Meningitis is an infection of the three membranes, called the meninges, that lie between the brain and the skull. The thin membranes that cover the spinal cord may also be involved. This disorder is more common in children than in adults.
Meninges of the central nervous system (CNS): dura mater, arachnoid, and pia mater.
Meningitis may develop in response to a number of causes, usually bacteria, viruses and other pathogens, but also physical injury, cancer or certain drugs. While some forms of meningitis are mild and resolve on their own, meningitis is a potentially life-threatening condition due to the proximity of the inflammation to the brain and spinal cord. The potential for serious neurological damage or even death necessitates prompt medical attention and evaluation. Infectious meningitis, the most common form, is typically treated with antibiotics and requires close observation. Some forms of meningitis (such as those associated with meningococcus, mumps virus or pneumococcus infections) may be prevented with immunization.
Meningitis can affect anyone in any age group, from the newborn to the elderly.
The "Meningitis Belt" is an area in sub-Saharan Africa which stretches from Senegal in the west to Ethiopia in the east in which large epidemics of meningococcal meningitis occur (this largely coincides with the Sahel region). It contains an estimated total population of 300 million people. The largest epidemic outbreak was in 1996, when over 250,000 cases occurred and 25,000 people died as a consequence of the disease.
Meningitis was first described in the 1020s in Avicenna's The Canon of Medicine, and again more accurately by Avenzoar of al-Andalus in the 12th century. Symptoms of the disease were also noted in 1805 by the Swiss Gabinetto Vieusseux (a scientific-literary association) during an outbreak in Geneva, Switzerland. In 1887, Dr. Anton Weichselbaum (1845-1920) of Vienna became the first to isolate the specific germ, meningococcus.
In the 19th century, meningitis was a scourge of the Japanese imperial family, playing the largest role in the horrendous pre-maturity mortality rate the family endured. In the mid-1800s, only the Emperor Komei and two of his siblings reached maturity out of fifteen total children surviving birth. Komei's son, the Emperor Meiji, was one of two survivors out of Komei's six children, including an elder brother of Meiji who would have taken the throne had he lived to maturity. Five of Meiji's 15 children survived, including only his third son, Emperor Taisho, who was feeble-minded, perhaps as a result of having contracted meningitis himself. By Emperor Hirohito's generation the family was receiving modern medical attention. As the focal point of tradition in Japan, during the Tokugawa Shogunate the family was denied modern "Dutch" medical treatment then in use among the upper caste; despite extensive modernization during the Meiji Restoration the Emperor insisted on traditional medical care for his children.
Most cases of meningitis are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, that spread into the blood and into the cerebrospinal fluid (CSF). Non-infectious causes include cancers, systemic lupus erythematosus and certain drugs.
The most common type of meningitis is viral meningitis. This disease causes comparatively mild symptoms, such as headache and malaise, and usually improves on its own in a week or two. Also called aseptic meningitis, viral meningitis usually occurs in conjunction with other diseases. Almost 50 percent of cases of viral meningitis infections are caused by intestinal viruses. This condition may also accompany mumps or a herpes outbreak, and it can be carried by mosquitos as well.
Bacterial meningitis is the more serious infection and it requires prompt, aggressive medical treatment. The bacteria responsible for most outbreaks of bacterial meningitis are Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), Nemophilus influenza type B and group B Streptococcus. Neisseria and Streptococcus are the leading causes of infection since, after 1990, routine immunization curbed the outbreaks of H. influenza type B (Hib). Haemophilus influenzae (type B) incidence has been much reduced by immunization in many countries. Neisseria meningitidis and Streptococcus pneumoniae are the most common pathogens in patients without immune deficiency, with meningococcal disease being more common in children. Staphylococcus aureus may complicate neurosurgical operations, and Listeria monocytogenes is associated with poor nutritional state and alcoholism. Mycobacterium tuberculosis (the causative agent of tuberculosis) rarely causes meningitis in Western countries but is common and feared in countries where tuberculosis is endemic.
In the case of N. meningitidis, at any one time, some 5 to 20 percent of the population carry this bacteria in their saliva without feeling any ill effects - but it can be transmitted through saliva to other people. The Streptococcus pneumonia bacteria is commonly found in the throat and is not contagious.
VIRAL MENINGITIS QUICK OVERVIEW
The early symptoms of viral meningitis include:
- Sore throat.
- Stiff neck.
- Vomiting (possibly).
- Rash (possibly).
BACTERIAL MENINGITIS QUICK OVERVIEW
The symptoms of bacterial meningitis include:
- Stiff and painful neck, especially when trying to touch the chin to the chest.
- High fever.
- Delirium, confusion, and decreased level of consciousness.
- Sensitivity to light and eye pain from bright lights.
- Blotchy skin rash may appear.
- Dizzy spells.
- Sluggishness, muscle aches and weakness, and strange feelings (such as tingling) or weakness throughout the body.
In infants, the signs include:
- Poor muscle tone.
- Difficulty feeding and decreased appetite.
- Irritability that is difficult to calm.
- A high-pitched, shrill cry.
- A bulging fontanelle (soft spot) that is not caused by crying.
- A stiff body.
- Babies may cry when handled.
Young children with meningitis may act like they have the flu (influenza), cough or have trouble breathing.
Older adults and people with other medical conditions may have only a slight headache and fever. They may not feel well and may have little energy.
The incubation period is the time from exposure to the infection to when the first symptoms appear. This depends on the type of organism causing the infection.
Changes in temperament and extreme sleepiness signal dangerous changes in the cerebrospinal fluid (the fluid that surrounds and cushions the brain). Meningococcal meningitis kills 10 to 15 percent of those affected; among the survivors, 10 to 15 percent suffer hearing loss, diminished intellect, or need to have limbs amputated because of blood poisoning (septicemia).
Other conditions with similar symptoms to meningitis include viral hepatitis and flu.
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MoonDragon's ObGyn Information: Hepatitis
DESCRIPTION OF COMMON MENINGITIS SYMPTOMS
Severe headache is the most common symptom of meningitis (87 percent) followed by nuchal rigidity ("neck stiffness", found in 83 percent). The classic triad of diagnostic signs consists of nuchal rigidity (being unable to flex the neck forward), sudden high fever and altered mental status. All three features are present in only 44 percent of all cases of infectious meningitis. Other signs commonly associated with meningitis are photophobia (inability to tolerate bright light), phonophobia (inability to tolerate loud noises), irritability and delirium (in small children) and seizures (in 20-40 percent of cases). In infants (0-6 months), swelling of the fontanelle (soft spot) may be present.
Nuchal rigidity is the inability to flex the neck forward passively due to increased tone in the neck muscles. Other signs of meningism include Kernig's sign and Brudzinski's sign. Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are limited.
Kernig's sign is typically assessed with the patient lying supine, with one hip flexed to 90 degrees and the knee flexed to 90 degrees. If pain is elicited when the knee is passively extended, and it is not able to reach full extension, this indicates meningism.
Brudzinski's sign is used in infants, where forward flexion of the neck may cause involuntary knee and hip flexion.
In meningococcal meningitis (i.e. meningitis caused by the bacteria Neisseria meningitidis), a rapidly spreading petechial rash is typical, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet. Other clues to the nature of the cause may be the skin signs of hand, foot and mouth disease and genital herpes, both of which may be associated with viral meningitis.
An autopsy demonstrating signs of streptococcus pneumoniae (pneumococcus) meningitis. The forceps (center) are retracting the dura mater (white). Underneath the dura mater are the leptomeninges, which are edematous and have multiple small hemorrhagic foci (red).
Meningitis can be diagnosed after death has occurred. The findings from a post mortem are usually a diffuse (widespread) inflammation of the pia-arachnoid area. Neutrophil leucocytes tend to have migrated to the cerebrospinal fluid and the base of the brain, along with cranial nerves and the spinal cord, may be surrounded with pus - as may the meningeal vessels.
CDC RECOMMENDATIONS - IMMUNIZATION WITH VACCINATIONS
Haemophilus influenzae type b (Hib) virus. According to the The Centers for Disease Control and Prevention (CDC), vaccinations against Haemophilus influenzae (Hib) have decreased early childhood meningitis significantly. Conventional protocol for the Hib vaccine is that it is recommended for all children between 2 months and 5 years of age and anyone older than 5 who has a medical condition such as sickle cell disease or an impaired immune system.
Neisseria meningitidis and Streptococcus pneumoniae bacteria. Immunizations against these bacteria are recommended for people who have medical conditions such as impaired immune systems or people who have had meningitis in the past. The meningococcal vaccine (MCV4) helps protect against certain strains of neisseria meningitidis. The CDC recommends this vaccine for adolescents and for college freshman living in dormitories. Adolescents should get this shot at age 11 or 12. Teens ages 13 to 18 who haven't had the shot should get it as soon as possible. This vaccine also may be given to others who may be at higher-than-normal risk, such as travelers to countries known to have outbreaks of meningitis, people without a spleen, and those with HIV.
