How do you check for meningitis: Meningitis – Symptoms and causes

23.07.202308.07.2023 by alexxlab

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Meningitis Glass Test – Meningitis Rash Test

A rash that does not fade under pressure can be a sign of meningococcal septicaemia (meningococcal bacteria can cause meningitis and septicaemia). Using the glass test on a rash that appears on someone’s skin will help you to determine whether the rash is a medical emergency or not

People with septicaemia may develop a red rash of tiny ‘pin pricks’, which can develop into purple bruising.

This rash does not fade under pressure.

The meningitis glass test

Performing the meningitis glass test is very straight forward, follow the instructions below:

Press the side of a clear glass firmly against the skin
Spots/rash may fade at first
Keep checking
Fever with spots/rash that do not fade under pressure is a medical emergency
Do not wait for a rash. If someone is ill and getting worse, get medical help immediately

On dark skin, the spots/rash can be more difficult to see, check lighter areas such as the palms of the hands, soles of the feet, inside the eyelids and the roof of the mouth. Be aware of all meningitis signs and symptoms.

What is the rash?

The rash associated with meningitis is actually caused by septicaemia, more information below:

Meningococcal bacteria can cause meningitis and septicaemia
People will often have both together
When the bacteria are in the bloodstream, they multiply rapidly and begin to release endotoxins (poisons) from their outer coating
The body’s natural defences have little effect on these poisons and eventually blood vessels become damaged. As septicaemia advances, it affects the whole body and can cause organ damage or failure
The rash associated with septicaemia is caused by blood leaking into the tissues under the skin

It’s important to know that septicaemia can also cause other more specific symptoms to look out for (as well as the red rash):

Fever with cold hands and feet
Joint or muscle pain
Rapid breathing
Stomach cramps and diarrhoea

If you are worried about spotting the symptoms in time, let us help you. Download our phone optimised videos and images on your phone, or request one of our free credit-card sized signs and symptoms cards by calling our Meningitis Helpline on 0808 80 10 388.

Concerned about meningitis?

If you live on your own, always make sure you tell someone if you are not feeling well. They can check up on you and take action if needed
Trust your instincts. You know your loved ones, and your own body, best
Describe the symptoms and say you think it could be meningitis or septicaemia
Early diagnosis can be difficult. If you have had medical advice and are still worried, get medical help again

Do not wait for a rash. If someone is ill and getting worse, get medical help immediately.

Septicaemia and sepsis

Many medical experts now use the term sepsis instead of septicaemia. Sepsis describes the life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs.

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Bacterial Meningitis | Cedars-Sinai

ABOUT

CAUSES
DIAGNOSIS

TREATMENT

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What is bacterial meningitis?

Meningitis is an infection of the membranes (meninges) that protect the spinal cord
and brain. When the membranes become infected, they swell and press on the spinal
cord or brain. This can cause life-threatening problems. Meningitis symptoms strike
suddenly and worsen quickly.

What causes bacterial meningitis?

Bacteria or a virus can cause meningitis. Viral meningitis is more common, but
bacterial meningitis is often more serious. It can lead to brain damage, seizures,
paralysis, or stroke. In some cases, it can be fatal.

Many
different types of bacteria can cause meningitis
. Vaccines are available that
target many of these bacteria. For this reason, it’s important to know what’s causing
meningitis. Even though all types affect the same area of the body, they can have
different outcomes and need different treatments.

Who is at risk for bacterial
meningitis?

Experts don’t always know why meningitis happens. Some people get it when their immune
system is weak or they’ve recently been sick. A head injury may also increase risk.

Bacterial meningitis is more common in infants younger than age 1 and people ages
16
to 21. College students living in dorms or other close quarters are at increased risk.
Also at risk are adults with certain medical problems, including those without a
spleen.

What are the symptoms of bacterial meningitis?

The most common symptoms of bacterial meningitis are:

Painful, stiff neck with limited range of motion
Headaches
High fever
Feeling confused or sleepy
Bruising easily all over the body
A rash on the skin
Sensitivity to light

These are symptoms to look for in children:

Irritability
Vomiting from a high fever
Frequent crying
Swelling of the head
Lack of appetite
Seizures (sometimes also seen in adults if the meningitis is advanced)

Symptoms typically come on quickly, in as little as a couple of hours or up to a day
or
two. If you think you or your child may have meningitis, go to an emergency room (ER)
right away.

