Death meningitis: Bacterial Meningitis | CDC

10.10.202319.07.2023 by alexxlab

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Bacterial Meningitis | CDC

Bacterial meningitis is serious. Some people with the infection die and death can occur in as little as a few hours. However, most people recover from bacterial meningitis. Those who do recover can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities.

Causes

Several types of bacteria can cause meningitis. Leading causes in the United States include

Streptococcus pneumoniae
Group B Streptococcus
Neisseria meningitidis
Haemophilus influenzae
Listeria monocytogenes
Escherichia coli

Mycobacterium tuberculosis, which causes tuberculosis or TB, is a less common cause of bacterial meningitis (called TB meningitis).

Many of these bacteria can also be associated with another serious illness, sepsis. Sepsis is the body’s extreme response to infection. It is a life-threatening medical emergency. Sepsis happens when an infection triggers a chain reaction throughout your body. Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.

Some causes of bacterial meningitis are more likely to affect certain age groups:

Newborns: Group B Streptococcus, S. pneumoniae, L. monocytogenes, E. coli
Babies and young children: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, M. tuberculosis
Teens and young adults: N. meningitidis, S. pneumoniae
Older adults: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, L. monocytogenes

Risk Factors

Certain factors increase a person’s risk for getting bacterial meningitis. These risk factors include:

Age: Babies are at increased risk for bacterial meningitis compared to people in other age groups. However, people of any age can develop bacterial meningitis. See section above for which bacteria more commonly affect which age groups.
Group setting: Infectious diseases tend to spread where large groups of people gather. For example, college campuses have reported outbreaks of meningococcal disease, caused by N. meningitidis.
Certain medical conditions: Certain medical conditions, medications, and surgical procedures put people at increased risk for meningitis. For example, having an HIV infection or a cerebrospinal fluid leak, or not having a spleen can increase a person’s risk for several types of bacterial meningitis.
Working with meningitis-causing pathogens: Microbiologists routinely exposed to meningitis-causing bacteria are at increased risk for meningitis.
Travel: Travelers may be at increased risk for meningococcal disease, caused by N. meningitidis, if they travel to certain places, such as:
- The meningitis belt in sub-Saharan Africa, particularly during the dry season
- Mecca during the annual Hajj and Umrah pilgrimage

In many countries, TB is much more common than in the United States. Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).

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How It Spreads

Certain germs that cause bacterial meningitis, such as L. monocytogenes, can spread through food. But most of these germs spread from one person to another.

How people spread the germs often depends on the type of bacteria. It is also important to know that people can have these bacteria in or on their bodies without being sick. These people are “carriers.” Most carriers never become sick, but can still spread the bacteria to others.

Here are some of the most common examples of how people spread each type of bacteria to each other:

Group B Streptococcus and E. coli: Mothers can pass these bacteria to their babies during birth.
H. influenzae, M. tuberculosis, and S. pneumoniae: People spread these bacteria by coughing or sneezing while in close contact with others, who breathe in the bacteria.
N. meningitidis: People spread these bacteria by sharing respiratory or throat secretions (saliva or spit). This typically occurs during close (coughing or kissing) or lengthy (living together) contact.
E. coli: People can get these bacteria by eating food prepared by people who did not wash their hands well after using the toilet.

People usually get sick from E. coli and L. monocytogenes by eating contaminated food.

Signs and Symptoms

Being pregnant increases a person’s risk of getting a Listeria infection (L. monocytogenes). Pregnant people with a Listeria infection may not have any symptoms or may only have a fever and other flu-like symptoms, such as fatigue and muscle aches. However, infection during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn, including meningitis. Find out which foods are more likely to contain Listeria and steps you can take to protect your and your baby’s health.

Pregnant women can pass group B Streptococcus (group B strep) to their baby during delivery. Newborns infected with group B strep can develop meningitis or other serious infections soon after birth. Talk with your doctor or midwife about getting a group B test when you are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent infections in newborns.

