Those with meningitis, especially because the bacteria that cause, have a high risk of blood infection or septicemia. Hospitals go directly necessary for these patients.
Treatment of bacterial meningitis
- Was hospitalized urgently. With severe infections, treatment in an intensive care unit (ICU) is recommended.
- The diagnosis of the causative organism is made. Certain bacteria and sensitivity to antibiotics need to be determined before the targeted antibiotics may be given.
- Antibiotics used to treat infections. Early empirical antibiotic or “blind” begin without delay and this may continue or turn out to be more specific antibiotics after the causative organism was confirmed by laboratory tests. Antibiotics are often given by injection into a vein on the forearm.
- Antibiotic therapy blind including third generation cephalosporins such as cefotaxime or ceftriaxone and Amoxicillin if listeriosis is suspected.
- Benzylpenicillin is given if the suspected meningococcal infection (usually for 7 days) and Rifampicin or ciprofloxacin for 2 days if nasal colonization is suspected.
- Meningitis suspected to be caused by pneumococci or hemophilis influenza type b requires cefotaxime for 10-14 days or benzylepenicillin. Rifampicin is usually given for four days before discharge for patients with infections hemophillus.
- Benzylpenicillin and gentamicin or cefotaxime itself is given for 14 days for meningitis caused by infection with Streptococcus Group B.
- Besides Amoxicillin and gentamicin for 10-14 days is usually given to listeriosis.
- Vital support including oxygen, intravenous fluids, nutritional support, etc. need to be started by the reception.
- Corticosteroids are given to reduce edema, swelling and inflammation of the meninges. Steroids such as dexamethasone has been shown to prevent hearing loss and other complications of meningitis. Dexamethasone or a similar corticosteroid should be started right before the first dose of antibiotics given, and continued for four days.
- General measures such as anti-emetics for nausea and vomiting and Anti-seizure drugs or anticonvulsants for seizures recommended.
- Usually a week or more than the cost of the hospital is required if the patient is also responding to antibiotics. People with more severe disease may need to stay in the hospital again.
Treatment of viral meningitis
- Severe viral meningitis require hospital admission.
- Treatment begins with vital support with oxygen and intravenous fluids and antibiotics.
- Once the diagnosis is made and viruses that cause is identified, antibiotics withdrawn since they infective against the virus. However, intravenous fluids will be continued.
- Some severe infections may require antiviral drugs. Aciclovir considered useful in treating herpetic viral infection but only when given very early in the course of infection. Patients need to be given a dose of aciclovir immediately if there is suspicion of herpes encephalitis or brain infection. Effective ganciclovir for cytomegalovirus infection.
- Those with mild viral meningitis will not require hospital treatment. These patients need rest, plenty of fluids and painkillers for headache and anti-emetics for nausea and vomiting.
- Recovery is usually within one or two weeks
Oleh Dr Ananya Mandal, MD