Vaccines against type A and C Neisseria meningitidis, the kind that causes most disease in preschool children and teenagers in the United States, have also been around for a while. Type A is also prevalent in sub-Sahara Africa and W135 outbreaks have affected those on the Hajj pilgrimage to Mecca. Immunization with the ACW135Y vaccine against four strains is now a visa requirement for taking part in the Hajj.
Vaccines against type B Neisseria meningitidis are much harder to produce, as its capsule is very weakly immunogenic masking its antigenic proteins. There is also a risk of autoimmune response, and the porA and porB proteins on Type B resemble neuronal molecules. A vaccine called MeNZB for a specific strain of type B Neisseria meningitidis prevalent in New Zealand has completed trials and is being given to many people in the country under the age of 20 free of charge. There is also a vaccine, MenBVac, for the specific strain of type B meningococcal disease prevalent in Norway, and another specific vaccine for the strain prevalent in Cuba. According to reports released in May 2008, Novartis is in the advanced stages of testing a general meningococcus type B vaccine. According to reports released in May 2008, Novartis is in the advanced stages of testing a general meningococcus type B vaccine.
Although college students' overall risk of meningitis from Neisseria meningitidis bacteria is low, freshmen, especially those who live in dormitories, have a moderately higher risk than other people their age.6 If you are a college freshman living in a dormitory, the CDC recommends the meningococcal vaccine (MCV4). College freshmen who do not live in dormitories may also be vaccinated to reduce their risk of infection.
Pneumococcal polysaccharide vaccine against Streptococcus pneumoniae is recommended for all people 65 years of age or older. Pneumococcal conjugate vaccine is recommended for all newborns starting at 6 weeks - 2 months, according to American Academy of Pediatrics (AAP) recommendations. Routine vaccination with pneumococcal conjugate vaccine (PCV) is recommended for children age 2 and younger to help prevent infection from Streptococcus pneumoniae.
An association has been found between meningitis and cochlear implants for severe hearing loss. To help protect against meningitis from Streptococcus pneumoniae, experts recommend that people with cochlear implants get the pneumococcal conjugate vaccine (PCV). Also, some people with implants have ear infections before they get meningitis, so people with implants should receive prompt antibiotic treatment for ear infections.
Measles, mumps, and rubella viruses. The measles, mumps, and rubella (MMR) vaccine is routinely given to children between 12 months and 15 months of age and again at 4 to 6 years of age. According to conventional medical practitioners, the mumps vaccination has led to a sharp decline in mumps virus associated meningitis, which prior to vaccination occurred in 15 percent of all cases of mumps.
Varicella (chickenpox) virus. Two doses of the chickenpox vaccine are recommended for children, the first at 12 to 15 months and the second at 4 to 6 years old. Older children, teens, and adults who have not had chickenpox can also get immunized.
MoonDragon's Health & Wellness: Vaccination Information - Pros & Cons
NOTE: Investigate before you inoculate! Be an informed consumer about vaccinations before you or a member of your family gets them. Know the pros and cons to each vaccination and options available and make an informed decision about whether or not they should be given to you or a member of your family. Certain health conditions or pregnancy may be a contraindication for certain vaccinations. Research alternatives to conventional vaccinations. Vaccinations are not 100% reliable and there can be mild to serious adverse reactions in some sensitive individuals. The best prevention for any disease or ailment is to have a healthy immune system and to avoid infected individuals. Take precautions when exposed, such as proper handwashing techniques, hygiene, and positive lifestyle choices, such as good nutrition and avoiding exposure to toxic substances such as alcohol, tobacco, and recreational drugs. Discuss options and concerns with your conventional health care provider and your alternative health care practitioner about various choices available for your particular situation.
HolisticNetwork: Alternatives To Vaccinations By Keith Post, N.D.
World Health Center (WHC): Vaccination Risks & Alternatives
Holistic Pediatric Association: Alternatives To Vaccinations
REDUCING YOUR RISK
Some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease.
In cases of meningococcal meningitis, prophylactic treatment of close relatives with antibiotics (e.g. rifampicin, ciprofloxacin or ceftriaxone) may reduce the risk of further cases.
During birth, a mother can pass organisms that cause meningitis to her baby even if the mother does not have symptoms. Delivery a baby by cesarean section rather than through the birth canal does not always protect the baby from getting the infection. Both bacteria and viruses can be transmitted this way. Maintaining a healthy pregnancy and a healthy immune system free from the organisms known to cause meningitis is important for the mom and her baby. It is very important that the baby receives the colostrum and breastmilk from the mother after the birth to help reduce risks of infection and boost the baby's developing immune system.
RECOMMENDED MENINGITIS PREVENTION
You can take steps to reduce your risk of infection and prevent the spread of meningitis by:
- Separating people with meningitis from other people in the home.
Enteroviruses, the most common cause of viral meningitis, are most often spread through direct contact with respiratory secretions (e.g., saliva, sputum, or nasal mucus) of an infected person. This usually happens by shaking hands with an infected person or touching something they have handled, and then rubbing your own nose or mouth. The virus can also be found in the stool of persons who are infected. The virus is spread through this route mainly among small children who are not yet toilet trained. It can also be spread this way to adults changing the diapers of an infected infant. The incubation period for enteroviruses is usually between 3 and 7 days from the time you are infected until you develop symptoms. You can usually spread the virus to someone else beginning about 3 days after you are infected until about 10 days after you develop symptoms.
- Avoiding people who have meningitis.
The viruses that cause viral meningitis are contagious. Enteroviruses, for example, are very common during the summer and early fall, and many people are exposed to them. However, most infected persons either have no symptoms or develop only a cold or rash with low-grade fever. Only a small proportion of infected persons actually develop meningitis. Therefore, if you are around someone who has viral meningitis, you have a moderate chance of becoming infected, but a very small chance of developing meningitis.
Organisms can be passed from one person to another through kissing, sexual contact, or contact with infected blood. The human deficiency virus (HIV) also can cause meningitis and can be passed from the infected person to another person through blood or sexual contact, but not through kissing.
If you come in close contact with someone who has bacterial meningitis, taking antibiotics may keep you from getting the illness. For example, a person who has come in contact with the saliva or mucus of someone with meningitis caused by Neisseria meningitidis bacteria may be given the antibiotics ciprofloxacin, ceftriaxone, or rifampin. However, ciprofloxacin is not usually used in people younger than 16 years of age or in pregnant women. Rifampin also is not recommended for pregnant women. If you have only casual contact with someone who has meningitis, for example at school or at work, you do not need to take antibiotics.
- Washing your hands often if you have meningitis or are caring for someone with meningitis. Wash your hands after using the toilet or helping a sick child use the toilet, after changing a sick baby's diaper, and after handling used bed sheets, towels, clothes, or personal items of a person with meningitis.
Because most persons who are infected with enteroviruses do not become sick, it can be difficult to prevent the spread of the virus. However, adhering to good personal hygiene can help to reduce your chances of becoming infected. If you are in contact with someone who has viral meningitis, the most effective method of prevention is to wash your hands thoroughly and often.
MoonDragon's ObGyn Information: Handwashing Tips - Infection Control
Also, cleaning contaminated surfaces and soiled articles first with soap and water, and then disinfecting them with a dilute solution of chlorine-containing bleach (made by mixing approximately 1/4 cup of bleach with 1 gallon of water) can be a very effective way to inactivate the virus, especially in institutional settings such as child care centers. Hospital laboratories use a 10 percent bleach-water solution for disinfecting surfaces exposed to various microorganisms and to prevent cross-contamination of patient blood-tissue samples and to ensure accurate diagnostic test results.
- Avoiding insects and rodents that carry organisms that cause meningitis. If you live in or visit an area of the world where there are insects (such as mosquitoes and ticks) and rodents (such as mice and rats) that carry organisms that cause meningitis, take steps to avoid contact with them. The most common of these are arboviruses (including the St. Louis encephalitis and West Nile viruses), which are transmitted through dust and food contaminated by the urine of infected mice, hamsters, and rats. Use insect repellent and keep all rodents out of your home and other buildings.
COLOSTRUM & BREASTMILK PROTECTION
Breast-feeding may protect children ages 2 to 5 months (some sources state up to 6 months if the baby is totally breastfed from birth) against meningitis caused by Haemophilus influenzae type b (Hib) bacteria. However, according to the CDC, it is still important to give breast-fed babies the Hib vaccine.