Meningitis symptoms include sudden onset of

Fever
Headache
Stiff neck

There are often other symptoms, such as

Nausea
Vomiting
Photophobia (eyes being more sensitive to light)
Altered mental status (confusion)

Newborns and babies may not have, or it may be difficult to notice the classic symptoms listed above. Instead, babies may

Be slow or inactive
Be irritable
Vomit
Feed poorly
Have a bulging fontanelle (the “soft spot” on a baby’s head)
Have abnormal reflexes

If you think your baby or child has any of these symptoms, call the doctor right away.

Typically, symptoms of bacterial meningitis develop within 3 to 7 days after exposure; note, this is not true for TB meningitis, which can develop much later after exposure to the bacteria.

People with bacterial meningitis can have seizures, go into a coma, and even die. For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Diagnosis

If a doctor suspects meningitis, they will collect samples of blood or cerebrospinal fluid (fluid near the spinal cord). A laboratory will test the samples to see what is causing the infection. Knowing the specific cause of meningitis helps doctors treat it.

Treatment

Doctors treat bacterial meningitis with a number of antibiotics. It is important to start treatment as soon as possible.

Prevention

Vaccination

Vaccines are the most effective way to protect against certain types of bacterial meningitis. There are vaccines for 4 types of bacteria that can cause meningitis:

Meningococcal vaccines help protect against N. meningitidis
Pneumococcal vaccines help protect against S. pneumoniae
Haemophilus influenzae serotype b (Hib) vaccines help protect against Hib
Bacille Calmette-Guérin vaccine helps protect against tuberculosis disease, but is not widely used in the United States

Make sure you and your child are vaccinated on schedule.

Like with any vaccine, these vaccines do not work 100% of the time. The vaccines also do not protect against infections from all the types (strains) of each of these bacteria. For these reasons, there is still a chance vaccinated people can develop bacterial meningitis.

Prophylaxis

When someone has bacterial meningitis, a doctor may recommend antibiotics to help prevent people around the patient from getting sick. Doctors call this prophylaxis. CDC recommends prophylaxis for:

Close contacts of someone with meningitis caused by N. meningitidis
Household members of someone with a serious Hib infection when the household includes one or more people at increased risk of Hib based on age, vaccination status, and/or immunocompromising conditions

Doctors or local health departments recommend who should get prophylaxis.

Healthy Pregnancy Practices

Pregnant women should talk to their doctor or midwife about getting tested for group B Streptococcus. Women receive the test when they are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent passing group B strep to their newborns.

Pregnant women can also reduce their risk of meningitis caused by L. monocytogenes. Women should avoid certain foods during pregnancy and safely prepare others.

Healthy Habits

You can also help protect yourself and others from bacterial meningitis and other health problems by maintaining healthy habits:

Don’t smoke and avoid cigarette smoke as much as possible
Get plenty of rest
Avoid close contact with people who are sick
Wash your hands often with soap and water (use hand sanitizer if soap and water aren’t available)
Cover your mouth and nose with a tissue when you cough or sneeze (use your upper sleeve or elbow if a tissue isn’t available)

These healthy habits are especially important for people at increased risk for disease, including:

Young babies
Older adults
People with weak immune systems
People without a spleen or a spleen that doesn’t work the way it should

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The cause of death in bacterial meningitis

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. 2020 Feb 27;20(1):182.

doi: 10.1186/s12879-020-4899-x.

A Sharew¹, J Bodilsen², B R Hansen³, H Nielsen^{2

4}, C T Brandt^{5

6}

Affiliations

¹ Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark.
² Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
³ Department of Infectious Diseases, University Hospital Copenhagen Hvidovre, Hvidovre, Denmark.
⁴ Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
⁵ Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark. [email protected].
⁶ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. [email protected].

PMID:
32106821
PMCID:
PMC7045616
DOI:
10.1186/s12879-020-4899-x

Free PMC article

A Sharew et al.

BMC Infect Dis.

2020.

Free PMC article

. 2020 Feb 27;20(1):182.

doi: 10.1186/s12879-020-4899-x.

Authors

A Sharew¹, J Bodilsen², B R Hansen³, H Nielsen^{2

4}, C T Brandt^{5

6}

Affiliations

¹ Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark.
² Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
³ Department of Infectious Diseases, University Hospital Copenhagen Hvidovre, Hvidovre, Denmark.
⁴ Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
⁵ Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark. [email protected].
⁶ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. [email protected].

