obtain a sample of spinal fluid to identify type of bacteria responsible by performing a  lumbar puncture with local anesthetic and a needle inserted into an area in the lower back where fluid in the spinal canal, but the risk of lumbar puncture can lead to brain herniationis  if there is an elevation of a mass in the brain (tumor or abscess) or the intracranial pressure (ICP)(33).

2.  The Xpert EV test
Approved by the Food and Drug Administration (FDA) in 2007, when used in combination with other laboratory tests, will help physicians distinguish between viral meningitis and the less-common, but more severe, version of meningitis caused by detecting the RNA of the enterovirus that causes meningitis, but results from the Xpert EV test are available in two and one-half hours(34)

3. Meningococcal rash pressure test
Patient with rash and a cold or flu with fever, headache, aches and pains in joints and muscles and suspected to have menigitis, meningococcal rash pressure test may be the best choice. By using medical instruments to apply pressure to the skin around, bacterial meningitis will not whiten under pressure. As Meningococcus bacteria cause several different infections besides meningitis. They can cause different forms of blood poisoning: septicemia, which is severe; and meningococcemia, a milder form; also pneumonia, arthritis, and infections of the heart, eye, or other parts of the body(35)

4. Blood Culture Tests
Blood Culture Tests is to  is a microbiological culture of blood to detect for the presence of  meningococcal bacteria.

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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
(33) http://cdn.intechopen.com/pdfs/31941/InTech-Lumbar_puncture_techniques_complications_and_csf_analyses.pdf
(34) http://www.news-medical.net/news/2007/03/19/22622.aspx
(35) http://www.meningitis.ca/en/what_is_meningitis/meningococcal.shtml