How is bacterial meningitis diagnosed?

To
diagnose this condition, a healthcare provider will do a spinal tap (lumbar puncture)
to
take a sample of fluid from around the spinal cord. The fluid is then tested for
bacteria. The provider will also ask about your symptoms and do a physical exam.

Other tests may include:

Brain
imaging such as a CT scan or MRI
Blood
and urine testing
Swab of
fluids from your nose or throat

How is bacterial meningitis treated?

Prompt treatment of bacterial meningitis is crucial. It can save your life. Antibiotics
that can treat a broad range of bacteria are given right away. The antibiotics can
be
changed once the specific bacteria is found.

Antibiotics are given through a needle placed into a vein (usually in the arm or hand).
They may also be given along with a corticosteroid to help reduce inflammation and
swelling. Treatment also includes plenty of fluids to prevent dehydration.

What are possible complications of
bacterial meningitis?

With quick treatment, many people with bacterial meningitis don’t have any permanent
problems. However, even with prompt treatment, some may battle seizures, brain damage,
hearing loss, and disability for the rest of their lives. Meningitis can be fatal
and some people with this infection will die.

What can I do to prevent bacterial
meningitis?

Vaccines are available to help prevent certain forms of bacterial meningitis. Children
now routinely get a meningitis vaccine around ages 11 to 12. A booster shot is given
at
age 16. Ask your healthcare provider if you or your children should be vaccinated.

Bacterial meningitis is contagious. If you’ve been around someone who has it, call
your provider to talk about how to keep from getting sick.

Key points about bacterial meningitis

If you feel like you’ve got the flu with unusual stiffness in your neck, it could
be meningitis.
Get any symptoms checked out and treated as soon as possible to help ward off complications.
Ask your healthcare provider about vaccines that may protect you from bacterial meningitis.
If
you’ve been around someone who has bacterial meningitis, call your provider to talk
about how to keep from getting sick.

Next steps

Tips
to help you get the most from a visit to your healthcare provider:

Know
the reason for your visit and what you want to happen.
Before
your visit, write down questions you want answered.
Bring
someone with you to help you ask questions and remember what your provider tells
you.
At the
visit, write down the name of a new diagnosis and any new medicines, treatments, or
tests. Also write down any new instructions your provider gives you.
Know
why a new medicine or treatment is prescribed, and how it will help you. Also know
what the side effects are.
Ask if
your condition can be treated in other ways.
Know
why a test or procedure is recommended and what the results could mean.
Know
what to expect if you do not take the medicine or have the test or procedure.
If you
have a follow-up appointment, write down the date, time, and purpose for that
visit.
Know how you can contact your provider if you have
questions.

Medical Reviewer: Joseph Campellone MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

How to recognize meningitis and diagnose the disease in the Optimum medical laboratory in Sochi (Adler)

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Symptoms, diagnosis and prevention of meningitis

Meningitis is an inflammation of the membranes of the brain or spinal cord, which can be triggered by infections of viral and bacterial etiology. Pathology is accompanied by a severe headache, a typical body position in bed, hemorrhagic rashes on the skin and stiffness of the muscles of the occipital zone. Children and adolescents, as well as elderly people with weakened immune systems, are especially susceptible to this disease.

Causes of meningitis

The main cause of meningitis are infections of viral and bacterial etiology. The causative agent of the inflammatory process can be:

pneumococci;
Haemophilus influenzae;
Escherichia coli;
streptococci;
amoeba.

In childhood, the main cause of the development of pathology is enteroviruses that enter the body by airborne droplets. Infection can occur during childbirth, through contaminated food, dirty water, and insect bites. The main causes of non-infectious meningitis are trauma and damage to the skull, as well as tumor processes occurring in the brain.

Mechanism of development

For the development of pathology, the pathogen must penetrate the cranial cavity and provoke an inflammatory process in the brain. In some cases, this is observed when foci of infection occur in tissues located near the meninges. Pathologies such as purulent otitis media or sinusitis can provoke meningitis.

