Bacterial vs. Viral Meningitis Devin Leslie and Steve Lovett
May 20,2010


Bactrial Meningitis

I. Abstract

This project gives a brief overview of a specific strain of bacterial meningitis known as pneumococcal meningitis. The various symptoms, diagnosis, treatments, preventions, and other facts regarding this common bacterial meningitis will be discussed. The cause of this bacterial meningitis is a bacteria known as Streptococcus pneumonia which attack the respiratory tract and the reason it turns pathogenic is still unknown. This bacterial meningitis has several similar and different characteristics to viral meningitis which will also be discussed in this presentation.
I. Introduction

Recently I had a friend die of bacterial meningitis and I also just discovered that as a baby I was diagnosed with viral meningitis which sparked my interest on the topic. Once I found out exactly what we had to do for this project, I felt that this would be the perfect time for me to gain a better understanding of ​what exactly it was. I had always figured that there was only one strain of bacterial meningitis, however, to my surprise there are several. Therefore I have chosen to focus my research on one specific, more prevalent strains of the disease known as pneumococcal meningitis.

What is Pneumococcal meningitis?

Pneumococcal meningitis is a disease caused by the bacteria Streptococcus pneumonia which causes inflammation in the spinal cord and brain. Currently, it is considered to be the "most common bacterial cause of meningitis, accounting for 47% of cases. It is also associated with one of the highest mortality rates among the bacterial agents that cause meningitis (19-26%)" (Razonable 2009). This specific type of meningitis is contracted through the respiratory tract in nasopharyngeal colonization. From the respiratory tract, it is said that the bacteria invades the submucosa by avoiding host defenses and gains access to the central nervous system through the bloodstream. Once inside the central nervous system, the bacteria survives because the defense system is limited in this area and the "presence and replication of infectious agents remain uncontrolled and incite a cascade of meningeal inflammation" (Razonable 2009). This causes severe intracranial pressure which are developed because of the interstitial edema and cytotoxic edema. According to the Meningitis Foundation of America, 20% of the patients who contract pneumococcal meningitis die and 50% experience longterm health effects such as deafness, paralysis, loss of a limb, or even mental retardation.
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III. Discussion

What are the signs and symptoms?

Some of the symptoms for pneumococcal meningitis make it hard to detect, these include fever, headache, stiffness in the neck, ect. Other that symptoms may be present are irritability, nausea or vomiting, and low appetite. If these symptoms are being experienced, then it is advised to seek immediate medical attention because it is life-threatening and develops rapidly.

How is it diagnosed?

Early diagnosis is crucial when dealing with meningitis. If it is suspected, doctors will take samples of blood or cerebrospinal fluid and sent to the lab for tests. If bacteria is present, they are cultured and then doctors will stain the bacteria in order to correctly identify it which will give the selection of the antibiotics. Careful handling of the bacteria is required "because many of the likely pathogens are very sensitive and will not survive much storage time or even changes in temperature" (Case 614).

How is it treated?


Pneumococcal meningitis is treated with the antibiotics "ceftriaxone or penicillin and oral antibiotics such as ciproflaxin or rifampin, until the infection's resistance to the drugs contradicts treatment" (Common 2010). Treatment is most affective in early diagnosis and the proper antibiotics can reduce the risk of dying to "below 15%, although the risk is higher among the elderly" (Treatment 2009). In some cases even with the treatment, "an episode of pneumococcal meningitis results in a long-term decrement in overall health related quality of life and is significantly related to hearing loss" (Legood 2009).


Is it contagious and if so how is it spread?

Yes, like all bacteria, the pneumococcal meningitis bacteria can be spread by direct contact from the discharge of the nose or throat of the infected person, however this does not pose any higher risk of the infection contact with healthy children. A person who is in the same household or in direct contact with a person who has the disease is definitely at a higher risk for getting the infection but it is less contagious than just the common cold (Transmission 2009).

How is it prevented?