PMID:
32106821
PMCID:
PMC7045616
DOI:
10. 1186/s12879-020-4899-x

Abstract

Background:

Death from bacterial meningitis is rarely attributed to the actual event causing death. The present study therefore categorized and characterized the cause and time of death due to bacterial meningitis.

Methods:

In a cohort of patients > 15 years of age with community acquired bacterial meningitis the medical records were reviewed, and a clinical cause of death categorized into six main categories: 1) CNS complications, 2) Systemic complications, 3) Combination of systemic and CNS complications, 4) Sudden death, 5) Withdrawal of care, or 6) Unknown.

Results:

We identified 358 patients of which 84 (23%) died in-hospital. Causes of death were ascribed to CNS complications in 43%, Systemic complications in 39%, Combined CNS and systemic complications in 4%, Sudden death in 7% and withdrawal of care in 5%. Brain herniation, circulatory failure, intractable seizures and other brain injury were the most common specific causes of death within 14 days from admission (55%).

Conclusion:

Fatal complications due to the primary infection – meningitis – is most common within 14 days of admission. The diversity of complications causing death in meningitis suggest that determining the clinical cause of death is essential to the evaluation of novel treatment strategies.

Keywords:

Bacterial meningitis; Brain herniation; Cause of death; Central nervous system complications; Sepsis; Systemic complications.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Time from admission to death.…

Fig. 1

Time from admission to death. At 7 days from admission 41 of 84…

Fig. 1

Time from admission to death. At 7 days from admission 41 of 84 patients were dead (49%). Within 14 days of admission 56 patients (66%) had died. Median time to death was 8 days (3 to 16.8)

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References

1. Brandt CT. Experimental studies of pneumococcal meningitis. Dan Med Bull. 2010;57(1):B4119.
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1. Weisfelt M, van de Beek D, Spanjaard L, Reitsma JB, de Gans J. Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series. Lancet Neurol. 2006;5(2):123–129. doi: 10.1016/S1474-4422(05)70288-X.
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Meningitis: threat or reality? | Articles by doctors of the EMC clinic about diseases, diagnosis and treatment

Children’s Clinic

Moscow, st. Pravdy, 15 building 1

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November 10, 2015

It is unlikely that there will be a person in a civilized society who has never heard of such a disease as meningitis. And everyone understands that we are talking about a serious infection that can become fatal or have severe complications.

Meningitis can be caused by both viruses and bacteria. Among the latter, the most significant are Haemophilus influenzae B, pneumococcus (Streptococcus pneumoniae) and meningococcus (Neisseria miningitidis). Since the widespread vaccination against Haemophilus influenzae and pneumococcal infection was introduced, meningococcus has become the most common causative agent of meningitis. Also, meningitis is not the only disease caused by N. miningitidis. No less terrible is systemic meningococcal infection – menigococcemia .

Children of the first two years of life and people of the older generation are most susceptible to the disease.

Symptoms of meningitis

The first manifestations of meningococcal infection are non-specific: high fever, nausea, vomiting, headache, muscle pain, disorientation. Similar symptoms can occur with viral infections, especially influenza. But the severity of the patient’s condition and the rapid progression of the disease make it possible to suspect meningitis. Patients are hospitalized, as a rule, on the first day of the disease. Treatment of infection is difficult and lengthy.

Despite modern methods of diagnosis and treatment, the risk of death still remains. Among children, the risk of such an outcome of infection is 10 times higher than in adults.

The insidiousness of the infection lies in the fact that it leaves serious consequences even with proper and timely treatment. Among the complications of meningitis, such disorders of the nervous system as convulsions, hydrocephalus, neuropsychiatric retardation, mental retardation, ataxia, significant hearing loss, and others are known.

Prophylaxis

Vaccines have been developed to protect the body against meningococcal disease . They differ in composition, the possible age of the start of vaccination, the frequency of vaccine administration. For example, until recently, vaccines were available that were allowed only in children over 2 years of age. But sometimes it may be too late. Since 2013, the European Commission has adopted a decision on the routine vaccination of children in the European area from the age of 2 months. A monovalent vaccine is used, that is, it protects only against meningitis caused by one type of bacterium (serotype B). Drugs that provide protection against several serotypes (C, B, Y, W135) have been used since 9- one month old. In Europe and North America, meningitis vaccination is mandatory.