In some cases, craniocerebral trauma becomes a provoking factor in the development of pathology, but the infection mainly penetrates into the cranial cavity along with the blood flow. The very process of entering the pathogen into the blood and its further spread to the meninges is associated with a poor state of immunity.

Symptoms

Meningitis causes the following clinical picture:

rise in body temperature;
photophobia;
muscle tension in the occipital region;
confusion;
convulsive syndrome;
strabismus;
muscle pain syndrome;
mental disorders;
tachycardia;
rashes on the skin.

If these symptoms develop, seek medical attention as soon as possible because meningitis has a high mortality rate.

Diagnostic methods

The main method for diagnosing meningitis is lumbar puncture with further examination of cerebrospinal fluid. This diagnostic method is used in all cases when there is a suspicion of a disease.

In addition, the doctor analyzes the patient’s complaints and collects an anamnesis, as well as conducts a neurological examination. With the help of a blood test, it is possible to diagnose signs of inflammation, and PCR of blood and cerebrospinal fluid helps to identify the pathogen.

Computed and magnetic resonance imaging allows to assess the structure of the brain and diagnose indirect manifestations of the pathological process in the meninges of the brain.

Prevention

Some forms of meningitis can be prevented by vaccination, which is effective for several years. As a preventive measure, it is recommended to treat chronic and acute pathologies of an infectious nature in a timely manner and take courses of immunostimulating drugs in the foci of meningococcal disease. In addition, you should harden the body, avoid visiting places with large crowds of people and severe hypothermia. In the autumn-winter period, you need to drink multivitamin complexes or vitamin C.

Tests for meningococcal infection

The causative agent of meningococcal infection is Neisseria meningitidis (meningococcus). Meningococcus colonizes the posterior wall of the human nasopharynx and, depending on the virulence of the strain and the resistance of the infected person, causes an infectious process with a wide range of clinical manifestations: asymptomatic carriage, nasopharyngitis and a generalized form – meningococcemia and / or meningitis. Meningococcal infection affects people of all ages, but more often (70%) children get sick. The lethality rate averages 10%, which determines the high social significance of the disease. Capsular strains of meningococcus, depending on the chemical structure of the capsular polysaccharide, are divided into a number of serological groups: A, B, C, X, Y, Z, W-135, 29-E, H, I, K, L. More than 90% of cases of generalized forms of meningococcal infection are caused by strains of serogroups A, B and C, much less often by strains of serogroups X, Y and W-135, the remaining serogroups are not of epidemiological interest. The determination of the serogroup is the most important procedure for the selection of an adequate vaccine product. All meningococci express on their surface one of the allelic variants of class 2 or 3 outer membrane proteins (PorB). Most meningococci express class 1 proteins (PorA). The antigenic structure of the PorB protein determines the serotype of the strain, while the PorA protein determines the serosubtype. Based on the chemical structure of the capsular lipopolysaccharide, the immunotype is determined. The antigenic characteristic may include some other AGs: Ora and Ors (class 5 outer membrane proteins), pili, FetA surface protein.

Indications for examination

Diagnostic studies are carried out in a hospital with suspected purulent meningitis and / or a generalized form of meningococcal infection;
studies according to epidemic indications are carried out in the focus of a generalized form of meningococcal infection among those who have been in contact with the patient and have clinical manifestations of nasopharyngitis.

Study material

Blood – microscopic examination, culture;
CSF – microscopic examination, culture, DNA detection, AH detection;
swabs from the oropharynx and nose – culture;
blood serum – detection of hypertension, determination of specific antibodies

Differential diagnosis

Causative agents of purulent meningitis of other etiologies: Streptococcus pneumonia, Haemophilus influenza, Staphylococcus aureus, etc.;
in the study of the nasopharynx – pigmenting Neisseria subflava, Neisseria flavescens, Neisseria mucosa, Neisseria sicca, Neisseria lactamica.

Laboratory diagnosis of a generalized form of meningococcal infection includes microscopy of biological material, inoculation of biological material with further cultural and biochemical identification of the pathogen, determination of antibiotic sensitivity; detection of specific genetic fragments of meningococcus and its AG, detection of specific antibodies.