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Fortunately, Streptococcus pneumonia is one of the three bacteria that can be prevented with a vaccine. The Center for Disease Control and Prevention recommends the first vaccine to be given at 24 months and then at various dates after that. Further prevention can be just from living by healthy practices, having a routine vaccine and staying away from people who are sick. According to the Meningitis Foundation of America, the vaccine Prevnar "protects against the 7 out of 80 most common strains of Streptococcus pneumoniae that are in neonates and infants. Those 7 are accountable for 86% of if invasive pneumococcal infections" (Common 2010). Another vaccine called the PCV7, which began in 2000, was observed over a couple of years. Researchers found that "overall, an estimated 3330 pneumococcal meningitis hospitalizations and 394 deaths were prevented in persons of all ages during 2001-2004 in the United States" (Tsai 2008).

What is it's pathology?


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The bacteria Streptococcus pneumonia is a gram-positive, encapsulated diplococcus bacteria. People are more susceptible to contracting the infection if they have a weak immune system and usually is a progression of an ear infection or pneumonia. Though few people are aware of it, "about 70% of the general population are healthy carriers" (Case 614). The reason that this bacteria attacks the body, however is still unknown.


IV. Literature Cited


Case, Christine L., Funke, Berdell R., and Tortora, Gerard J. Microbiology: An Introduction. San Francisco: Peterson Education Inc. 2010.

"Common Bacterial: Pneumonococcal Meningitis." Meningitis Foundation of America.
2010. http://www.meningitisfoundationofamerica.org/templates/content-view/79/index.html

"Diagnosis" Center for Disease Control and Prevention. 6 Aug. 2009.
http://www.cdc.gov/meningitis/about/diagnosis.html

Legood, Rosa, et al. "Health related quality of life in survivors of pneumococcal meningitis." Acta Paediatrica 98.3 (Mar. 2009). Biological Abstracts 1969 - Present. EBSCO. 15 May 2009 <http://0-search.ebscohost.com.iii.sonoma.edu/login.aspx?direct=true&db=boh&AN=BACD200900104313&loginpage=Login.asp&site=ehost-live&scope=site>.

"Prevention." Center for Disease Control and Prevention. 16 March, 2010. http://www.cdc.gov/meningitis/about/prevention.html

Razonable, Raymund R., "Meningitis." eMedicine from WebMD. 26, Aug. 2009.
http://emedicine.medscape.com/article/232915-overview

"Transmission." Center for Disease Control and Prevention. 6 Aug. 2009. http://www.cdc.gov/meningitis/about/transmission.html

"Treatment." Center for Disease Control and Prevention. 6 Aug. 2009.
http://www.cdc.gov/meningitis/about/treatment.html

Tsai, Chiaojung Jillian, et al. "Changing epidemiology of pneumococcal meningitis after the introduction of pneumococcal conjugate vaccine in the United States." Clinical Infectious Diseases 46.11 (01 June 2008). Biological Abstracts 1969 - Present. EBSCO. 15 May 2009 <http://0-search.ebscohost.com.iii.sonoma.edu/login.aspx?direct=true&db=boh&AN=BACD200800252776&loginpage=Login.asp&site=ehost-live&scope=site>.


Viral Meningitis


I. Abstract

This research project will discuss the viral form of meningitis. The fact that other forms of meningitis exist will be covered. Since bacterial meningitis is also part of this project, the differences and similarities will be readily apparent. This report will cover all of the basics of viral meningitis. The causes, symptoms, treatment, prevention and other topics will be reviewed. After the presentation the audience should have a fairly good idea about this problem.

II. Introduction

I had heard of meningitis quite a few times over the years but never really knew what it was. All I knew was that it could cause severe headaches. I figured this was a good opportunity to finally understand more. Bacterial viruses tend to cause the most severe symptoms but the fact is that meningitis can be caused by many "different types of pathogens, including viruses, bacteria, fungi and protozoa" (Case, Funke, Tortora 612). Of course, this section will only deal with viral meningitis.

What is viral meningitis?