RISKS OF INFECTION
Factors that may increase the risk for meningitis include:
- Genetics. Some people may inherit the tendency to get meningitis. If they come in contact with organisms that can cause the infection, they may be likely to get infected.
- Being male. Males get meningitis more often than females.
- Age. In general, babies, young children, young adults, and older adults are at highest risk of getting meningitis.
- Crowded living conditions. People in camps, schools, and college dormitories are more likely than others to get meningitis caused by organisms that can spread easily from one person to another. For example: College freshmen. Freshmen who live in dormitories have a slightly greater chance of getting meningitis compared with other people their age. However, the risk in college students overall is as low as in people their age who are not going to college.
- Children attending day care centers. Children who attend day care centers are more likely than other children to get meningitis caused by organisms that are easily spread through stool or contaminated hands or water.
- Exposure to insects and rodents. People who live in or visit areas of the world where insects or rodents carry organisms that cause meningitis risk getting the disease.
- Not getting the mumps (MMR). Haemophilus influenzae type b (Hib), and pneumococcal conjugate (PCV) immunizations before age 2.
- Being an older adult who has not gotten the pneumococcal polysaccharide (PPV) immunization and/or does not have a working spleen, which is part of the body's immune system.
- Travel to areas where meningitis is common. For example, people traveling to the "meningitis belt" in sub-Saharan Africa should receive the meningococcal vaccine.
Medical conditions that increase the risk of meningitis include:
- Poor overall health. People who are in poor health or have other medical conditions may be more likely to get meningitis because their bodies' natural defenses may be weak. For example, children who have sickle cell disease or cancer are at higher risk than other children.
- Having a birth defect of the skull, a head injury, or brain surgery.
- Undergoing treatment with a kidney dialysis machine.
- Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
- Being born to a mother infected with an organism that causes meningitis. Viruses such as the enteroviruses and herpes viruses, and some bacteria can be passed from an infected mother to a baby during birth.
- Having had meningitis in the past. Some people who have had meningitis are more likely than others to get it again. These include people with birth defects or injuries to their skull and face, impaired immune systems, or unexpected reactions to some medicines.
- Having a cochlear implant for severe hearing loss. A recent study indicates that children with cochlear implants have an increased risk for bacterial meningitis.
Children with cochlear implants to treat hearing loss have a greater risk of developing bacterial meningitis than children in the general population. A study conducted by the U.S. Centers for Disease Control & Prevention, the U.S. Food & Drug Administration, and state and local health departments, and published in The New England Journal of Medicine, found that children with a specific type of cochlear implant that had an extra piece called a positioner had 4.5 times the risk of developing meningitis compared to those who had other types of implants. It is possible that individuals who are candidates for implants may have factors that increase their risk of meningitis.
Diagnosis of meningitis is based on a medical history, a physical exam, and tests.
A health professional also may do the following tests to see if there are other causes for your symptoms:
- Blood tests (electrolytes, liver and kidney function, inflammatory markers and a complete blood count).
- Usually X-ray examination of the chest to check for lung infections.
- Urine test, to check for infection in the urinary tract.
- Blood culture, to check for infections.
- Biopsy of a skin rash.
- Computed tomography (CT scan) or magnetic resonance image (MRI), to look for swelling of brain tissue or for complications such as brain damage.
LUMBAR PUNCTURE (LP)
Your health care provider will almost always do a lumbar puncture test (also known as a spinal tap) if he or she thinks you have meningitis. A lumbar puncture takes samples of the fluid around the spine and brain, known as cerebral spinal fluid (CSF). A culture of the spinal fluid is done to check for organisms known to cause illness. It often takes several days to several weeks to get results from a spinal fluid culture. But other tests also can be done on the spinal fluid to determine which organism is causing the infection. The results of these tests may be ready before the results of a culture.
The most important test in identifying or ruling out meningitis is analysis of the cerebrospinal fluid (fluid that envelops the brain and the spinal cord) through lumbar puncture (LP). However, if the patient is at risk for a cerebral mass lesion or elevated intracranial pressure (recent head injury, a known immune system problem, localizing neurological signs, or evidence on examination of a raised ICP [intracranial pressure]), a lumbar puncture may be contraindicated because of the possibility of fatal brain herniation. In such cases a CT or MRI scan is generally performed prior to the lumbar puncture to exclude this possibility. Otherwise, the CT or MRI should be performed after the LP, with MRI preferred over CT due to its superiority in demonstrating areas of cerebral edema, ischemia, and meningeal inflammation.
During the lumbar puncture procedure, the opening pressure is measured. A pressure greater than 180 mm H2O is indicative of bacterial meningitis.
The cerebrospinal fluid (CSF) sample is examined for white blood cells (and which subtypes), red blood cells, protein content and glucose level. Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis; microbiological culture of the sample may still yield a causative organism. The type of white blood cell predominantly present predicts whether meningitis is due to bacterial or viral infection.
Other tests performed for bacterial or viral DNA on the CSF sample include:
- Latex agglutination test.
- Limulus lysates.
- Or polymerase chain reaction (PCR).
If the patient is immunocompromised, testing the CSF for toxoplasmosis, Epstein-Barr virus, cytomegalovirus, JC virus and fungal infection may be performed.
CSF FINDING IN DIFFERENT CONDITIONS
CONDITION GLUCOSE PROTEIN CELLS Acute Bacterial Meningitis Low High High, Often greater than 300/mm3 Acute Viral Meningitis Normal Normal or High Mononuclear, less than 300/mm3 Tuberculous Meningitis Low High Pleocytosis, Mixed, More than 300/mm3 Fungal Meningitis Low High More than 300/mm3 Malignant Meningitis Low High Usually Mononuclear Subarachnoid Hemorrhage Normal Normal, or High Erythrocytes
In bacterial meningitis, the CSF glucose to serum glucose ratio is less than 0.4. The Gram stain is positive in greater than 60 percent of cases, and culture in greater than 80 percent. Latex agglutination may be positive in meningitis due to Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, Group B Streptococci. Limulus lysates may be positive in Gram-negative meningitis.
Cultures are often negative if CSF is taken after the administration of antibiotics. In these patients, PCR can be helpful in arriving at a diagnosis. It has been suggested that CSF cortisol measurement may be helpful.
Aseptic meningitis refers to non-bacterial causes of meningitis and includes infective etiologies such as viruses and fungi, neoplastic etiologies such as carcinomatous and lymphomatous meningitis, inflammatory causes such as sarcoidosis (neurosarcoidosis) and chemical causes such as meningitis secondary to the intrathecal introduction of contrast media.
Although the term "viral meningitis" is often used in any patient with a mild meningeal illness with appropriate CSF findings, certain patients will present with clinical and CSF features of viral meningitis, yet ultimately be diagnosed with one of the other conditions categorized as "aseptic meningitis". This may be prevented by performing PCR or serology on CSF or blood for common viral causes of meningitis (enterovirus, herpes simplex virus 2 and mumps in those not vaccinated for this).
A related diagnostic and therapeutic conundrum is the "partially treated meningitis", i.e. meningitis symptoms in patients who have already been receiving antibiotics (such as for presumptive sinusitis). In these patients, CSF findings may resemble those of viral meningitis, but antibiotic treatment may need to be continued until there is definitive positive evidence of a viral cause (e.g. a positive enterovirus PCR).
The Bacterial Meningitis Score predicts reliably whether a child (older than two months) may have infectious meningitis. In children with at least 1 risk factor (positive CSF Gram stain, CSF absolute neutrophil count equal to or greater than 1000 cell/uL, CSF protein equal to or greater than 80 mg/dL, peripheral blood absolute neutrophil count equal to or greater than 10,000 cell/uL, history of seizure before or at presentation time) it had a sensitivity of 100 percent, specificity of 63.5 percent, and negative predictive value of 100 percent.
CONVENTIONAL MEDICAL TREATMENT
Treatment for meningitis depends on the organism causing the infection, your age, the extent of the infection, and the presence of other medical conditions or complications of meningitis.
Most people with viral meningitis usually start getting better within 3 days of feeling sick and recover within 2 weeks. However, it is important to see your health professional if symptoms of meningitis develop so that he or she can rule out bacterial meningitis, which is more serious. With mild cases of viral meningitis, you may only need home treatment, including fluids to prevent dehydration and medicine to control pain and fever. If you do not get better or if symptoms get worse, you may need further testing to check for other causes of illness.
Bacterial or severe viral meningitis may require treatment in a hospital, including:
A person who has severe meningitis may need to be treated in the intensive care unit (ICU) of a hospital. Health professionals watch the person closely and provide care if needed.
- Antibiotics. These medicines usually are given through a vein (intravenously, or IV) to treat meningitis. Antibiotics are given only when bacteria are causing the infection. Giving antibiotics when they are not needed may cause drug resistance.
