[8] The type of white blood cell predominantly present (see table) indicates whether meningitis is bacterial (usually neutrophil-predominant) or viral (usually lymphocyte-predominant),[8] although at the beginning of the disease this is not always a reliable indicator. [2] These occur in about 15% of survivors. Most people who receive the vaccine don’t have any serious side effects or complications. Aseptic meningitis may also result from infection with spirochetes, a group of bacteria that includes Treponema pallidum (the cause of syphilis) and Borrelia burgdorferi (known for causing Lyme disease), and may also result from cerebral malaria (malaria infecting the brain).[4]. Meningitis may occur as the result of several non-infectious causes: spread of cancer to the meninges (malignant or neoplastic meningitis)[43] and certain drugs (mainly non-steroidal anti-inflammatory drugs, antibiotics and intravenous immunoglobulins). 4 days but can range between 2 and 10 days. [33], There are a number of risk factors for fungal meningitis, including the use of immunosuppressants (such as after organ transplantation), HIV/AIDS,[34] and the loss of immunity associated with aging. It can affect anyone, but is most common in babies, young children, teenagers and young adults. Keep reading to learn about the recommended schedule for receiving this vaccine and the side effects. Initial diagnosis of meningococcal meningitis can be made by clinical examination followed by a lumbar puncture showing a purulent spinal fluid. In the African meningitis belt, chemoprophylaxis for close contacts is recommended in non-epidemic situations. These may require specific treatment, and sometimes indicate severe illness or worse prognosis. Meningitis can be very serious if not treated quickly. [4] Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. Thus, corticosteroids are recommended in the treatment of pediatric meningitis if the cause is H. influenzae, and only if given prior to the first dose of antibiotics; other uses are controversial. Adults very rarely need meningitis vaccines. Very low blood pressure may occur at an early stage, especially but not exclusively in meningococcal meningitis; this may lead to insufficient blood supply to other organs. [47][48] Given that most of the benefit of the treatment is confined to those with pneumococcal meningitis, some guidelines suggest that dexamethasone be discontinued if another cause for meningitis is identified. If you receive a MenB shot, you’ll need a second MenB shot in 6 months. [57] Both can be transmitted through droplets of respiratory secretions during close contact such as kissing, sneezing or coughing on someone,[57] but bacterial meningitis cannot be spread by only breathing the air where a person with meningitis has been. Eine Meningitis ist eine Hirnhautentzündung. Rather, the relevant knowledge has mostly derived from laboratory studies in rabbits. rifampicin, ciprofloxacin or ceftriaxone) can reduce their risk of contracting the condition, but does not protect against future infections. [2], Inflammation of the meninges may lead to abnormalities of the cranial nerves, a group of nerves arising from the brain stem that supply the head and neck area and which control, among other functions, eye movement, facial muscles, and hearing. Take a look at the maps to find out more about what types of N. meningitidis serogroups and clonal complexes can be found where in the world. Eine bakterielle Meningitis kann sich nämlich innerhalb weniger Stunden zum lebensgefährlichen Notfall entwickeln. Bacterial meningitis is rarer but more serious than viral meningitis. Die virale Meningitis, die durch Viren verursacht wird, ist die häufigste Form. [16] The classic triad of diagnostic signs consists of neck stiffness, sudden high fever, and altered mental status; however, all three features are present in only 44–46% of bacterial meningitis cases. . The MenACWY vaccine used today was introduced in 2010. [54][81] Raised intracranial pressure is common in fungal meningitis, and frequent (ideally daily) lumbar punctures to relieve the pressure are recommended,[54] or alternatively a lumbar drain. A significant proportion of the population (between 5 Präventive Maßnahmen 2. Gram staining is also less reliable in particular infections such as listeriosis. the diagnosis. Meningitis is very rare, so data on vaccine effectiveness is limited. [68] While antibiotics are frequently used in an attempt to prevent meningitis in those with a basilar skull fracture there is not enough evidence to determine whether this is beneficial or harmful. A ratio ≤0.4 is indicative of bacterial meningitis;[51] in the newborn, glucose levels in CSF are normally higher, and a ratio below 0.6 (60%) is therefore considered abnormal. [17], Other problems can produce symptoms similar to those above, but from non-meningitic causes. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises. Klinische Symptomatik Dauer der Ansteckungsfähigkeit Diagnostik 1. The outermost membrane, the dura mater, is a thick durable membrane, which is attached to both the arachnoid membrane and the skull. Bacterial and viral meningitis are contagious, but neither is as contagious as the common cold or flu. Erfahren Sie mehr . [52] The initial appearance of the fluid may prove an indication of the nature of the infection: cloudy CSF indicates higher levels of protein, white and red blood cells and/or bacteria, and therefore may suggest bacterial meningitis. Though the benefit of corticosteroids has been demonstrated in adults as well as in children from high-income countries, their use in children from low-income countries is not supported by the evidence; the reason for this discrepancy is not clear. The most common cause of recurrent meningitis is a skull fracture,[31] particularly fractures that affect the base of the skull or extend towards the sinuses and petrous pyramids. Most cases of meningitis in the United States are caused by a viral infection. Overall, it's estimated up to 1 in every 10 cases of bacterial meningitis is fatal. Let's look at the symptoms to know. Learn more about how you get meningitis, its symptoms, and how it's treated at WebMD. Once they do, empiric therapy may be switched to specific antibiotic therapy targeted to the specific causative organism and its sensitivities to antibiotics. N. meningitidis, causing meningococcal meningitis, is the one with the potential to produce large epidemics. C-reactive protein, complete blood count), as well as blood cultures. Microbiological culture of the sample is more sensitive (it identifies the organism in 70–85% of cases) but results can take up to 48 hours to become available. Maßnahmen bei Ausbrüchen Gesetzliche Grundlage Meldepflicht gemäß IfSG Ein Meningitisausschlag tritt auf, wenn Blut in das Gewebe unter der Haut austritt. ", "Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america", "Treatment for HIV‐associated cryptococcal meningitis", Centers for Disease Control and Prevention, "Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates", "Prospects for vaccine prevention of meningococcal infection", "First vaccine approved by FDA to prevent serogroup B Meningococcal disease", "Antibiotics for preventing meningococcal infections", "Osmotic therapies added to antibiotics for acute bacterial meningitis", "Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis", "Corticosteroids for acute bacterial meningitis", "Corticosteroid administration and outcome of adolescents and adults with acute bacterial meningitis: a meta-analysis", "Corticosteroids for managing tuberculous meningitis", "Dexamethasone in adults with bacterial meningitis", "Non-corticosteroid adjuvant therapies for acute bacterial meningitis", "Mortality and Burden of Disease Estimates for WHO Member States in 2002", "Hearing loss during bacterial meningitis", "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010", "Infections and inflammatory involvement of the CNS", "The results of the serum treatment in thirteen hundred cases of epidemic meningitis", Journal of the American Medical Association, "Save the date for World Meningitis Day 2020 | Meningitis Research Foundation", https://en.wikipedia.org/w/index.php?title=Meningitis&oldid=1158620890, Older children are more commonly affected by, This page was last edited on 5 June 2023, at 05:42. Although Kernig's sign and Brudzinski's sign are both commonly used to screen for meningitis, the sensitivity of these tests is limited. The MenB vaccine always requires at least two doses, but it doesn’t require a booster. Es gibt drei verschiedene Meningokokken-Impfungen. Your Guide to Salmonella Meningitis and How to Spot It, Group B Streptococcal (GBS) Meningitis: Symptoms, Treatment, Outlook, and More, Everything You Need to Know About Mollaret’s Meningitis, Understanding What Adult Onset Cystic Fibrosis Means. In jedem Fall ist eine sofortige ärztliche Behandlung notwendig. African epidemics became much more common in the 20th century, starting with a major epidemic sweeping Nigeria and Ghana in 1905–1908. Ciprofloxacin antibiotic is the antibiotic of choice, and ceftriaxone an alternative. [52], Untreated, bacterial meningitis is almost always fatal. The most common parasites implicated are Angiostrongylus cantonensis, Gnathostoma spinigerum, Schistosoma, as well as the conditions cysticercosis, toxocariasis, baylisascariasis, paragonimiasis, and a number of rarer infections and noninfective conditions.