Meningitis vs Meningococcal | Meningococcal vs Meningitis Clinical Features, Investigations, Management, Complications, and Prognosis
Meningitis is the inflammation of the leptomeninges and sub archnoid space. The disease is caused by a wide variety of organisms, viral infections being the most common cause. Rest of the causes involved bacterial, fungal, protazoal, prion and helminthic infections. Among them, meningococcus is one of the causes of pyogenic meningitis commonly found in 5-30 years age group, which produces severe complications leading to high mortality rates. This article points out the differences between meningitis and meningococcal disease with regard to clinical picture, investigations, management, complications and prognosis.
Patient with meningitis presents with the classic symptoms of pyrexia, headache and meningism. They can have photophobia and neck stiffness. However, the severity of these features varies according to the virulence of the causative organism. On examination, Kernig’s sign and Brudzinski’s signs are found to be positive, and generally, the patient is unwell.
Cerebrospinal fluid analysis helps in making the diagnosis and in identifying the causative organism. In viral infections, protein levels are high while sugar level remains normal, and neutrophils are predominant. In contrast, high protein levels, low sugar levels, and raised cell counts are seen in bacterial meningitis.
Viral meningitis is a self-limiting condition and does not need specific treatment, so that the management is just supportive. Cure by its own is the rule. Pyogenic meningitis needs special attention and immediate intervention for better prognosis.
Meningococcus is an obiquitous bacterium, which is responsible for life threatening conditions if not diagnosed and treated immediately.
Its transmission is by droplets, human being the only known reservoir and usually colonizes the nasopharynx. Once the bacteria get in to the blood stream, and multiply rapidly they produce toxins results in septicaemia. Once these bacteria reach the meninges it results in meningococcal meningitis.
Apart from the classic symptoms mentioned above, patient with meningococcal meningitis can present with morbilliform, petechial or purpuric rash, which is characteristic. Due to concomitant septicaemia, the patient is extremely unwell and may have hypotension, shock, confusion, coma and death. In extreme cases, they can develop disseminated intra vascular coagulation and hemorrhage into the adrenals may or may not be present.
If this condition is not treated aggressively, mortality rate can go up to 100%.
The bacteria in blood, cerebrospinal fluid, petechial and joint aspirated confirms the diagnosis.
Management includes benzylpenicillin intravenously, started immediately on suspicion of the disease and with identifying and treating the complications. Complications are more severe including shock, intravenous coagulation, renal failure, peripheral gangrene, arthritis and pericarditis.
On discharge, rifampicin should be given to all the close contacts as a prophylaxis.
What is the difference between meningitis and meningococcal?
• Meningitis is the inflammation of the meninges while meningococcal is an organism causing septicaemia and meningitis.
• Apart from the classic symptoms of meningitis, patient with meningococcal septicaemia may present with a characteristic purpuric rash.
• Meningococcal meningitis if not treated aggressively mortality rate can go up to 100%.
• Meningococcal meningitis can cause serious complications such as shock, intravenous coagulation, renal failure, peripheral gangrene, arthritis and pericarditis.
• Prophylaxis is given to close contacts in meningococcal meningitis.