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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:

  • A high fever that prevents one from eating or drinking
  • Severe headache
  • Nausea
  • Vomiting
  • Confusion
  • Seizures
  • Progressive lethargy
  • Drowsiness
  • 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
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.

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).

Diagnosing Meningitis

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.

Treating Meningitis

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 and dehydration. 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 the disease.

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

  • hearing loss
  • blindness
  • loss of speech
  • learning disabilities
  • paralysis
  • cerebral palsy
  • brain damage
  • coma
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.

Medical Malpractice

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:

  • 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
The above are only examples and are by no means intended to be an exhaustive list of acts of malpractice.

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.

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Law Office of Joseph A. Hernandez, P.C.
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