At the age of two months old my brother was diagnosed with meningitis in the

year of 1978. He had a fever of 104.0 and was taken to St.Christopher’s hospital but then

after a few hours was released by staff, stating there was nothing more that they could do.

My mother then took him to CHOP Children’s Hospital Of Philadelphia where they

immediately started running test on him. The results were in. the doctor’s had concluded

that he had a rare case of meningitis, and would need to stay in the hospital for a while

before they could find a cure or treatment. In the mean time the staff did everything they

could to break the fever, and once it was broken they realized something. My brother

wasn’t making any sounds or noises even when they called his name. The social worker

came into the room, and spoke to my mother regarding our experience at St.Christopher’s

hospital.She was told to speak to a lawyer at once to take legal action for the safety of

her child. My mom was grateful to the staff and she thanked them for saving my brothers

life. The Er nurses and doctors explained to us that he would have died if he hadn’t come

to the Er the time that he did. This is a very serious condition and at this time very less

about it was known. Several weeks later the fever finally dropped and stabilized but his

hearing was lost. This was such a big transition for us to adjust to but, without knowing

how we were going to communicate with him was the biggest. As the years go by we

later discover that we had to take sign language classes to help us to communicate with

him and until then we were to write down what we needed to say on paper. I was five

years old at the time when my family and I enrolled at the Pennsylvania school for the

deaf . I remember learning the alphabet first then, learning to put those letters together

into words. This was an awesome experience even as a child I was excited about learning

this and was told that I caught on fast. I sporadically took classes at this school

throughout the years for years. We as a family can now communicate with him with no

problem and anyone else for that matter who might be deaf or hard of hearing.

Meningitis is a inflammation of the membranes called the meninges which is the

protective covering of the brain and spinal cord. It is caused by an infection and can be

found in children and teens with weak immune systems. The two main types are viral

and bacterial meningitis. Viral is the most common but not serious caused by viruses, and

bacterial is not as common but very serious caused by bacteria. It is very contagious and

can be caught by a cough or just close contact. The most common symptoms for both are

fever, headache , altered mental status, a stiff neck , vomiting, confusion and the inability

to bare any type of noises. The other symptoms are dizzy spells, tingling, weakness, eye

pain and sensitivity to the light. In children it’s a little different their signs are only

drowsiness with irritability, a high fever, a poor appetite and a shrill cry. The bulging soft

spots on the head is a dead giveaway. If one has any of these symptoms one should go to

the emergency room right away because it can turn deadly really fast.

Bacterial meningitis for adults has three major symptoms ; nuchal rigidity, high

fever, and a altered mental status. This simply means a stiffness of the neck that’s so bad

one can’t drop ones head down to ones chin because it is stuck in an awkward position.

The percentage of 44-46% is found with all three symptoms present : high fever, altered

mental status, and nuchal rigidity. The severe headaches are found in about 90% of all

meningitis cases and if not, then meningitis is not the diagnosis.

Neck stiffness is found in about 70% of all bacterial meningitis cases along with

the Kerning’s sign and Brudzinski’s sign. In the kerning’s sign a person is lying on their

back with both knees at a 90 degree angle, then tries to straighten them but has extreme

pain. This is a positive sign. Brudzinski’s sign is when ones flexion of the neck makes

ones knees and hips move involuntarily. These two test are the most common for

screening meningitis because the sensitivity of the test are limited, also these signs rarely

occur with any other disease so it’s easier to recognize. The jolt accentuation maneuver

is used to determine meningitis in a person complaining of a fever and headache. To do

this test a person is to rotate the head rapidly and horizontally and if the headache isn’t

worse this rules out meningitis.

In small children its harder to detect since they only seem irritable and don’t look

very well. In an newborn to six months old the fontalle (soft spot on top of the baby’s

head) is buldging. The other distinguished features are abnormal skin color, leg pain and

very cold extremities.

Meningitis is caused by the bacterium (meningococcal) and is very different from

meningitis by the rash that spreads quickly on the trunk of the body. Red and purple spots

on the mucous membranes, eyes, palms of the hands and soles of the feet. In the early

stages of the this illness sepsis is a concern , low blood pressure , tachycardia ,a high or

low temp and rapid breathing. In the more serious meningococcal meningitis there are

cases of gangrene of the limbs, and hemorrhaging of the adrenal glands which are fatal

and can lead to a fatal disease called the Waterhouse-Friderichsen syndrome. This is very

dangerous because the brain tissue may swell and the pressure of the swelling can cause

the brain to penetrate through the skull base. Also the cerebral spinal fluid isn’t flowing

freely the way it should so the meninges are affected causing the nerves enclosed in the

brain stem not to react. The motor sensory functions are located in this part of the body.

