Meningitis is an infection caused by the inflammation of the meninges, a membrane covering the brain
and spinal cord. It can be caused by a virus or bacteria, and death can result in a matter
of hours if untreated. Acute illness may settle down into a chronic state and may lead to
serious brain damage. Meningitis is a disease that parents fear the most, and with 50% of
the cases occurring in children under five, it's easy to see why. It's encouraged that
parents familiarise themselves with the symptoms so that they can spot any of the tell-tale
signs straightaway and get urgent medical help.
There are two types of meningitis, viral and bacterial. With viral meningitis, it can be
caused by a variety of viruses and infections and can be spread through coughing, sneezing,
poor hygiene, and sewage-polluted water. It is the more common and less life-threatening.
Viral meningitis has the following symptoms: Headache, fever, drowsiness. Rarely it can
lead to deep coma, and serious cases can show muscle weakness, paralysis, speech problems,
vision problems, and epileptic fits. Bacterial meningitis is caused by different types of
bacteria found naturally in the back of the nose and throat in one in 10 people. They
could be spread by prolonged contact with coughing, sneezing, kissing. Sometimes bacteria
can cause blood poisoning or septicaemia, and it's a medical emergency that needs immediate
treatment with antibiotics.
The symptoms of bacterial meningitis include flu-like symptoms which can delay treatment,
a rash of tiny blood spots which can appear and give the appearance of a bruise which
can come on in one or two days or just a few hours. Symptoms may not be there all the time,
which also confuses diagnosis. With older children and adults, signs and symptoms include
a high temperature, loss of appetite, neck, which doesn't allow the chin to touch the
chest, joint pain, fits, and disorientation. With infants and toddlers, the signs and symptoms
include high temperature, neck retraction with arching back, floppiness, lethargic,
convulsions, difficult to wake, and they may be whimpering, and finally, they may have
a tense, bulging fontanelle, which is the soft spot on the head.
Many people know about the glass test for meningitis, but the rash we're looking for
is not the first sign and comes out as the condition progresses. It is a common misconception
that meningitis rash appears in every case of meningitis. This is not true. If someone
has meningitis but not septicaemia, they would not have a rash that does not fade, but they
will still be seriously unwell. Never wait for the rash to appear. The rash is caused
as meningococcal bacteria multiply rapidly in the bloodstream. They begin to release
endotoxins or poisons from their outer coating. The body's natural defences have little effect
on these poisons, and eventually, blood vessels become damaged. As septicaemia or blood poisoning
advances, it will affect the whole body and can cause organ damage or failure. The rash
associated with septicaemia is caused by the blood leaking into the tissues under the skin.
It is important to know that septicaemia can also cause other more specific symptoms to
look out for as well as the rash. These include fever with cold hands and feet, joint and
muscle pain, rapid breathing, and stomach cramps and diarrhoea. To complete the glass
test, roll the glass over the spots. If they do not disappear, this indicates meningitis.
Press the side of a clear glass firmly against the skin. The spots may fade at first, but
they will still be there as you roll the glass over. If you find that the spots vanish, then
this may indicate this is not meningitis. If in doubt, seek medical assistance. Do not
wait for a rash. If someone is ill and getting worse, get medical help immediately. On dark
skin, the spots or the rash can be more difficult to see. Do not wait for the rash, be aware
of all the signs and symptoms of meningitis.
After carrying out a primary assessment, make sure the child is comfortable, lying back
against cushions. Keep the child cool. Call the emergency services and describe the symptoms,
and say meningitis is suspected. Monitor their ABCs, and monitor and record their vital signs.
Finally, to recap, the glass test is where the red spots do not vanish when the glass
is rolled over the skin. Meningitis is caused by the inflammation around the spinal cord
and the brain, and is caused by a virus or bacteria and is easily confused with other
common illnesses. A survey showed that 50% of children with meningitis were initially
sent home, so you need to ensure that you get help as the condition gets worse. For
more information, look on the Meningitis Now website at www.meningitisnow.org.