[42]. ICD-Codes für diese Krankheit: G02A39A87G01G03. [31], Viruses that cause meningitis include enteroviruses, herpes simplex virus (generally type 2, which produces most genital sores; less commonly type 1), varicella zoster virus (known for causing chickenpox and shingles), mumps virus, HIV, LCMV,[22] Arboviruses (acquired from a mosquito or other insect), and the Influenza virus. [8][47] The likely mechanism is suppression of overactive inflammation. [63] Although the pattern of epidemic cycles in Africa is not well understood, several factors have been associated with the development of epidemics in the meningitis belt. Licensed vaccines against meningococcal disease have been available for more than 40 years. [8] The results of the CSF culture generally take longer to become available (24–48 hours). [77], Additional treatment with corticosteroids have a different role in children than in adults. [18][19], Neck stiffness occurs in 70% of bacterial meningitis in adults. Meningitis is a serious infection of the meninges, the membranes covering the brain and spinal cord. [41], Bacterial meningitis occurs in about 3 people per 100,000 annually in Western countries. children who’ve had their spleens surgically removed, children who take complement inhibitor medications, adults who will be traveling to high risk parts of the world, adults who are microbiologists and work professionally with meningitis bacteria. Medicare and most private insurance will cover vaccines as part of preventive care. [91][92], It appears that epidemic meningitis is a relatively recent phenomenon. [95] Mortality from meningitis was very high (over 90%) in early reports. [60] Two new vaccines, both approved in 2014, are effective against a wider range of group B meningococci strains. Sie kann durch Viren, Bakterienoder andere Mikroorganismen verursacht werden, aber auch aufgrund nichtinfektiöser Reize auftreten. Stand: 1.6.2021 Alle öffnen Wer sollte gegen Meningokokken geimpft sein? infects humans. [1] Outbreaks of bacterial meningitis occur between December and June each year in an area of sub-Saharan Africa known as the meningitis belt. [16][17] If none of the three signs are present, acute meningitis is extremely unlikely. Is the meningitis vaccine 100% effective? For example, children who receive the MenACWY vaccine need a booster after 5 years. If there are signs of raised intracranial pressure, measures to monitor the pressure may be taken; this would allow the optimization of the cerebral perfusion pressure and various treatments to decrease the intracranial pressure with medication (e.g. Typische Symptome sind schmerzhafte Bläschen an Händen, und Füßen sowie im Bereich des Mundes. [41] Other less common pathogenic fungi which can cause meningitis include: Coccidioides immitis, Histoplasma capsulatum, Blastomyces dermatitidis, and Candida species. The disease can occur in a range of situations from sporadic cases, small clusters to large epidemics throughout the world, with seasonal variations. [88] Attack rates of 100–800 cases per 100,000 are encountered in this area,[89] which is poorly served by medical care. [2] Some of the hearing loss may be reversible. [58][59] Similarly, immunization against mumps has led to a sharp fall in the number of cases of mumps meningitis, which prior to vaccination occurred in 15% of all cases of mumps. [12] Non-infectious causes include malignancy (cancer), subarachnoid hemorrhage, chronic inflammatory disease (sarcoidosis) and certain drugs. The MenB vaccine is available from two major brands and first became available in 2014. Durch eine Infektion, die Sie bereits haben, zum Beispiel eine Ohrenentzündung. There is no difference in terms of mortality or acute severe neurological complications in children given a maintenance regimen over restricted-fluid regimen, but evidence is in favor of the maintenance