The hearing , eyesight, and facial movements may be lost as a result of this and

weakness or loss of feeling in that part of the body. Aseptic meningitis is caused by a

virus with bacterial infection found in a different part of the body not the meninges. It

actually goes through the blood stream causing (endocarditic) the infection of the heart

valves. Age has everything to do with the type of bacterial meningitis infection that one

gets . In premature babies up to three months old streptococci inhabit the vagina and

digestive tract carrying the K-1 antigen causing newborns to be affected in epidemics.

Older children and adults are affected by meningococcal but with the vaccine

pneumococcal the rates have been lowered for both age groups. Tuberculosis meningitis

found in people with immune system problems like : aids and also in countries where

tuberculosis is a epidemic. Recurrent meningitis is caused by skull fractures through

anatomical defects either acquired or by disorders of the immune system. Fungal

meningitis can be caused by immunosuppressants and contaminated medications. In this

case its more gradual with headaches and fevers for about two weeks before it is even

noticed. The most common fungal is cryptococcal especially in Africa and accounts for

20-25 percent of Aids related deaths there as well. If meningitis is a suspicion then blood

work, blood cultures and C reactive protein is tested. This test is done by removing (CSF)

cerebral spinal fluid through the lumbar puncture known as a spinal tap. The only time

this test may not give the exact diagnosis is if the brain has a tumor or a abscess and in

this case it would alter the test results. In some cases a intracranial pressure can be

elevated , and if so a CAT scan or MRI is needed before any spinal tap can be done.

Neurological signs or problems with the immune system can give false readings and in

that event antibiotics are given first to prevent a delay in treatment (better safe than

sorry).

In doing a spinal tap a person is lying on their left side, a local anesthetic is given

and a needle is placed in the dural sac to collect fluid from the spine. The opening

pressure is measured using a manometer and is considered normal between six and

eighteen cm of water. In bacterial meningitis the pressure is elevated but in cryptococcal

meningitis intracranial pressure is elevated. Cloudy CSF means high protein levels,

suggesting bacterial meningitis but is checked for white and red blood cells and its

glucose levels. Gram staining may possibly be bacteria in meningitis but only in about 60

percent of the cases, and if the antibiotics were given it reduces the number to about 20

percent. Glucose in cerebral spinal fluid is normally above 40 percent and that 40 percent

is in the blood but in bacterial meningitis it tends to be lower. The cerebral spinal fluid

glucose level is divided by the blood glucose giving us the ratio. PCR is another test used

to detect bacterial or viral DNA in cerebral spinal fluid. PCR Polymearse chain reaction

a very sensitive test that can help distinguish the various causes whether it’s the herpes

simplex virus or mumps. A problem occurs when partially treated meningitis symptoms

pops up after receiving antibiotics such as presumptive sinusitis. Cerebral spinal fluid

results are similar to those of viral meningitis so antibiotics may need to be continued to

the results of the test come back negative. Even in death meningitis can be detected by

pus in the surrounding tissues of the cranial nerves and spinal cord. Sometimes

vaccinations and antibiotics can prevent meningitis but it all depends on the type of

meningitis that it is. Viral and bacterial meningitis are contagious but not like a cold or

the flu. It can be transmitted through the secretions of kissing, coughing or sneezing on

someone. Antibiotics prophylaxis is another prevention method in meningococcal

meningitis and in this treatment it can sometimes reduce the risk of catching the virus

itself. If this condition is not treated it can turn life threatening and then deadly.

Treatment with antibiotics should be delayed until the results of the test are confirmed

and if meningococcal is present then benzyl penicillin be given before being transferred

to the hospital along with IV fluid. In some cases a vent for respiratory failure is needed

along with mannitol. In the event that this is the case one is in for the ride of their life

literally . Meds along special treatment is needed to nurse one person back to health. My

brother is thirty five years old today , has three children and works for the Marriott hotel

in downtown center city. He is able to still hold down a job even though he is completely

deaf and unable to hear. He even goes out to the clubs with his friends and occasionally

one might catch him dancing with the beat. He was sick as a child but as he got older he

learned to deal with his handicappness and to get educated as well. Chapter fifteen in the

sociology a brief introduction book states that healthcare cost has gone up 73 billion

dollars to almost 2.6 trillion dollars from 1970 to 2010. These numbers include rare

diseases such as meningitis and the cost that it takes to do research on the cure as well as

the time that it takes. It takes time and money to figure out what type of infection it is,

how it can be treated and which drugs should be used to do so. Experimentation is a big

part of this as well and in the process of this the price continues to go up and up. The

doctors and experts that do this research have to be paid as well and with saying that it

cost. The (WHO) World Health Organization monitors alternative medicine around the

world and about eighty percent of people use these meds to try and heal themselves back

to health. This is due to the fact that medication now is so high for all diseases especially

if there is no health insurance. Resources were : Sociology a brief introduction chapter 15, Web MD and

Wikipedia..