Comparative characteristics of laboratory research methods and features of interpretation of their results. Microscopy of native cerebrospinal fluid or a “thick drop” blood product (stained with an aqueous-alcoholic solution of methylene blue) on a blue background reveals morphologically clear cocci, diplococci, stained in dark blue, resembling coffee beans or bean seeds, adjacent to each other with concave sides , sometimes the capsule comes to light. Microbial cells can be located both outside and inside leukocytes. The intensity of CSF contamination by microbial cells varies considerably and depends on the stage of development of the infectious process at the time of sampling. If antibiotic treatment has been carried out, the typical microbial cell morphology is lost. The study is recommended to be carried out in the active phase of the disease (the first two days after admission to the hospital).

Inoculation of CSF and blood on nutrient media with further incubation for 24 hours at 37°C in an atmosphere with 5–10% CO2 and high humidity makes it possible to identify the characteristic tinctorial properties of the pathogen. The study is recommended to be carried out in the active phase of the disease (the first two days after admission to the hospital) before the start of intensive antibiotic therapy.

When determining the saccharolytic activity, the results of sowing a pure culture on dense nutrient media with carbohydrates are taken into account. The method makes it possible to differentiate different types of Neisseria and some other types of microorganisms (Table 16). Sometimes there is variability in saccharolytic activity in different strains of the same species.

Clarification of the biochemical properties of meningococci is carried out using reagent kits for an extended study of their enzymatic and metabolic activity, which within 2 hours allows you to determine the species of the pathogen.

The determination of the serogroup of meningococci is carried out in the agglutination reaction on glass with a set of agglutinating serogroup antisera (serogroups A, B, C, X, Y, Z, W-135,29E). The reaction is carried out only with a pure culture of meningococci that has passed all stages of identification. Meningococci of serogroups A, B and C are most often the cause of generalized forms of meningococcal infection, the agglutination reaction is carried out primarily with antisera to meningococci of these serogroups. The absence of a reaction with one of the main serogroup antibodies indicates the need to continue similar studies with other specific antisera (X, Y, Z, W-135, 29e). Only if a strain of meningococcus confirmed by all tests did not show a positive result in the agglutination test with a full set of agglutinating antisera, it should be classified as a non-agglutinating strain (NA).

Latex agglutination reaction is used to detect AG in CSF and/or blood serum. The study of native cerebrospinal fluid (express method) is carried out if it contains signs of purulent inflammation and / or microscopic detection of pathogens. The use of the reaction allows in the shortest possible time (15-20 minutes) to identify specific AG of meningococci of the most common serogroups (A, B, C, Y, W-135). It is recommended to conduct a study in the active phase of the disease (the first two days after admission to the hospital).

CSF and/or a fresh pure culture of Neisseria meningitidis grown on Petri dishes is used to detect pathogen DNA. Detection of specific genetic fragments of the microorganism is performed using PCR. The method has high diagnostic sensitivity and specificity, allows to detect microorganisms contained in single quantities or in a non-viable state in a clinical sample, is characterized by high reproducibility and short deadlines for performing the study (within several hours).

Indications for conducting studies to detect DNA in the diagnosis of bacterial meningitis are:

negative results of diagnosis by other methods, especially in the case of examination of CSF samples after massive antibiotic therapy or in the late stages of the disease;
the need for an urgent response about the etiology of the pathogen;
Examination of material samples delivered frozen or fixed in ethanol.

Detection of specific antibodies in the blood serum in the diagnosis of meningococcal infection is carried out using RNHA. It is recommended to conduct the study twice: in the active phase of the disease (the first two days after admission to the hospital) and on the 12-14th day of the disease. The diagnosis is considered confirmed when the increase in titers of antibodies by four or more times within the specified period.

The use of RNHA for research in “paired sera” reveals the dynamics of the increase in titers of specific antibodies to meningococcus in the blood and allows you to determine whether the pathogen belongs to the most common serogroups of meningococci (A and C). The detection of AT makes it possible to conduct a retrospective laboratory diagnosis of generalized forms of meningococcal infection, since the final answer is obtained only 12-14 days after the onset of the disease. The primary research opportunities are laboratory confirmation of meningococcemia, in which the use of other methods of laboratory diagnostics, as a rule, is not very effective.