It is very important to get vaccinated if you are traveling to areas where the infection is most common. These are the countries of northern Africa (the so-called Meningitisbelt), such as Guinea, Burkina Faso, Nigeria, Chad, Sudan, Ethiopia. Vaccination is also mandatory for those who go on a pilgrimage to Mecca. At the same time, it should be borne in mind that for those planning a trip to these regions, a single (routine) vaccination will not be enough.

One of the meningococcal vaccines is also available at our clinic. Check with your pediatrician. Perhaps you should vaccinate your child tomorrow?

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How to distinguish meningococcal meningitis from SARS and what kind of vaccination to make against a deadly infection – July 7, 2023 / TASS

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Meningococcus – a terrible infection that can literally lead to death in a day or to such meningitis, about which the people say “had been ill and become a fool.”

The most notorious outbreaks of meningoccal infection in the last year occurred among employees of the popular marketplace. At the end of 2022, 11 people became infected and fell ill at the Ozon warehouse in Istra near Moscow. At the same time, according to Fontanka, an employee of the St. Petersburg Ozone died in the Botkin hospital – a girl who had come to St. Petersburg from Murmansk. Now seven people have fallen ill, of which two Ozon employees in Yekaterinburg have died. With the help of doctors, Fontanka figured out why people die from this bacterial infection in general in our time and whether it is possible to protect themselves from it.

According to Fontanka, 10 Petersburgers with meningitis are currently being treated in the city’s Botkin hospital. Almost every day, an ambulance delivers patients with such a diagnosis. But these are only those who have the so-called primary meningitis – serous, tick-borne and yes, meningococcal. With the secondary, they go to ordinary, non-infectious hospitals. For example, bacterial endocarditis can cause embolic meningitis. Such patients are hospitalized in cardiosurgical departments of general hospitals. When otitis or sinusitis as a complication of a common cold becomes the cause of bacterial meningitis, they are dealt with by ENT doctors in multidisciplinary hospitals.

As Mikhail Komarov, head of the ENT department of the City Hospital No. 26, explained, when a patient develops secondary meningitis due to an ear or nose disease (there are 2–3 such patients per month), a surgical intervention is performed to remove the primary focus infections: “If by this time an abscess has not formed in the brain, then the patient is treated with antibiotics that penetrate the blood-brain barrier and destroy the infection in the cerebrospinal fluid spaces and brain tissues. The probability of dying from this group of diseases is very high and is 10%, no less than the possibility of remaining disabled with a deep neurological deficit. These outcomes may have predisposing causes – old age, diseases of the cardiovascular system, immune deficiency, and others.

Otorhinolaryngologist Komarov emphasizes: secondary bacterial meningitis is not associated with meningococcal infection, the treatment of patients with which is carried out only in an infectious diseases hospital with strict adherence to anti-epidemic measures.

In a specialized hospital – the Botkin hospital – they told Fontanka that in recent years there have been few patients with meningococcal infection – the Neisseria meningitidis bacterium, no more than 5-10 people a year. In general, there have been no outbreaks of meningococcal infection in St. Petersburg for a long time, the last one happened more than 15 years ago.

The disease is dangerous because it can proceed in different ways, for example, with meningococcemia – bleeding in the adrenal glands and with septic shock. And this is deadly: from the appearance of the first symptoms to the most severe condition, they can develop in a matter of hours. If you miss the moment when you can help avoid serious complications, then a person will either become disabled or die.

Information:

In 2021, 10 children were registered in St.

In 2022, 17 people with meningococcal infection were registered, including 9 children under the age of 17. One person died.

In 2023, 17 cases have already been registered, of which three are children under 17 years old. One person died.

Meningococcal infection became more active after covid, when the coronavirus weakened, and other infections began to return. More precisely, meningococcus did not go anywhere, but behaved with restraint. It is always around us – in the air, especially in humid regions, which include St. Petersburg. In a “dormant” state, meningococcus lives in the nasopharynx in 10-15% of the population – the risk of developing the disease increases if someone’s immunity is sharply weakened. It happens that it sits in the nose and immediately dies when the immune system is strong, it happens that it takes root in it and nasopharyngitis develops, the disease proceeds like an acute respiratory viral infection and this is where it all ends. And in a weakened person, it penetrates through the nose into the brain and develops severe generalized meningitis.

