Bacterial Meningitis and its Therapeutic Management
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Bacterial meningitis is a leading cause of disease and mortality, particularly in children under the age of five. The disease's fast development of symptoms and possibly severe effects demand early detection and treatment. The most frequent bacterial meningitis consequences include shock, coagulation problems, endocarditis, pyogenic arthritis, and persistent fever. Despite the availability of several new antibacterial medicines, bacterial meningitis mortality rates remain high, with reported rates ranging from 2% to 30%. In 10% to 20% of those who survive, permanent sequelae such as epilepsy, mental retardation, or sensorineural deafness are found. In general, all human microorganisms can cause meningitis, although just a few species are responsible for the majority of bacterial meningitis cases. S. agalactiae and E. coli typically infect infants up to 3 months of age and are acquired via the baby's transit through a contaminated vaginal canal. H. influenzae affects unvaccinated children aged 3 to 6 months to 6 years. N. meningitidis is the sole bacterium that causes meningitis outbreaks and infects children and young adults. S. pneumoniae infects children on occasion, and the frequency rises with age.
L. monocytogenes appears to be foodborne (dairy products, processed meat, and raw vegetables) and infects those with weakened immune systems or those undergoing particular treatments. Even before the findings of the lumbar puncture and CSF analysis are available, empiric antibiotics (treatment without a definite diagnosis) should be begun right away. The ideal antibiotic for CNS infection would be cheap and effective against a wide spectrum of gram-positive and gram-negative bacteria. If the infecting organism is found on a Gram-stained smear of CSF sediment from a patient with probable bacterial meningitis, targeted medication is started; otherwise, empirical antimicrobial therapy is started.
Treatment of bacterial meningitis as soon as possible typically leads in fast recovery of neurologic function. Different antibacterial families, including beta-lactams, cephalosporins, aminoglycosides, fluoroquinolones, and other medications, such as trimethoprim-sulfamethoxazole and vancomycin, are used to treat bacterial meningitis. The type of antibiotic to use, its dose and duration, and whether to combine it with other antibiotics are all decisions made by the doctor based on the aetiology, the patient. Many subtypes of H. influenzae type b, meningococcal serogroups (A, C, Y, and W-135), S. pneumoniae, M. tuberculosis, and S. agalactiae now have effective vaccinations available. The incidence of meningitis caused by any of the species is significantly decreased by following advised immunisation regimens. According to earlier research, five bacteria H. influenzae, N. meningitidis, S. pneumoniae, L. monocytogenes, and S. agalactiae were responsible for about 80% of meningitis cases. However, the proportion of infections caused by these five pathogens was significantly reduced once conjugate vaccinations were introduced.