- Measures to reduce pressure within the brain. If meningitis is causing pressure within the brain, corticosteroid medicines such as dexamethasone may be given to adults or children.
- Measures to reduce fever. Medicines such as acetaminophen (Tylenol), fluids, and good room ventilation reduce fever. If you have a high fever, you also may need a device such as a cooling pad placed on the bed.
- Measures to prevent seizures. If you have seizures, your surroundings will be kept quiet and calm. Medicines such as phenobarbital or dilantin can help stop seizures.
- Oxygen therapy. Oxygen may be given if you have trouble breathing and to increase the amount of oxygen in all parts of the body. Oxygen therapy helps to ease breathing and reduces the amount of work on the heart. Oxygen may be delivered by a hood or tent placed over the body, a face mask placed over the nose and mouth, a nose piece (nasal cannula) held loosely under the nose, or, in severe cases, a tube through the mouth into the trachea (windpipe). A pulse oximeter often is used to measure the amount of oxygen in the blood. In addition, if people are too sick to breathe on their own, they may need a machine called a ventilator to do their breathing for them.
- Monitoring fluids. You may need to drink extra liquids because infections increase the body's need for fluids. Increasing liquids also reduces the possibility of dehydration. Liquids are given into a vein (IV) if you have an infection and are vomiting or are not able to drink enough or for people who are too sick to drink liquids. Health professionals control the amount of fluids given because people with meningitis may develop problems if they have too much or not enough fluid.
- Monitoring blood chemicals. Frequent blood tests are done to measure essential body chemicals, such as sodium and sugar in the blood.
- Suctioning. Suctioning may be done to remove mucus from the bronchial tubes. A small plastic tube is inserted into the mouth or nose. The tube is attached to a machine that gently sucks out mucus. Other treatments, such as breathing exercises and massage, also can be used to remove mucus.
INITIAL TREATMENT FOR MENINGITIS
Meningitis is a life-threatening condition and treatment should not be delayed for confirmation if suspected. If a health care provider is present on scene then treatment should begin immediately with benzylpenicillin. High-flow oxygen should be administered as soon as possible, along with intravenous fluids if hypotensive or in shock.
Bacterial meningitis is a medical emergency and has a high mortality rate if untreated. All suspected cases, however mild, need emergency medical attention. Empiric antibiotics must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. Antibiotics started within 4 hours of lumbar puncture will not significantly affect lab results. Adjuvant treatment with corticosteroids reduces rates of mortality, severe hearing loss and neurological sequelae in adults, specifically when the causative agent is Pneumococcus.
AGE GROUP CAUSES Neonates Group B Streptococci
Infants Neisseria meningitidis
Children Neisseria meningitidis
Adults Streptococcus pneumoniae
The choice of antibiotic depends on local advice. In most of the developed world, the most common organisms involved are Streptococcus pneumoniae and Neisseria meningitidis:
- First line treatment in the UK is a third-generation cephalosporin (such as ceftriaxone or cefotaxime). In those under 3 years of age, over 50 years of age, or immunocompromised, ampicillin should be added to cover Listeria monocytogenes.
- In the U.S. and other countries with high levels of penicillin resistance, the first line choice of antibiotics is vancomycin and a carbapenem (such as meropenem).
- In sub-Saharan Africa, oily chloramphenicol or ceftriaxone are often used because only a single dose is needed in most cases.
Staphylococci and gram-negative bacilli are common infective agents in patients who have just had a neurosurgical procedure. Again, the choice of antibiotic depends on local patterns of infection:
- Cefotaxime and ceftriaxone remain good choices in many situations, but ceftazidime is used when Pseudomonas aeruginosa is a problem, and intraventricular vancomycin is used for those patients with intraventricular shunts because of high rates of staphylococcal infection.
- In patients with intracerebral prosthetic material (metal plates, electrodes or implants, etc.) then sometimes chloramphenicol is the only antibiotic that will adequately cover infection by Staphylococcus aureus (cephalosporins and carbapenems are inadequate under these circumstances).
Once the results of the CSF analysis are known along with the Gram-stain and culture, empiric therapy may be switched to therapy targeted to the specific causative organism and its sensitivities.
Neisseria meningitidis (Meningococcus) can usually be treated with a 7-day course of IV antibiotics:
- Penicillin-sensitive: Penicillin G or ampicillin.
- Penicillin-resistant: Ceftriaxone or cefotaxime.
- Prophylaxis for close contacts (contact with oral secretions): Rifampin 600 mg bid for 2 days (adults) or 10 mg/kg bid (children). Rifampin is not recommended in pregnancy and as such, these patients should be treated with single doses of ciprofloxacin, azithromycin, or ceftriaxone.
Streptococcus pneumoniae (Pneumococcus) can usually be treated with a 2-week course of IV antibiotics:
- Penicillin-sensitive: Penicillin G.
- Penicillin-intermediate: Ceftriaxone or cefotaxime.
- Penicillin-resistant: Ceftriaxone or cefotaxime + vancomycin.
Listeria monocytogenes is treated with a 3-week course of IV ampicillin + gentamicin. Gram negative bacilli: Ceftriaxone or cefotaxime. Pseudomonas aeruginosa: Ceftazidime. Staphylococcus aureus:
- Methicillin-sensitive: Nafcillin.
- Methicillin-resistant: Vancomycin.
Streptococcus agalactiae: Penicillin G or ampicillin. Haemophilus influenzae: Ceftriaxone or cefotaxime.
Patients diagnosed with mild viral meningitis may improve quickly enough to not require admission to a hospital, while others may be hospitalized for many more days for observation and supportive care. Overall, the illness is usually much less severe than bacterial meningitis.
Unlike bacteria, viruses cannot be killed by antibiotics. Drugs such as acyclovir may be employed if herpes virus infection is either suspected or demonstrated.
This form of meningitis is rare in otherwise healthy people but is a higher risk in those who have AIDS, other forms of immunodeficiency (an immune system that does not respond adequately to infections) and immunosuppression (immune system malfunction as a result of medical treatment). In AIDS, Cryptococcus neoformans is the most common cause of fungal meningitis; it requires Indian ink staining of the CSF sample for identification of this capsulated yeast. Fungal meningitis is treated with long courses of highly dosed antifungals.
There is no surgical treatment for meningitis.
PROGNOSIS & FOLLOW-UP CARE
Most healthy adults who have recovered from meningitis do not need follow-up care. However, adults who have existing medical conditions that make them more likely than others to develop long-term complications or get meningitis again should see their health professional after recovery. Babies and children treated for meningitis always need follow-up care after recovery and need to be checked for long-term complications such as hearing loss.
RECOVERY FROM MENINGITIS
The course of meningitis often depends on your age, general health, and the organism causing the infection. The illness can range from mild to severe.
Viral meningitis is more common in the late summer and early fall. It usually does not cause serious illness. However, it is important to see your health professional if symptoms of meningitis develop so that he or she can rule out bacterial meningitis, which is more serious. With mild cases of viral meningitis, you may need only home treatment and can recover within 2 weeks. However, some people may feel light-headed and tired for several months after the illness.
Bacterial meningitis occurs most often from late winter to early spring. It usually causes serious illness and can be life-threatening. The symptoms of bacterial meningitis usually develop suddenly and last for 2 to 3 weeks. A person with bacterial meningitis is treated with antibiotics in a hospital.
Home treatment usually is all that is needed for most people who have viral meningitis. It includes:
- Resting. Rest promotes healing and provides relief from symptoms such as headache. Quiet activities, such as reading books, playing board games, watching videos, or listening to music, help pass the time.
- Reducing fever. Sometimes no treatment is needed for fever. Cool washcloths to the forehead, cool baths, and medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Nuprin) can be used to reduce fever.
MoonDragon's Health & Wellness: Fever
- Relieving minor pain. Headache is a common symptom of meningitis. Some people also have muscle aches and pains. Minor pain usually can be relieved with medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Nuprin).
- Preventing dehydration. Common signs of dehydration include a dry, sticky mouth and urinating only small amounts of dark-colored urine. You can prevent dehydration by drinking extra liquids such as water, juices, teas, and rehydration drinks. Children may enjoy frozen juice bars or snow cones. If a person vomits, he or she needs to avoid solid food and take frequent small sips of water or other liquids.
MoonDragon's Health & Wellness: Dehydration
- Watching for signs of complications during illness. The most common complications include fever lasting for longer than expected and seizures. Some people with complications during illness may need to be treated in a hospital.
- Home treatment also is necessary after recovery. It is important to look for signs of long-term complications of meningitis, such as hearing loss.