Help

The three main symptoms of meningococcal meningitis are:

9 0079 1. Chills and rapid temperature increase above 38-39 degrees.

2. Extremely severe, intolerable headache for which pain pills do not help.

3. Hyperesthesia – increased sensitivity to light, sounds, touch.

Meningococcus is a cyclically recurring infection, and periods of “calm” are just 15-20 years. Therefore, now infectious disease specialists are wary of information about the emerging diseases of generalized meningoccal infection.

Marina Dessau, Head of the Department of Infectious and Parasitic Diseases at City Polyclinic No. 122, explains: “The cyclical activity of meningococcal infection suggests that the incidence of meningococcal disease increases strongly every 15–20 years. And the larger the gap – the “quiet period”, the more aggressively this microbe will behave in a year of high activity.”

In the outpatient network, physicians usually deal with the aftermath of a generalized infection or when a patient is reported to be infected with Neisseria meningitidis. “Doctors work in the “center”, examine those who have been in contact with the infected. But it is still difficult to identify the source if there are no clinical manifestations, says Marina Dessau. – There are many carriers of this infection, each of them can potentially become its distributor. But not everyone to whom it is transmitted will develop a severe clinical picture of the disease: it is easiest to infect a young child or a debilitated elderly person, and they are also at high risk of a severe course of the disease.

Information:

According to statistics, if the diagnosis is made within the first 12 hours from the onset of the disease, the risk of death is reduced to 0.7-1.5%. If treatment was started in a day – up to 2-4%, after two days – 5-6%, after three or four days – 15-18%. Without treatment, 85% of patients die, 15% remain severely disabled.

However, when there are symptoms, it is rare to diagnose the disease at an early stage. Because meningococcal meningitis begins with signs of a common cold. It is possible to differentiate with a respiratory infection with appropriate vigilance three days after the onset of the disease. In a person with SARS, the symptoms should decrease, with meningococcus they increase, including the temperature rises, the headache becomes more intense. But even this does not always make it possible to distinguish meningococcal infection from a respiratory virus. It is good if the patient is hospitalized before meningococcemia and the appearance of a rash on the body. But even in these cases, patients are difficult and long treated in the hospital. And when they return home, they are observed in outpatient medical facilities by local therapists (pediatricians) and neurologists, who work with complications that depend on the severity of the disease — hearing loss, visual impairment, memory problems, paresis and paralysis.

Doctors say that the best prevention is sun and water, vitamins, and with them – good immunity. But it is not exactly. Only vaccination gives 100% certainty. An expensive vaccine has recently been included in the National Immunization Schedule.

Meningococcal bacterium Neisseria meningitidis, which causes severe forms of generalized sepsis, can be of different groups, a quarter of registered cases occur in a representative of serogroup B, against which the Bexero vaccine (GSK, UK) protects. She is not in St. Petersburg today.

It is possible to get vaccinated with the Menactra vaccine (Sanofi, USA), which protects against other serotypes.

As the infectious disease specialist Marina Dessau explained, free of charge, within the framework of the National Immunization Calendar, vaccination is carried out only for children, adults – according to indications, for example, contacts, as well as those who live in crowded groups, for example, military personnel in barracks.

Photo: Sergey Savostyanov / TASS

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Death meningitis: Bacterial Meningitis | CDC

Bacterial Meningitis | CDC

Causes

Risk Factors

How It Spreads

Signs and Symptoms

Diagnosis

Treatment

Prevention

Vaccination

Prophylaxis

Healthy Pregnancy Practices

Healthy Habits

The cause of death in bacterial meningitis

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Meningitis: threat or reality? | Articles by doctors of the EMC clinic about diseases, diagnosis and treatment

Symptoms of meningitis

Prophylaxis

How to distinguish meningococcal meningitis from SARS and what kind of vaccination to make against a deadly infection – July 7, 2023 / TASS

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