regimen in terms of emergence of chronic severe neurological complications. [2] Disseminated intravascular coagulation, the excessive activation of blood clotting, may obstruct blood flow to organs and paradoxically increase the bleeding risk. [2] Giving antibiotics to people with significant exposure to certain types of meningitis may also be useful. [38] In Africa, cryptococcal meningitis is now the most common cause of meningitis in multiple studies,[39][40] and it accounts for 20–25% of AIDS-related deaths in Africa. People with suspected meningitis will usually have tests in hospital to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection. The schedule you need will depend on your age. [3], Mechanical ventilation may be needed if the level of consciousness is very low, or if there is evidence of respiratory failure. Deutlich seltener tritt die bakterielle Gehirnhautentzündung auf. When this has been achieved, the "opening pressure" of the CSF is measured using a manometer. Most of the antibiotics used in meningitis have not been tested directly on people with meningitis in clinical trials. [70] Given that meningitis can cause a number of early severe complications, regular medical review is recommended to identify these complications early[48] and to admit the person to an intensive care unit if deemed necessary. by growing the bacteria from specimens of spinal fluid or blood, or by polymerase chain reaction (PCR). The average incubation period is [99], "Primary amebic meningoencephalitis – Arizona, Florida, and Texas, 2007", "Practice guidelines for the management of bacterial meningitis", "Meningococcal meningitis Fact sheet N°141", "Clinical features and prognostic factors in adults with bacterial meningitis", "Management of invasive meningococcal disease in children and young people: summary of SIGN guidelines", "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis", "Meningitis | About Bacterial Meningitis Infection", "Effect of pneumococcal conjugate vaccine on pneumococcal meningitis", "Can we prevent cochlear implant recipients from developing pneumococcal meningitis? They include: medical conditions (immunological susceptibility of the population), demographic conditions (travel and large population displacements), socioeconomic conditions (overcrowding and poor living conditions), climatic conditions (drought and dust storms), and concurrent infections (acute respiratory infections). transmitted from person-to-person through droplets of respiratory or throat Next review due: 25 October 2025, a rash that does not fade when a glass is rolled over it (but a rash will not always develop), co-ordination, movement and balance problems. The identification of the meningococcal serogroups and testing for susceptibility to antibiotics are important to define control measures. When components of the bacterial cell membrane are identified by the immune cells of the brain (astrocytes and microglia), they respond by releasing large amounts of cytokines, hormone-like mediators that recruit other immune cells and stimulate other tissues to participate in an immune response. [2] Other clues on the cause of meningitis may be the skin signs of hand, foot and mouth disease and genital herpes, both of which are associated with various forms of viral meningitis. Meningococcal meningitis can affect anyone of any age, but mainly affects babies, preschool children and young people. Sie betrifft insbesondere Kinder und Jugendliche, wobei etwa 70 Prozent der Fälle bei Kindern unter fünf Jahren auftreten. How often do you need a meningitis vaccine? In bacterial meningitis, bacteria reach the meninges by one of two main routes: through the bloodstream (hematogenous spread) or through direct contact between the meninges and either the nasal cavity or the skin. The diagnosis is confirmed It can be fatal without prompt treatment. . Diagnose Maybe you would like to learn more about one of these? [18] The rash consists of numerous small, irregular purple or red spots ("petechiae") on the trunk, lower extremities, mucous membranes, conjunctiva, and (occasionally) the palms of the hands or soles of the feet. A person is asked to rapidly rotate the head horizontally; if this does not make the headache worse, meningitis is unlikely. [74] Even in high-income countries, the benefit of corticosteroids is only seen when they are given prior to the first dose of antibiotics, and is greatest in cases of H. influenzae