Complications during illness and long-term complications are more common with bacterial than with viral meningitis. Newborns and young children with bacterial meningitis, people with impaired immune systems, and older adults with long-term medical conditions are more likely than others to develop immediate and/or long-term complications of meningitis.
RISK OF DEATH
People who have bacterial meningitis run the risk of death if they are not treated promptly. Newborns, children younger than 2, older adults, or people with weakened immune systems are at a greater risk of death than other people. The likelihood of death from bacterial meningitis in adults is highest in those who are older than 50, have seizures during the first 24 hours of illness, delay getting treatment, are in a coma when admitted to the hospital, are in shock, or cannot breathe without help from a machine. Most survivors recover completely.
Meningitis caused by Streptococcus pneumoniae is more likely to cause death than meningitis caused by other bacteria. Getting the pneumococcal conjugate vaccine (PCV) usually protects people from diseases (including meningitis) caused by most strains of the bacteria.
NEUROLOGICAL, AUDITORY, & INTELLECTUAL DISABILITIES IN CHILDREN
In children there are several potential disabilities which result from damage to the nervous system. These include sensorineural hearing loss, epilepsy, diffuse brain swelling, hydrocephalus, cerebral vein thrombosis, intra cerebral bleeding and cerebral palsy. Acute neurological complications may lead to adverse consequences. In childhood acute bacterial meningitis deafness is the most common serious complication. Sensorineural hearing loss often develops during the first few days of the illness as a result of inner ear dysfunction, but permanent deafness is rare and can be prevented by prompt treatment of meningitis.
Those who contract the disease during the neonatal period and those infected by S. pneumoniae and gram negative bacilli are at greater risk of developing neurological, auditory, or intellectual impairments or functionally important behavior or learning disorders which can manifest as poor school performance.
CNS COMPLICATIONS IN ADULTS
In adults central nervous system complications include brain infarction, brain swelling, hydrocephalus, intracerebral bleeding; systemic complications are dominated by septic shock, adult respiratory distress syndrome and disseminated intravascular coagulation. Those who have underlying predisposing conditions e.g. head injury may develop recurrent meningitis. Case-fatality ratio is highest for gram-negative etiology and lowest for meningitis caused by H. influenzae (also a gram negative bacilli). Fatal outcome in patients over 60 years of age is more likely to be from systemic complications e.g. pneumonia, sepsis, cardio-respiratory failure; however in younger individuals it is usually associated with neurological complications. Age more than 60, low Glasgow coma scale at presentation and seizure within 24 hours increase the risk of death among community acquired meningitis.
HERBAL & HOLISTIC RECOMMENDATIONS
The recommendations in this section are designed to support medical treatment, not replace it. Meningitis can progress very quickly and become life threatening in a matter of 24 hours for adults, much less for children. If untreated, this disease can cause permanent brain damage and paralysis, even coma and death.
Diagnosis of meningitis requires microscopic analysis and culture of the cerebralspinal fluid.
If there are no complications, recovery from viral meningitis generally takes 3 weeks under a health practitioner's care.
Antibiotics do not fight viruses, so they are not appropriate treatment for viral meningitis. Only strains of bacterial meningitis can be treated with antibiotics.
For bacterial meningitis, aggressive treatment with antibiotics is necessary. For viral meningitis, antibiotics are ineffective and therefore inappropriate. If meningitis is caused by a fungal infection, treatment with antifungal medication is used.
Antibiotics may be prescribed as a preventive measure for those who have been in close contact with a person who has bacterial meningitis.
It is wise to seek prompt treatment for a bacterial infection anywhere in the body, such as strep throat or an ear infection.
Adults tend to be immune to H. influenza type B, and the Hib vaccine is recommended to protect most young children. However, if you have been in close contact with someone who has this infection, you may need to see your health care provider to inquire about antibiotic treatment.
The long-term use of antibiotics often leads to candida infection. If you must take antibiotics, it is wise to take some form of acidophilus because antibiotics kill "friendly" bacteria along with "unfriendly" bacteria.
Corticosteroids may be prescribed to reduce inflammation. Anti-nausea and strong pain medication may also be needed.
If you are a parent contemplating the placement of a cochlear implant in your child, discuss with your health care provider all of the potential risks and benefits, and whether or not the child has certain medical conditions that might make meningitis more likely. If you opt for the implant, consider making sure your child is up to date on vaccines at least 2 weeks before the procedure. If the implant has already been done, check with the child's health care provider to ensure that vaccines are updated. Conventional medicine states that the current vaccines protect against the most common strains of meningitis-causing bacteria, but not all. Watch for possible signs and symptoms of meningitis such as high fever, headache, stiff neck, nausea or vomiting, discomfort looking into bright lights, sleepiness, or confusion. A young child or infant may be sleepy, cranky, or eat less. Also watch for signs of infection, which can include ear pain, fever, and decreased appetite. Seek prompt medical attention for these symptoms.
FOR MORE INFORMATION
NIM-NIH: Patient Education Tutorials: Meningitis
MFA - Meningitis Foundation of America
Meningitis Research Foundation: Understand Meningitis & Septicemia
For fever, use Catnip tea enemas. Catnip tea is also good for sipping and is soothing for children.
MoonDragon's Health Therapy: Enemas
MoonDragon's Health Therapy: Catnip Enema
Echinacea boosts the immune system and is an immune enhancer.
Herbal Remedies: Echinacea Tincture For Children, Orange Flavor, Alcohol Free, 100% Organic, 1 fl. oz.
Echinacea is well-accepted and respected as a primary immune stimulating and strengthening herb. It is known to enhance the production and release of the body's own white blood cells, the immune cells. This encourages a quick and effective response to both bacterial and viral infections. ChildLife's great tasting Echinacea can provide extra support at the first sign of colds, flu, sore throats, upper respiratory symptoms, sinusitis, and ear infections. Periodic use, especially during the winter months, may increase the overall strength of your child's natural defense system. See product label for specific and safe instructions for use. ChildLife's Echinacea is the only standardized echinacea formulated especially for children. This means that each bottle consistently contains the optimum levels of active ingredients. It is alcohol - free, organically grown and flavored with natural sweet orange essence.
Herbal Remedies: Echinacea Information
Herbal Remedies: Echinacea Root Supplements & Products
Goldenseal is a natural antibiotic. Take 1/2 dropperful of alcohol-free goldenseal extract three times a day for one week or as instructed on product label. It can be taken under the tongue for fast results or added to tea. Caution: Do not take goldenseal internally on a daily basis for more than one week at a time, do not use it in large quantities during pregnancy, and use it with caution if you are allergic to ragweed.
Herbal Remedies: Echinacea & Goldenseal Tincture, Nature's Way, Alcohol Free, 1 fl. oz.
Echinacea & Goldenseal Tincture promotes well being during cold and flu season, and supports the immune system, it is combined with other herbs traditionally used for the same purpose and to promote general well being.
Herbal Remedies: Goldenseal Information
Herbal Remedies: Goldenseal Supplements & Products
Olive Leaf extract helps fight viral infections.
Herbal Remedies: Olive Leaf Herb, Nature's Way, 470 mg, 100 Caps
Europeans have used olive leaf herb for centuries for it's natural benefits. Traditionally grown in the Mediterranean regions of Europe and the Middle East, the olive tree has been used extensively as a source of food, flavoring and oil. - Olive Leaf Contains natural amounts of Olueropein. Recently, numerous new studies have shown its benefit as an herbal supplement. Dose Recommendation: In addition to the daily diet, take 3 capsules 2 - 3 times daily with water or food.
Herbal Remedies: Bio Defender, Antibacterial, Antiviral & Antifungal Formula, Balanceuticals, 56 Caps
This unique antibacterial, antiviral and antifungal formula is a clinical nutritionist response to bio terrorism such as anthrax. Its ingredients are well documented in peer-reviewed research reports as shown below. The synergistic effects make it a powerful formulation to boost the body's natural defense. It destroys virus, fungus and pathogenic bacteria without hurting the good ones. Bio Defender is researched and formulated by Dr. Arthur Fierro, DC, DACBN, FACCN © 2005 Patent Pending.
