. Sunday, September 28, 2008
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Justify FullYou’ve never before hurt so much. Your forehead is hot enough to roast chestnuts. You’ve just vomited what seems like your last eight meals. And inside your head, a battalion of cackling gremlins is driving needles into your most sensitive nerve endings. Could it be the flu? Or could it be something worse, like meningitis?

Meningitis, an ugly but fortunately rare disease, often starts off with the same symptoms as the common flu. But along with the fever, nausea and headaches, you might also experience a stiff neck, an oversensitivity to bright light and, occasionally, a deep red or purplish rash.

What these symptoms may mean is that your meninges, the membranes that cover your brain and spiral cord, have become infected and inflamed. The cause is usually an invasion by either viruses or bacteria. Sometimes these organisms are carried to the meninges by the bloodstream from another part of the body, such as the lungs. Sometimes a head injury, like a skull fracture, or an infected sinus or ear can open the door to such an invasion.

The Essential Diagnosis

The symptoms of both types of meningitis, viral and bacterial, are the same. But the bacterial kind is much more dangerous––in fact, potentially deadly if not treated quickly. That is why it’s important to act on these symptoms immediately by going to your doctor or a hospital emergency room.

There’s only one way to tell the two kinds of meningitis apart, says Bradley Perkins, M.D., a specialist in meningitis with the federal Centers for Disease Control (CDC) in Atlanta. That one way is with a spinal tap. Doctors remove a dose of spinal fluid for analysis to tell what kind of organism may be at the source of your woes.

If that organism is a virus, you can breathe a sigh of relief. You’ll feel rotten for a while, but you’ll probably be well in two or three weeks.

The Viral Variety

The kind of meningitis caused by viruses is not only the less dangerous of the two, it’s also the more common. These viruses usually spread from person to person and tend to spread quickly among groups, much like a flu. The favorite victims if viral meningitis are children and young adults. “Their immune systems are usually strong enough that they get better without medication,” Dr. Perkins says. “Antibiotics don’t work against a virus, and antiviral drugs have so many side effects that it’s usually not worth giving them.”

In other words, if you have viral meningitis, you simply need to tough it out as you would a flu. What can you do to feel better? The same things you’d do if you had the flu.

Stay home and rest. Let your body devote its energy to fighting the infection, Dr. Perkins says. “You won’t feel like getting out of bed anyway.”

Drink plenty or fluid. Fever dehydrates you. And you’ve got to keep elimination system well watered to flush out the debris of the war in progress between your immune system and the virus.

Reach for the bottle. Take aspirin, ibuprofen or acetaminophen as needed for the pain, says Dr. Perkins. But don’t give aspirin to anyone under 21 because of the risk of Reye’s syndrome, a serious neurological disease.

Darken the room. Your eyes are probably hypersensitive to light, and that can make your headache worse.

Keep eating. It’s essential to keep up your strength.

Take an antinausea medication. How can you eat if you’re nauseated and throwing up? Try an over-the-counter preparation recommended by your doctor or pharmacist.

Take it easy. Don’t go out and run races or dance till dawn right after you’ve recovered––that’s risking a relapse. Again, think of yourself as having had the world’s worst flu, and act accordingly. Give yourself time to regain your strength.

The Bacterial Blight

Even though bacterial meningitis is extremely dangerous, it’s much less common than it used to be, and if caught early, it is usually highly curable, Dr. Perkins says. Bacterial culprits include very common bacteria like streptococcus pneumoniae and hemophilus influenzae type b (Hib). “Most of us carry these bacteria around, but we don’t get sick, because our immune systems keep them in check,” says Dr. Perkins. “The people most susceptible are probably those with some kind of immune deficiency or those who have gotten some new strain of bacteria that they haven’t developed an immunity to” Babies, the elderly and people traveling through certain nations with epidemic diseases are most at risk.

No matter the specific bacteria, treatment is the same hospitalization and intravenous antibiotics. “You should be in the hospital for a minimum of 7 days, and often up to 14 days,” Dr. Perkins says. “You’ll usually get dramatically better very fast.” When you’re discharged, you may take oral antibiotics for another couple of weeks. Treatment is essential; without it, bacterial meningitis is fatal at least 70 percent of the time.

Although some forms of meningitis will probably be with us for some time, the kind caused by the bacteria Hemophilus influnzae type b may be on the wane. This number one cause of bacterial meningitis in American children is the target of an immunization plan by the CDC. It recommends every child get a first vaccination for Hemophilus influenzae type b at two months of age. “We expect a dramatic reduction in Hib meningitis,” says Dr. Perkins.


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