spinal meningitis


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Related to spinal meningitis: Bacterial Meningitis

meningitis

 [men″in-ji´tis] (pl. meningi´tides)
inflammation of the meninges, usually by either a bacterium (bacterial m.) or a virus (viral m.). When it affects the dura mater it is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis. The term meningitis does not refer to a specific disease entity but rather to the pathologic condition of inflammation of the tissues of the meninges. The etiologic agent can be anything that activates an inflammatory response, including both pathogenic and nonpathogenic organisms, such as bacteria, viruses, and fungi; chemical toxins such as lead and arsenic; contrast media used in myelography; and metastatic malignant cells. Enteroviruses are the most common causes of aseptic meningitis.
Bacterial Meningitis. This form occurs when pathogenic bacteria enter the subarachnoid space and cause a pyogenic inflammatory response. The most common causes are Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, which are responsible for approximately 70 per cent of all cases. The incidence is age-related. In adults, S. pneumoniae and N. meningitidis cause most of the cases; in children aged 1 month to 15 years, N. meningitidis and H. influenzae predominate; in neonates less than 1 month old, the disease is usually a nosocomial infection with gram-negative enteric bacilli.

Almost all bacterial infections of the meninges enter the nervous system after having invaded and infected another region of the body and then are spread by local extension, as from the sinuses, or through the blood, as in septicemia. The organisms gain access to the ventriculosubarachnoid spaces and the cerebrospinal fluid where they cause irritation of the tissues bathed by the fluid.

Bacterial meningitis typically begins with headache, nausea and vomiting, stiff neck (nuchal rigidity), and chills and fever. Irritability and confusion occur early in the course of the disease, and convulsive seizures occur in about 25 per cent of patients. As the disease progresses the patient becomes less rational, has decreasing levels of consciousness, and lapses into coma. Inability to straighten the knee when the hip is flexed (a positive kernig's sign) and involuntary flexing of the hip and knee when the neck is flexed forward (a positive brudzinski's sign) are indicative of meningeal irritation.

A diagnosis of bacterial meningitis is verified by isolation of the organism from a specimen of cerebrospinal fluid obtained by lumbar puncture. Treatment with the appropriate antibacterial agent is begun at once to reduce the numbers of proliferating bacteria attacking the central nervous system. Supportive measures include rest, maintenance of fluid and electrolyte balance, and prevention or control of convulsions with anticonvulsant drugs.

The prognosis is generally good, especially for meningococcal meningitis in which residual neurologic deficits and persistent convulsive seizures are rare. Pneumococcal meningitis and meningitis due to Haemophilus influenzae are more likely to be complicated by these sequelae as well as by septic shock and hydrocephalus.
Benign Viral Meningitis. This term encompasses a group of disorders in which there is some meningeal irritation but no pyogenic organism can be found in the cerebrospinal fluid. It is, therefore, called also aseptic meningitis complex, which is somewhat misleading because the meningeal irritation often follows infection with the mumps virus or with one of the picornaviruses.

The patient with this disorder typically complains of headache and signs characteristic of meningeal irritation, intolerance to light, and pain when the eyes are moved from side to side. Most of the symptoms are mild, and treatment is largely supportive and symptomatic; the disease is self-limiting.
Patient Care. Assessment of the patient with meningitis includes monitoring vital signs, neurologic status, and fluid and electrolyte status. The plan of care should include provisions for rest and relief from discomfort, a quiet and nonstimulating environment, protection from injury during convulsions, control of elevated body temperature, and isolation precautions as indicated by the specific causative organism. In general, enteric precautions are indicated for patients with aseptic meningitis caused by an enterovirus. Fungal and meningococcal meningitis require respiratory precautions. Antibiotics must be given precisely as ordered so as to avoid further damage to the central nervous system. Early signs of increased intracranial pressure from brain edema are reported promptly so that measures to reduce pressure can be taken as soon as possible. During the acute phase and convalescence the patient is watched for signs of complications such as septic shock, vascular collapse, and hydrocephalus. Nutritional status must be maintained throughout the course of illness to reinforce the patient's natural resources for combating infection and recovering from its deleterious effects.
Portals of entry resulting in meningitis, meningoencephalitis, and intracranial mass lesions. From Mahon and Manuselis, 2000.
aseptic meningitis any of several mild types of meningitis, most of which are caused by viruses; see viral meningitis.
bacterial meningitis meningitis caused by bacteria; common pathogens are Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and Mycobacterium tuberculosis. Some types may be serious, acute, or even fulminating. See also viral meningitis.
cerebrospinal meningitis an inflammation of the brain and spinal cord; it may be caused by any of numerous different organisms.
epidemic cerebrospinal meningitis an acute infectious disease with seropurulent inflammation of the membranes of the brain and spinal cord, due to infection by Neisseria meningitidis (meningococcus). It usually occurs in epidemics, and symptoms are those of acute cerebral and spinal meningitis. There is also usually an eruption of erythematous, herpetic, or hemorrhagic spots on the skin. The fulminating or malignant form is known as Waterhouse-Friderichsen syndrome.
spinal meningitis inflammation of the meninges of the spinal cord.
viral meningitis meningitis due to any of various viruses, such as a coxsackievirus or the mumps virus, with lymphocytes in the cerebrospinal fluid. It usually has a short uncomplicated course characterized by malaise, fever, headache, stiffness of neck and back, and nausea. See also aseptic meningitis.