- Monolaurin - An oil found naturally in mother's milk and coconuts. It has the ability to dissolve a bacteria/virus outer protective membrane. Isaacs C.E, Thorner, H.: Membrane Disruptive Effects of Human Milk: Inactivation of enveloped viruses. J. Infectious Diseases 1986;154:996-971
- Extract of Olive Leaf - A compound found in olive leaves that splits bacteria and viruses DNA, preventing it from reproducing and spreading its disease. Bisignano, G., et. al: In vitro antimicrobial Activity of Oleuropein. J. Pharmacology 1999 Aug:51(8):971-4 IP6 - inositol hexaphosphate. IP6 effectively blocks bacteria and viruses main source of energy: iron. IP6 "starves" them to death. Berridge, MJ, Irvine, RF Inosital phosphates and cell signaling - 1987: Nature 314:197-205
- Beta 1, 3 Glucan - made from purified yeast and thought to be the most powerful "activator" to mobilize our own immune system to "go on the attack". Czopjk, Austen, KF: A b-glucan inhibitable receptor on human monocytes; Its identity with phagocytic receptor for particular activators of alternate complement pathways. J. Immunology 1985;134:2588-2593
- Colostrum or "first milk" is from mothers' milk. It builds our immune system by supplying the immuloglobulins IgA, IgG, and IgM. Zoltan Rona: Clinical Applications: Bovine Colostrum as Immune System Modulators The Am. J. of Natural Medicine March, 1998 No2 p 19-23.
- MSM - Methysulfonylmethane is found in mothers' milk, fruits and vegetables. MSM has many health benefits. In fighting bacteria and viruses it provides natural sulfur, the specific antioxidant that protects our white blood cells. Herschler, RJ Methylsulfonylmethane and Methods of Use Am Academ. Science 1983 (411)
- Calcium Phytate - In this formula, calcium in the Phytate form serves two purposes: to raise the body's pH to an alkaline state. Bacteria and viruses do not thrive in an alkaline environment. This form of calcium acts as a substrate for the construction of new DNA E. Neumann,.S. Kakorin, et. al.: Calcium Mediated DNA Adsorption to yeast cells and kinetics of cell transformation by electroporation - Biophysical Journal Vol 71:868-877 1996
Other natural antibacterials, antivirals, antifungals and antioxidants: Alpha Lipoic Acid, N-acetyl-cysteine, Echinacea, zinc, DMG, glutathione, Neem Leaf Extract, garlic and Golden Seal.
The following is a partial list of bacteria, viruses and fungi that have been shown in the literature to be effectively destroyed with the ingredients found in Bio-Defender:
- Influenza (The Flu), Strep (Strep Throat), Mononucleosis Staph, Measles (Rubella), Botulism (Food poisoning), Conjunctivitis Cold sores (Herpes Simplex), Tinea Curis (Jock itch), Diarrheal problems, Otitis Media (Ear Infections), Ringworm, Chicken Pox, Klebsiela, Anthrax, Athlete's Foot (Tinea Pedis), Yersinia, Pestus (Plague), Listeria, Epstein-Barr Virus, Helicobacter pylori, Candidiasis
Suggested Dosage: Take 4 capsules a day: 2 in the morning, 2 in the evening. Anyone over the age of 5 who is feeling ill from any virus, bacteria or fungal infection. Anyone who is immune compromised and wants preventive measures. Children under the age of 5 should not take this as it contains nutrients that may not appropriate for them. This product is not recommended for anyone who is under the age of 5 because there are not enough studies about providing children with immunoglobulins IgG and IgA as in the colostrum. Additionally pregnant women should not take BioDefender. There are no statistics showing any contraindications for pregnancy but you do not want to take the chance. Take Bio-Defender at the first sign of illness. If you have been ill for a few weeks or more, start on Bio-Defender as soon as possible. This is a natural product and can be taken for another few weeks, if needed once symptoms subside. If you are still ill, you should be evaluated by your health care provider. Although you can continue on this supplement, it was not meant to be taken as a preventive supplement. Take supplements when you need them. If your health care provider advises you to do so, you may double the dosage for 3 to 4 days to get a larger quantity of BioDefender nutrients into your body. You should not need to purchase more or less supplement than you need. Taking 4 capsules a day for 2 weeks is 56 capsules. This prevents unnecessary storage of unused product. If you can't take pills or capsules, the capsules can be opened up and sprinkled on or in food or drink.
St. John's Wort is good for viral infection.
Herbal Remedies: St. John's Wort Tincture, Alcohol-Free, 1 fl. oz.
St. John's Wort promotes a positive mood and extracts of St. John's Wort have been proven in many clinical studies in Europe, to have antidepressant effects, and is widely used for this reason. St. John's Wort is a great anti-depressant and mood elevator. For comparison sake, 21 drops of this tincture equates to a 300 mg capsule at 0.3% hypericin. Also is a nerve sedative, regenerates tissue and has anti-viral properties. Dosage Directions: Shake well. Use 6-12 drops in juice, water, under the tongue or as desired. May be taken 3 times daily. Shake well. Store in cool dark place. Keep out of reach of children. Refrigerate after opening. Warnings: If using a prescription antidepressant, MAO-inhibitors, SSRI's, and drugs containing fen-fluramine should consult a health care provider before taking this product. Avoid excessive exposure to UV radiation when using this product. No recommended for use by pregnant or lactating women.
Herbal Remedies: St. John's Wort Information
Herbal Remedies: St. John's Wort Supplements & Products
If you develop symptoms characteristic of meningitis, see a health care provider or go to the emergency room of the nearest hospital immediately.
Avoid drinking out of the same glass or container as someone else, and avoid sharing cigarettes, food, lipstick, and eating utensils.
Avoid heavy use of alcohol.
Avoid passive smoking (second hand smoke).
Avoid aspirin, which increases bleeding tendencies.
Once the acute phase of the illness has passed and recovery has begun, eat a well-balanced diet including fresh fruits and vegetables (50 percent of them raw), grains, nuts, seeds and yogurt and other soured products.
If antibiotics are prescribed, be sure to take some form of acidophilus supplement daily and include yogurt products in your diet daily.
Herbal Remedies: Acidophilus Supplement Powder, Non-Dairy, 3 oz. Bulk
Herbal Remedies: Acidophilus, 3 Billion, NOW Foods, 90 Tabs
Herbal Remedies: Lactobacillus Acidophilus Supplement, Non-Dairy, 100 Caps
Herbal Remedies: Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose Free, Apple Strawberry Flavor, Dynamic Health, 16 fl. oz.
Nutrition Recipes: Homemade Yogurt
Consume fresh pineapple and papaya frequently. Pineapple reduces inflammation; papaya is good for digestion. Only the fresh forms are effective.
Avoid the following foods, which encourage the formation of mucus: animal protein and its by-products, caffeine, dairy products (except for yogurt or kefir), processed foods, salt, sugar, and white flour products.
Rest in bed in a dimly lit room. Get plenty of rest for a good recovery. Drink plenty of high quality liquids.
Take cool sponge baths.
Unless otherwise specified, the dosages recommended here are for adults. For a child between the ages of 12 and 17 years, reduce the dose to 3/4 the recommended amount. For a child between the ages of 6 and 12, use 1/2 the recommended dose, and for a child under the age of 6, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Helpful Acidophilus As directed on label. Take on an empty stomach. Needed to replenish essential friendly bacteria antibiotics destroy. Use a non-dairy formula.
Acidophilus Supplement Powder, Non-Dairy, 3 oz. Bulk,
Acidophilus, 3 Billion, NOW Foods, 90 Tabs,
Lactobacillus Acidophilus Supplement, Non-Dairy, 100 Caps,
Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose Free, Apple Strawberry Flavor, Dynamic Health, 16 fl. oz.,
Colloidal Silver As directed on the label. Taken internally, is effective against may disease-causing organisms. Also has anti-fungal properties.
Colloidal Silver, Trace Minerals, 8 fl .oz.,
Colloidal Silver Liquid, SilvaSolution, 10 ppm, 16 fl. oz.,
Colloidal Silver Liquid, SilvaSolution, Super Strength Pro 50, 8 fl. oz.,
Colloidal Silver Pump Spray, SilvaSolution, 2 fl. oz.,
Colloidal Silver Salve, SilvaSolution, 2 oz.
Dimethylglycine (DMG) 125 mg twice daily. Carries oxygen to the cells relieving many symptoms. Use a sublingual form, if available.
DMG Supplement N,N Dimethyl Glycine, NOW Foods, 125 mg, 100 Caps
As directed on label. A potent antibacterial, antifungal, and antiviral agent. Free Form Amino Acid Complex As directed on label. Needed for tissue repair and protection of membranes.
Amino 1000 Complete Blend, 20 Essential & Non-Essential Amino Acids, NOW Foods, 120 Caps,
Amino 1500 Complete Chewable Blend, 20 Essential & Non-Essential Amino Acids, Predigested, NOW Foods, 150 Tabs,
Garlic (Kyolic) 2-3 fresh cloves or 2 capsules 3 times daily, with meals. A powerful immune system stimulant. Acts as a natural antibiotic.
Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz.,
Garlic Bulb Cloves, Garlic Supplement, Nature's Way, 580 mg, 100 Caps,
Odorless Garlic Supplement, NOW Foods, 50 mg, 250 SoftGels,
Garlic Supplement, Kwai, Triple Concentrated, 180 Tabs,
Every Day Garlic Supplement, Kwai, 30 Tabs,
Garlic Tincture, 100% Organic, 2 fl. oz.,
Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic Supplements, 300 Caps,
Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz.,
Kyolic Aged Garlic Extract, One-A-Day, Vegetarian, 1000 mg, Wakunaga Kyolic, 30 Caps,
Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 Caps
GE-132 As directed on label. An antioxidant and immune stimulator. Maitake
As directed on label.
As directed on label.
As directed on label.
To help to build immunity and fight viral infection.
Mushroom Master 3 Mushroom Tincture, Red Reishi, Shiitake & Maitake Mushroom Extracts, Herbal Remedies USA, 2 fl. oz.,
Reishi Mushroom, Whole, 100% Organic, 4 oz.,
Shiitake Mushroom, Whole, 100% Organic, 4 oz.,
Maitake Mushroom, Whole, 100% Organic, 4 oz.
Multi-Vitamin & Mineral Complex As directed on label. All nutrients are needed for tissue protection and healing. Use a high potency formula.
Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption),
Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply)
As directed on label 2-3 times daily, between meals and at bedtime. To aid protein digestion and reduce inflammation.
Pancreatin 4X, NOW Foods, 500 mg, 100 Caps,
Bromelain 2000 GDU Supplement, NOW Foods, 500 mg, 90 Tabs,
MetabolicZyme (Hypoallergenic), Allergy Research Group / Nutricology, 900 Tabs,
Plant Enzymes, NOW Foods, Vegetarian, 120 VCaps,
Enzymes, All Complete, 250 mg, 90 Caps
Raw Thymus Glandular 500 mg twice daily. Enhances immune response. See Gland Therapy.
Thymus Organic Glandular (Hypoallergenic), Allergy Research Group/Nutricology, 75 Caps
As directed on label. An important antioxidant and immune system regulator necessary for white blood cell activation and neurological function. Use the liquid or sublingual form.
Taurine, Free Form, NOW Foods, 500 mg, 100 Caps,
Taurine, Double Strength, Free Form Amino Acid, NOW Foods, 1000 mg, 100 Caps,
Vitamin A 50,000 IU daily (Emulsion Form). Capsule Form: 25,000 IU daily for 7 days, then reduce to 15,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily. A powerful antioxidant and immune booster. Needed for protection and healing of all membranes. Emulsion form recommended for easier assimilation and greater safety at high doses.
Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels
25,000 IU daily. Important antioxidants.
Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
Vitamin C With Bioflavonoids 3,000-10,000 mg daily, in divided doses. Reduces infection and aids in cleansing the bloodstream.
Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps,
The Right C, Nature's Way, 1000 mg, 120 Tabs
Zinc 1 15-mg lozenge 3 times daily. Do not exceed 100 mg daily from all supplements. Important in all enzyme systems and tissue repair. Very important for the immune system and acts as immune system booster.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges,
Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges,
Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
MENINGITIS & SPINAL MENINGITIS DISEASE SUPPLEMENTS
Information, supplements and products for meningitis, an infection of the three membranes (called the meninges) that lie between the brain and skull, and sometimes, the membranes covering the spinal cord. Spinal meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain.
AHCC (Active Hexose Correlated Compound), NOW Foods, Vegetarian, 500 mg, 60 VCaps
NOW Foods AHCC is a rich source of polysaccharides such as beta glucan 1,3 and activated hemicellulose produced by enzymatic modification of organic medicinal mushrooms, including shiitake.
AHCC (Active Hexose Correlated Compound), NOW Foods, Vegetarian, 750 mg, 60 Caps
AHCC (Active Hexose Correlated Compound) is a proprietary extract produced from specially cultivated and hybridized mushrooms. AHCC supports immune system function through its effects on macrophages and NK (Natural Killer) Cells. NK cells and the intercellular mediators they produce are critical for the maintenance of healthy cell cycle function. AHCC has also been shown to possess antioxidant properties, and supports healthy liver function.
AHCC, 100% Pure Powder, NOW Foods, 2 oz.
AHCC (Active Hexose Correlated Compound) is a proprietary extract produced from specially cultivated and hybridized mushrooms. According to extensive research in humans, as well as numerous non-clinical studies, AHCC supports immune system function through its effects on macrophages and NK (Natural Killer) Cells.
Alive! Whole Food Multi-Vitamin & Mineral With Naturally Occurring Iron (No Iron Added), Nature's Way, 90 VCaps
No other supplement contains more life-giving nutrients than Nature's Way Alive Multi-Vitamin. Alive Multi-Vitamin is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands.
Alive! Whole Food Energizer, Multi-Vitamin & Mineral With Naturally Occurring Iron (No Iron Added), Nature's Way, 90 Tablets
No other supplement contains more life-giving nutrients than Nature's Way Alive Multi-Vitamin. Alive Multi-Vitamin is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands.
Bio Defender, Antibacterial, Antiviral & Antifungal Formula, Balanceuticals, 56 Caps
This unique antibacterial, antiviral and antifungal formula is a clinical nutritionist response to bio terrorism such as anthrax.
Bird Flu Tincture, Alternative Health & Herbs, 2 fl. oz.
Elderberry has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have anti-viral activity against influenza and herpes simplex.
Blue Cohosh (Caulophyllum thalictroides) Tincture, 100% Organic, 2 fl. oz.
Blue Cohosh supplements are used to regulate the menstrual flow and for treating suppressed menstruation.
Colloidal Silver Generator Kit, 1 Each
Colloidal Silver Generator is used to make your own colloidal silver, a natural suspended liquid silver supplement, at a low cost.
Colloidal Silver, Liquid Silver Homeopathic Formula, SilvaSolution Advanced Immune System Activator For Colds and Flu, 8 fl. oz.
TriMedica SilvaSolution Advanced Liquid Silver Homeopathic Formula integrates the basic principles of homeopathy and is a profound healing system designed to increase the body's ability to respond to immune challenges and restore optimal health.
Colloidal Silver Liquid, SilvaSolution, 10 ppm, 16 fl. oz.
Colloidal Silver is a potent yet non-toxic natural food supplement that has shown to support the immune system during the cold and flu season.
Colloidal Silver Liquid, SilvaSolution Super Strength Pro 50, 8 fl. oz.
Colloidal Silver Super Strength Liquid provides for a strong immune system, ears, sinuses, throat and lung support for the winter season.
Colloidal Silver Lotion, SilvaSolution, Homeopathic, 4 fl. oz.
Effective for minor skin irritations, rashes, hives, insect bites, sores, burns, inflammation, skin swelling, and dry, itchy, cracked skin.
Colloidal Silver Salve, SilvaSolution, 2 oz.
SilvaSolution Colloidal Silver Salve now contains added homeopathics that add a benefit that will enhance the SilvaSolutions effectiveness.
Colloidal Silver, Trace Minerals, 8 fl. oz.
Trace Minerals Super Oxygenated Pure Colloidal Silver Supplement is in a Fast Absorbing Liquid Formula. Colloidal Silver is a dietary supplement with over 30 ppm per dose of pure Colloidal Silver.
Colloidal Silver & Zinc Lozenges, SilvaSolution, 90 Lozenges
Now you can get powerful liquid silver in the most convenient form ever with new SilvaSolution Silver and Zinc Lozenges.
Colon & Liver Cleanser, Truman's CAC Tea, Loose Leaf, 1/2 lb.
Use of this cleansing tea has many additional benefits: improves overall digestion; strengthens the immunity; helps to prevent cancer; makes the skin more emollient and flexible: clears the eyes; and provides an overall tonic effect on the body.
Colon & Liver Cleanser, CAC Liquid, 16 fl. oz.
CAC liquid is a colon and liver cleanser and detoxifier as well as a blood cleanser that serves to regulate the bowel movements so that the stool is so soft it breaks up into a cloud.
DMG Supplement, N,N Dimethyl Glycine, NOW Foods, 125 mg, 100 Caps
NOW Foods' DMG Supplement is a methylated amino acid found in all cells. DMG is an antioxidant and methyl donor that has a number of beneficial effects. It has shown to have potential in increasing immune response to the flu and salmonella.
Echinacea Herb, Nature's Way, 400 mg, 180 Caps
Echinacea herb supports the immune system and promotes general well-being in cold and flu season.
Echinacea Root Tincture, 100% Organic, 2 fl. oz.
Echinacea Root is also known as Purple Coneflower and considered very valuable by the North American Indians.
