Treatment

Treatment

Meningitis is a medical emergency. It can develop quickly, over a matter of hours.

Diagnosis and treatment of meningitis varies from country to country, depending on access to medial care, availability of antibiotics and local antibiotic resistance patterns.

Wherever you are, it’s important to know the signs and symptoms and to get medical treatment fast.

In order to diagnose meningitis, doctors may do a blood test and take a sample of cerebrospinal fluid (CSF), the watery fluid that flows in and around the brain and spinal cord.

CSF is collected through a lumbar puncture and examined for the presence of white blood cells and bacteria. Blood and CSF samples will be cultured for the presence of bacteria.

Treatment should not be delayed for more than 1-2 hours while diagnostic tests are taking place.

Bacterial meningitis requires injectable antibiotics and fluid replacement. Transfer to a hospital with an intensive care department may be necessary.

If signs of septicaemia are present, treatment should be started as soon as possible. Diagnostic tests should be deferred until antibiotics have been given.

The choice of antibiotic will be based on the susceptibilities of the meningitis bacteria in each patient’s area. Because of the worldwide prevalence of penicillin-resistant pneumococci, ampicillin-resistant Hib and sulfonamide-resistant meningococci, treatment with a third generation cephalosporin (such as cefotaxime or ceftriaxone) is the current standard of care.

In areas with high-level penicillin-resistant pneumococci, vancomycin is usually added until the susceptibility of the infecting bacteria is known. If patients are allergic to these antibiotics, chloramphenicol may be used as an alternative.

Antibiotics do not kill viruses. Although viral meningitis is more common than bacterial meningitis, treatment with injectable antibiotics should be started until a bacterial cause can be excluded. Treatment for viral meningitis is generally rest and pain relievers.

Recovery

Survivors of bacterial meningitis may require ongoing treatment or therapy after their recovery.Almost all patients with viral meningitis recover without any permanent damage, although full recovery may take weeks to months.