spinal meningitis

n.
Inflammation of the membranes enclosing the spinal cord, especially a usually fatal form that affects infants and young children and is caused by a strain of gram-negative bacteria (Hemophilus influenzae) formerly thought to cause influenza.

spinal meningitis

an inflammation of the membranes of the spinal cord.

meningitis

inflammation of the meninges. When the inflammatory process affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis or meningitis proper. It is also classified as fibrinous, hemorrhagic, purulent or eosinophilic, depending on the principal reaction of the tissues.
The term meningitis does not refer to a specific disease entity but rather to the pathological condition of inflammation of the tissues of the meninges. The etiological agent can be anything that activates the inflammatory process, including both pathogenic and nonpathogenic organisms, such as bacteria, viruses and fungi; chemical toxins such as lead and arsenic; contrast media used in myelography; and metastatic malignant cells.
In animals there are no specific meningitides, most cases of meningitis occurring as secondary complications to other diseases and having a bacterial etiology. Clinical signs seen commonly include fever, cutaneous hyperesthesia and rigidity of the muscles of the neck and forelimbs. A cerebrospinal fluid tap should assist in the diagnosis.

Beagle meningitis
see beagle pain syndrome.
Bernese Mountain Dog meningitis
an acute, aseptic nonsuppurative meningitis seen in young Bernese Mountain Dogs of unknown etiology.
cerebrospinal meningitis
an inflammation of the brain and spinal cord; it may be caused by many different organisms.
Pug meningitis
spinal meningitis
inflammation of the meninges of the spinal cord.

spinal

pertaining to a spine or to the vertebral column and in many instances to the spinal cord.

spinal abscess
infection may be introduced hematologically from navel infection to a vertebral body or up the vertebral canal from an infected docking wound. Clinically there is a development of paresis over a few days then paraplegia when the abscess is in the lumbar region or quadriplegia when it is located in the cervical area.
spinal accessory nerve
see accessory nerve, Table 14.
congenital spinal stenosis
stenosis of the vertebral canal present at birth; recorded in calves.
spinal fibrocartilaginous emboli
see fibrocartilaginous embolic myelopathy.
focal symmetrical spinal poliomalacia
see focal symmetrical spinal poliomalacia.
spinal fusion
surgical creation of ankylosis of contiguous vertebrae.
spinal meninges
spinal meningitis
usually part of cerebrospinal meningitis. May be local related to spinal cord abscess and cause localized pain and muscle rigidity.
spinal muscular atrophy
see hereditary spinal muscular atrophy, hereditary neuronal abiotrophy of Swedish Lapland dogs.
spinal myelitis
spinal myelopathy
spinal nerve
any of the paired nerves arising from the spinal cord and passing out between the vertebrae.
spinal puncture
introduction of a hollow needle into the subarachnoid space of the spinal canal, usually for the purpose of collecting a sample of cerebrospinal fluid, to introduce radiopaque material for myelography, or the injection of an anesthetic.
spinal reflex
any reflex action mediated through a center at the spinal cord.
spinal stenosis
see spinal cord compression (above).
spinal tap
see spinal puncture (above).
spinal trauma
temporary or permanent dislocation of one or more spinal vertebrae; or fracture; causes immediate flaccid paralysis caudal to injury due to spinal shock, followed by residual signs due to damage to spinal cord tissue.
spinal walking
see reflex walking.
References in periodicals archive ?
1 -- color) Brandon Hance overcame a bout with spinal meningitis, among other health issues, to ascend to No.
Headaches are one of the symptoms of spinal meningitis.
Myers, who completely lost his hearing after contracting spinal meningitis at age 18 months, will represent the U.
Stevens reported in his book that near the completion of the dam, when one worker died after suffering a head injury in a fall, the cause of death was listed as spinal meningitis - a non-job-related malady, and thus not subject to compensation.
A 27-year-old jail inmate died Tuesday in the Los Angeles County-USC Medical Center of complications apparently stemming from spinal meningitis, a sheriff's deputy said.