5 Mushroom Formula, 100% Natural Immune System Supplement, 475 mg, 90 VCaps
5 Mushroom Formula is the most powerful "all mushroom" immune formula on the market, blending five premium quality extracts with Maitake Gold 404, Dr. Namba's patented extract.
Garlicin CF, Cold & Flu Formula, Odor-Free Garlic, Nature's way, 404 mg, 90 Enteric Coated Tabs
Garlicin CF Odor Free Garlic Immune Support Formula combines all the healthy benefits of high allicin release Garlicin with the added benefits of Echinacea, Ester-C, and OptiZinc.
Garlicin HC, Healthy Circulation Formula With Odor Free Garlic Supplement, Nature's Way, 90 Enteric Coated Tabs
Garlicin HC garlic supplement supports cardiovascular health with the help of hawthorn, cayenne and vitamin E.
Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz.
Garlic oil is often used to soothe the ear and as an antibiotic but most often used as a food and herb and also to lower serum cholesterol and blood pressure and to improve circulation as well as possibly inhibiting the growth of ulcer causing bacteria.
Goldenseal Herb, Nature's Way, 400 mg, 180 Caps
Goldenseal herb (hydrastis canadensis), a perennial wild native American herb, is also called Yellow Root. Native Americans used Goldenseal both internally and externally and also derived a dye from the root. Golden Seal is a very important traditional herb.
Goldenseal Root Tincture (Hydrastix canadensis), 100% Organic 2 fl. oz.
Goldenseal is an antibacterial and antiseptic. Use especially when mucus turns thick and discolored. Use short term only with other herbs.
Immune System Formula Tincture, 2 fl. oz.
The Immune System Formula can be used for AIDS, Autoimmune Diseases and Cancer.
Lymphatic Glands Formula Tincture, 2 fl. oz.
Helps the lymphatic glands cleanse the body of its wastes. May be used as a preventative and for acute conditions.
Multi-Mineral Optimum Complex, Nature's Way, 100 Caps
Nature's Way Multi-Mineral Optimum Complex offers a complete carefully dosed blend of minerals vital to the body. This multi Mineral Optimum Complex provides nutritional support for normal bone development, muscle function, reproduction and metabolism.
Multi-Vitamin & Multi-Mineral, Baby & Children's Liquid, Childlife, 8 fl. oz.
Children's liquid Multi-Vitamin & Multi-Mineral formula provides the optimal dosage of all the essential vitamins and minerals with trace elements for infants and children of all ages and it tastes great!
Nerves & Tension Tincture, 2 fl. oz.
To soothe the nervous system, which may help reduce stress and benefit Hyperactivity/Hyperkinetic, Mental Fatigue, Migraine Headache, Muscular Problems (aches, pain & spasms) Nervous Disorders, Neuralgia, Palsy, Parkinson's Disease, Schizophrenia, Spasms, Stress, and Tension among other things.
Olive Leaf Extract, Standardized, Nature's Way, 500 mg, 60 Caps
Nature's Way Standardized Olive Leaf extract is a technically advanced herbal product. Standardization assures specific measurable levels of important compounds that provide beneficial activity in the body.
Olive Leaf With Echinacea & Vitamin C, 100 Caps
Olive Leaf with Echinacea and Vitamin C represents the powerful synergy of current scientific research and traditional herbal medicine.
Shiitake & Maitake Extract (Standardized), 200 mg, 60 Caps
Nature's Way Shiitake and Maitake extract is formulated in a base of Oat powder standardized to a total of 8 percent beta glucan, the polysaccharide to which most of the health benefits are attributed.
Silver Biotics Liquid, Silver Supplement, 8 fl. oz.
Silver Biotics was tested by researchers and was found to kill every strain of bacteria that it was tested against and that these bacteria, many of which have become resistant to antibiotics, cause many human ailments.
Spleen & Pancreas Formula Tincture, 2 fl. oz.
Use the Spleen & Pancreas Formula to strengthen and nourish the spleen and pancreas naturally.
St. John's Wort, Perika, 300 mg, 60 Tabs
Nature's Way St. John's Wort is scientifically advanced to maintain a healthy emotional outlook.
Vitamin C Complex Powder, NOW Foods, Vegetarian Formula, 8 oz.
This Vitamin C Complex Powder is formulated with buffered Calcium Ascorbate for acid-sensitive individuals.
Vitamin C Liquid For Baby & Children, 4 fl. oz.
Vitamin C is known as a principal anti-oxidant, the need for which is greatly increased in infants and children due to today's elevated environmental stresses and pollution.
Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.
Zinc Lozenges With Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges
Nature's Way Zinc lozenge boosts cold season defense with zinc, widely recognized as an important nutritional support during the cold season, and echinacea pupurea, clinically shown to support the immune system, and Vitamin C, a vitally important vitamin for general health maintenance.
HerbalRemedies: Spinal Meningitis Information
HerbalRemedies: Spinal Meningitis Supplements & Products
HerbalRemedies: Meningitis Information
HerbalRemedies: Meningitis Supplements & Products
NOTIFY YOUR HEALTH CARE PROVIDER IF...
Watch for possible signs and symptoms of meningitis such as high fever, headache, stiff neck, nausea or vomiting, discomfort looking into bright lights, sleepiness, or confusion. A young child or infant may be sleepy, cranky, or eat less. Also watch for signs of infection, which can include ear pain, fever, and decreased appetite. Seek prompt medical attention for these symptoms.
You have any symptoms or an increase of symptoms or other signs of inflammation or infection.
You have any unexpected or unusual symptoms. Some people may have sensitivity, allergies, or other health conditions which would prevent them from using certain antibiotics, medications or treatments.
Call 9-1-1 or other emergency services immediately if:
Call your health professional immediately if:
- You or your child has symptoms of severe meningitis, such as fever, seizures, and confusion.
- Your baby has signs of severe meningitis such as trouble breathing or fever with a bulging soft spot on the head not caused by crying.
- You or your child has symptoms or signs of meningitis, such as severe and persistent headache, stiff neck, fever, rash, nausea, and vomiting.
- You or your child has viral meningitis and does not get better with home treatment after 3 days.
- You or your child is being treated for viral meningitis and develops signs of complications during illness (for example, a fever that lasts longer than 3 full days and does not go down during home treatment).
- Your baby has a fever that comes and goes, diarrhea, vomiting, swollen abdomen, and a shrill cry.
Call a health professional promptly if you believe you may have been exposed to meningitis. You can be treated with antibiotics, which may keep you from getting the illness.
Watchful waiting is a period of time during which you and your health care provider observe your symptoms or condition without using medical treatment. Bacterial meningitis, especially in a newborn, is a medical emergency. Watchful waiting is not appropriate if you think that you or your child has meningitis, especially because you will not know whether the infection is bacterial or viral. Call your health care provider as soon as symptoms or signs appear.
The following health professionals can diagnose and treat meningitis:
- Family medicine practitioner.
- Emergency room practitioner.
- Pediatric nurse practitioner or family nurse practitioner.
- Physician assistant.
Specialists may be needed to treat meningitis, especially if complications develop:
- Infectious disease specialist.
Meningitis Foundation of America
6610 North Shadeland Avenue
Indianapolis, IN 46220
Phone: 1-800-668-1129 or (317) 595-6395
Web Address: www.musa.org
This organization helps support people who have had meningitis and their families. Its Web site contains information about diagnosis and treatment. The Meningitis Foundation of America also supports the development of vaccines and other means of preventing the illness.
MUMS: National Parent-to-Parent Network
150 Custer Court
Green Bay, WI 54301-1243
Phone: 1-877-336-5333 (Parents Only) Toll-Free or (920) 336-5333
Fax: (920) 339-0995
Web Address: www.netnet.net/mums
MUMS is a national parent-to-parent organization for parents or caregivers of a child with any disability, rare or common disorder, chromosomal abnormality, or health condition. The organization's main purpose is to provide support to parents in the form of a networking system that matches them with other parents whose children have the same or a similar condition.
National Meningitis Association
738 Robinson Farms Drive
Marietta, GA 30068
Phone: 1-866-FONE-NMA (1-866-366-3662) Toll-Free
Web Address: www.nmaus.org
The National Meningitis Association (NMA) is a nonprofit group founded by five parents whose children have died or suffered long-term disabilities from meningococcal meningitis, a type of bacterial meningitis. The NMA educates families, medical professionals, and others about how to prevent bacterial meningitis.
U.S. Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, GA 30333
Phone: 1-800-311-3435 (Public Inquiries)
(404) 639-3534 (Public Inquiries)
TDD: (404) 639-3312
Web Address: www.cdc.gov
The Web site for the U.S. Centers for Disease Control and Prevention (CDC) provides health information for the public. The CDC is the leading federal agency for protecting U.S. citizens' health and safety by promoting health and by providing credible health information.
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