Meningitis is an infection and inflammation of the
membranes (meninges) and fluid (cerebrospinal fluid)
surrounding the brain and spinal cord. Meningitis is
most often caused by a bacterial or viral infection.
Other causes can also include a fungal infection, a
blow to the head, some types of cancer, inflammatory
diseases such as lupus, or a sensitivity reaction to
certain medications. While viral meningitis is
generally less severe and requires mild or no treatment,
bacterial meningitis can be severe and result in brain
damage, hearing loss, learning disability, and even
death. Most cases of bacterial meningitis occur when
bacteria from an infection in another part of the body
travel through the bloodstream to the brain and spinal
cord. Bacteria can also spread directly to the brain
or spine from a severe head injury or from an infection
in the ears, nose or teeth.
Warning signs and symptoms of bacterial meningitis
While the symptoms of meningitis may develop over a
period of 1 or 2 days, meningitis can also strike
suddenly, resulting in death within a matter of hours.
Even in less severe cases, the longer the delay in
receiving appropriate treatment, the higher the
likelihood of severe and permanent neurologic damage.
Warning signs and symptoms for adults include:
The earlier symptoms usually include a high fever,
severe headache and vomiting. There may also be
seizures. As the disease progresses, the brain
swells and may begin to bleed.
- A high fever that prevents one from eating
- Severe headache
- Progressive lethargy
- Stiff neck
- Sensitivity to light
- An accompanying skin rash, especially
near your armpits or on the hands or feet
- Rapid progression of small hemorrhages
under the skin
Newborns and young infants may not have the classic
symptoms of headache, fever and stiff neck. Instead,
they may cry constantly, seem unusually sleepy or
irritable, and feed poorly. Sometimes the soft spots
on their head may bulge. Babies who are very ill may
actually have a lower than normal temperature. A very
late symptom may be a spasm consisting of extreme
hyperextension of the body (opisthotonos).
Early diagnosis and treatment are critical in
cases involving bacterial meningitis. Following
the onset of symptoms, a physician can consider
the patientís medical history, perform a physical
exam to check for signs of infection around the
head, ears, throat and the skin along the spine,
and recommend certain diagnostic tests.
Diagnostic tests may include a throat culture to
check for the bacteria that cause meningitis, and
X-rays or a CT scan of the chest, skull or sinuses.
A cerebrospinal fluid evaluation may be required,
however, in order to be able to reach a proper
diagnosis. For the evaluation, spinal fluid is
extracted by performing a spinal tap (lumbar
puncture), in which a needle is inserted into an
area in the lower back where fluid in the spinal
canal is readily accessible. The fluid can be
analyzed for signs of meningitis, such as low sugar
(glucose) levels together with an increased white
blood cell count. Further, the sample can be
cultured and analyzed for the presence of
meningitis causing bacteria. Correctly identifying
the type of bacteria responsible is important for
the selection of the correct antibiotics with
which to treat the meningitis. If viral meningitis
is suspected, the doctor may order a test known
as a polymerase chain reaction (PCR) amplification
to check for the presence of certain viruses. In
cases involving chronic meningitis caused by cancer
or an inflammatory illness, other tests may be
required. In all cases, however, the doctor's goal
should be to make an accurate diagnosis and start
treatment as soon as possible.
Bacterial meningitis can be treated with a number
of effective antibiotics. Corticosteroids may be
necessary to help prevent hearing loss, one of
the most common complications of the disease.
Sometimes there may also be a need to provide
treatment for brain swelling, shock, convulsions
Infected sinuses or mastoids - the bones behind
the outer ear that connect to the middle ear -
may need to be drained. Any fluid that has
accumulated between the brain and the membranes
that surround it may also need to be drained
or surgically removed. It is critical, however,
that treatment be started early in the course of
Complications from Delayed Treatment
The severity of complications from meningitis
increases the longer the disease is present without
treatment. Complications include seizures and
permanent neurologic damage, such as
Non-neurologic complications may include kidney
and failure of the adrenal glands (that produce
a number of important hormones, including cortisone,
which helps the body deal with stress).
Bacterial infections of the central nervous system
can progress quickly. Within hours of the onset of
symptoms, the disease can lead to shock and death.
- hearing loss
- loss of speech
- learning disabilities
- cerebral palsy
- brain damage
If meningitis is detected and properly treated before
it advances, the chances of survival without
serious consequences is significantly better than
if the meningitis is not detected and treated
until has reached a more advanced stage. Any
undue delay in diagnosing or treating meningitis
can have tragic consequences. Unfortunately, too often
warning signs are ignored, and treatment is delayed.
The following are among the more common forms of
negligence or medical malpractice by physicians in
diagnosing and/or treating patients with meningitis:
The above are only examples and are by no means intended
to be an exhaustive list of acts of malpractice.
- Failing to test for meningitis when a patient
reports warning signs or symptoms that can be
caused by meningitis
- Delaying the diagnosis of meningitis
- Failing to order appropriate treatment for
a patient with meningitis
- Failing to follow-up with the patient
If you or someone you love have suffered from serious
complications of meningitis due to the neglect of a
physician or other health care provider, you should
immediately contact a competent attorney.
The attorney will work with you to determine
legal options that may be available.
Call or email for a Free Attorney Consultation
Law Office of Joseph A. Hernandez, P.C.
Phone: (781) 461-9400
Toll Free: (866) 461-9400
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