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Bacterial Meningitis: Diagnosis and Care

Emergency Situation: Bacterial Meningitis

Bacterial meningitis (BM) is an infectious disease that can be caused by Streptococcus pneumoniae, Group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes. The incubation period of the disease is around several hours, which makes it very hard for epidemiologists to encourage the right behavior among the target population. In 2003-2007, the epidemic curve of BM was huge, peaking at 4,100 cases and triggering 500 deaths on the identified time slot. The disease affects all age groups, including newborn babies, children, teenagers, young adults, older adults, and seniors. BM can be contracted through food, from a mother to a child during birth or breastfeeding, from a carrier to another person y sneezing or coughing, etc. (Centers for Disease Control and Prevention, 2017).

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Signs and Symptoms Description and Pathophysiology

The symptoms of BM are easily confused with other respiratory diseases, which makes it rather difficult for a patient to identify the problem and receive the necessary healthcare services. Fever and headache are the most common manifestations of BM at the onset stage. As the disease progresses, nausea, vomiting, photophobia, and changes in the patient’s mental status can be observed as well (Centers for Disease Control and Prevention, 2017). In case the disease is not addressed and is allowed to progress, the patient may experience seizures and even reach the state of a coma (Centers for Disease Control and Prevention, 2017). Neck stiffness is also often listed among typical signs of meningitis development, as well as a rapid increase in the sleepiness levels in the patient. Finally, the people affected by the disease may also become sensitive to light (Fayyaz et al., 2014).

Determining the Final Diagnosis: Steps

Kernig’s sign, which can be defined as stiffness in the patient’s legs, is often viewed as one of the factors that allow diagnosing BM with a significant amount of precision. For this purpose, the patient should be placed in a supine position, with their knees and elbows flexed to a right angle (Beek et al., 2016). If the extension of the patient’s knees or elbows to 135° causes any pain, BM is likely to be the cause of it.

As soon as BM is suspected, a blood test must be taken. The presence of antibodies may be the sign of an infection. The latter, in its turn, may be the sign of BM development.

A CT scan should be viewed as the next essential step in determining whether the patient has BM. The scan results will show the presence of any possible abnormalities, such as internal bleeding, inflammation, etc. Consequently, BM can be diagnosed.

If the CT scan does not deliver clear results, lumbar puncture can be viewed as the next step in diagnosing the issue. A sample of cerebral spinal fluid is collected during the test to detect any signs of infection. The levels of glucose, the presence of white blood cells, and protein are determined in the process. As a result, the nature of meningitis (bacterial, viral, or fungal) can be determined (Beek et al., 2016).

Assistance in Managing Care: Health Experts and Ancillary Staff

Antibiotics and corticosteroids must be administered to the patient by a physician or a pediatrician, the latter providing their assistance in case the patient is a child. The healthcare expert in question prescribes antibiotics that will help reduce the inflammation levels and help manage the disease. Corticosteroids are also prescribed to improve the neurological outcomes.

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Furthermore, the assistance of a family nurse or a pediatric nurse may be viewed as a necessity. The nurse will support the patient and administer the required medicine to them. Furthermore, a nurse practitioner will supervise the situation, preventing the patient from experiencing aggravation of their condition (Lee et al., 2014).

References

Beek, V. D., Cabellos, C., Dzupova, O., Esposito, S., Klein, M., Kloek, A. T.,… Brouwer, M. C. (2016). ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clinical Microbiology and Infection, 22(3), 37-62.

Centers for Disease Control and Prevention. (2017). Bacterial meningitis.

Fayyaz, J., Rehman, A., Hamid, A., Khursheed, M., Zia, N., Feroze, A. (2014). Age related clinical manifestation of acute bacterial meningitis in childrenpresenting to emergency department of a tertiary care hospital. Journal of the Pakistan Medical Association, 64(2), 296-299.

Lee, A. C. C., Chandran, A., Herbert, H. K., Kozuki, N., Markell, P., Shah, R.,… Baqui, M. H. (2014). Treatment of infections in young infants in low- and middle-income countries: A systematic review and meta-analysis of frontline health worker diagnosis and antibiotic access. PLoS One, 11(10), 1-22.

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