In simple terms, "meningitis is an inflammation of the delicate membranes that cover the spinal cord and brain" (Koop 56). To be more specific, meningitis can lead to "inflammation of the meninges, the membranes covering the brain and spinal cord" ("Meningitis" 15). The meninges is actually a collection of three different tissues. The meninges consists of the outer dura, middle arachnoid and inner pia mater. As these tissues become inflamed pain in the neck and head can become severe. In extreme cases blindness, permanent neurological damage or even death can result. However, viral meningitis tends to be the more mild form of meningitis. It can affect all age groups but children, babies and those with weakened immune systems are at a higher risk. This portion of the report will focus on how viral meningitis is different than bacterial meningitis but many similarities will be apparent as well.meninges-of-the-spine.jpg

III. Discussion
What are the signs and symptoms of viral meningitis?


The Kaiser Permanente Healthwise Handbook states that you should contact your doctor immediately if you develop the following symptoms, "severe headache with stiff neck, fever, nausea, and vomiting" (Kemper 160). Other symptoms include cold hands and feet, chills, painful joints, diarrhea and in later stages a skin rash may develop. Symptoms can be extremely severe as the following case study reveals. The Journal of Neurology reported the following symptoms from a man who was having stabbing pain in his forehead, right cheek and right jaw. "The pain attacks occurred at least once every two or three minutes, and at most every 10 seconds; attacks occurred with the frequency from 100 to 200 times per day" (Araki 667). Although this example was a result of viral meningitis, it is rarely ever this severe.

How is viral meningitis diagnosed?

If the above symptoms are encountered and the doctor suspects that meningitis is the cause, "samples of blood or cerebrospinal fluid are collected and sent to the laboratory for testing" ("Diagnosis" para. 2). The image below shows how a spinal tap may be done to collect cerebrospinal fluid.
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How is it treated?

Since this form of meningitis comes from a virus, antibiotics are not prescribed. In fact, the majority of patients will recover from this illness within 7-10 days. In severe cases a hospital stay may be required but this is rare.

Is it contagious?

Yes. First it is important to understand that this form of meningitis does come from common viruses. This means you may actually contract a virus from someone who has viral meningitis but it's unlikely that you would contract viral meningitis yourself. According to the Centers for Disease Control (CDC) and Prevention web site, viruses themselves "are most often spread from person to person through fecal contamination (which can occur when changing a diaper or using the toilet and not properly washing hands afterwards)" ("Transmission" para. 4). Viruses can also be spread through respiratory secretions such as, saliva, sputum or nasal mucus.

How is it prevented?
There are no vaccines for viral meningitis. The best defense is to use all of the same rules for preventing colds and flus.

  1. -Frequent handwashing after using the bathroom, changing diapers, blowing nose or coughing.
  2. -If you are around someone who is ill, clean contaminated surfaces such as doorknobs and handles.
  3. -Avoid sharing utensils, drinking glasses, lipstick and other similar items.
  4. -Avoid bites from mosquitoes and other insects that carry diseases.
  5. -Control mice and rats around your home.

What is it's pathology?

According to the CDC "most viral meningitis cases are caused by Enterovirus" ("Clinical" para. 2). However, other forms of virus can lead to meningitis. Viral meningitis can also result from the measles, influenza, mumps or herpesvirus. Mosquitoes and other insects may also carry a virus known as Arbovirus which can cause an infection which leads to viral meningitis. In very rare cases, some rodents are known to carry a virus that can cause viral meningitis.

IV. Literature Cited:
Araki, Nobuo, Yasuo, Ito, Kaori, Itokawa, Mikiko, Ninomiya, Kunio, Shimazu, Toshimasa, Yamamoto. "Secondary SUNCT syndrome caused by viral meningitis." Journal of Neurology. 256 (2009): 667-668

Case, Christine, Berdell Funke, Gerard Tortora. Microbiology An Introduction. San Francisco: Pearson Education Inc., 2010

"Clinical." Center for Disease Control and Prevention. 24 June 2009 http://www.cdc.gov/meningitis/clinical-info.html

"Diagnosis" Center for Disease Control and Prevention. 6 Aug. 2009 http://www.cdc.gov/meningitis/about/diagnosis.html

Kemper, Donald. Kaiser Permanente Healthwise Handbook. Boise: Healthwise, 2005

Koop, Everett. Dr Koop's Self Care Advisor. New York: The Health Publishing Group, 1996

"Meningitis." Encyclopedia Britannica. 15th Ed. 1993

"Meningitis." AllRefer Health. 15 May 2010 http://health.allrefer.com/health/meningitis-meninges-of-the-brain.html

"Transmission." Center for Disease Control and Prevention. 6 Aug. 2009 http://www.cdc.gov/meningitis/about/transmission.html