meningitis,[8][78] the incidence of which has decreased dramatically since the introduction of the Hib vaccine. Healthline Media does not provide medical advice, diagnosis, or treatment. However, confirmation of the diagnosis should not delay treatment. Eine Meningitis oder Hirnhautentzündung ist eine Entzündung der Hirn- und Rückenmarkshäute, also der Hülle des zentralen Nervensystems. Meningitis. It can cause life-threatening blood poisoning ( sepsis) and result in permanent damage . [8] Tuberculous meningitis requires prolonged treatment with antibiotics. Since 2010, a meningococcal A conjugate vaccine has been rolled out through mass preventive immunization campaigns in the meningitis belt of sub-Saharan Africa, dramatically bringing down cases of the A serogroup. Monitoring of the circulation of N. meningitidis strains is supported by the WHO Collaborating Centers for meningitis and is essential to detect the emergence of clones with high epidemic potential. In some cases, a MenB vaccine can be given at the same time. For example: If you have any questions about if and when you should get a booster or second dose of your vaccine, make sure to ask the healthcare professional that administers your shot. [8] Recipients of cochlear implants for hearing loss are more at risk for pneumococcal meningitis. [3], Tuberculous meningitis in children continues to be associated with a significant risk of death even with treatment (19%), and a significant proportion of the surviving children have ongoing neurological problems. [60][61][62] In countries where the vaccine for meningococcus group C was introduced, cases caused by this pathogen have decreased substantially. Sie gehören zum Genus Enterovirus in der Familie der Picornaviridae und sind, wie andere Enteroviren, relativ umweltresistent. Similarly, the limulus lysate test may be positive in meningitis caused by Gram-negative bacteria, but it is of limited use unless other tests have been unhelpful. Even with early diagnosis and adequate treatment, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms. [30], Recurrent bacterial meningitis may be caused by persisting anatomical defects, either congenital or acquired, or by disorders of the immune system. Wie oft muss geimpft werden? Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. Ursachen: Hirnhaut-Entzündung ( Meningitis) oder anders bedingte Hirnhaut-Reizungen (wie Subarachnoidal-Blutung, Sepsis oder Sonnenstich) Diagnostik: Anamnese, körperliche Untersuchung, Blut-Untersuchung, Liquorpunktion, bildgebende Verfahren (wie Computertomografie, Magnetresonanztomografie) sneezing or coughing on someone, or living in close quarters with an infected The disease can be caused by many different pathogens including bacteria, fungi or viruses, but the highest global burden is seen with bacterial meningitis. [17] Sub-Saharan Africa has been plagued by large epidemics of meningococcal meningitis for over a century,[87] leading to it being labeled the "meningitis belt". Find out more about the complications of meningitis, Page last reviewed: 25 October 2022 Besonders gefährlich ist bakterielle Miningitis, bei der sich innerhalb weniger Stunden ein schweres, lebensbedrohliches Krankheitsbild entwickeln kann. [18] Intravenous fluids should be administered if hypotension (low blood pressure) or shock are present. With treatment, mortality (risk of death) from bacterial meningitis depends on the age of the person and the underlying cause. Geographic distribution and epidemic potential differ according to serogroup. [3] Meningitis caused by H. influenzae and meningococci has a better prognosis than cases caused by group B streptococci, coliforms and S. [2] In adults, too, meningococcal meningitis has a lower mortality (3–7%) than pneumococcal disease. Am häufigsten sind aber Säuglinge im ersten Lebensjahr, Kleinkinder oder Jugendliche betroffen. In 1906, antiserum was produced in horses; this was developed further by the American scientist Simon Flexner and markedly decreased mortality from meningococcal disease. Someone with meningitis or sepsis can get a lot worse very quickly. The meninges comprise three membranes that, together with the cerebrospinal fluid, enclose and protect the brain and spinal cord (the central nervous system). [69] This applies to those with or without a CSF leak. [79] It is not clear if any of these therapies are helpful or worsen outcomes in people with acute bacterial meningitis.