Therapy

Once meningitis has been diagnosed, symptomatic and therapeutic treatment must begin immediately. Therapeutically, an antibiotic therapy must usually be started by infusion, which is based on the pathogen detected. In most cases, so-called 3rd generation cephalosporins (cefotaxime, ceftriaxone) are used.This treatment is supplemented with ampicillin.

The duration of treatment should not be less than 10 days. Intensive monitoring of the patient is essential. The symptomatic treatment of patients includes adequate pain management and control of intracranial pressure. If this pressure rises as a complication of meningitis, treatment with cortisone should be started immediately. In addition, regular blood checks should be carried out, which should immediately indicate electrolyte imbalances.

Duration of meningitis

The course and duration of meningitis varies greatly depending on the pathogen causing it. Bacterial infections often have a severe course. About 2 to 5 days after infection with the bacterium, the first symptoms appear (incubation period).

During this period, the bacterium spreads in the body and multiplies without the patient noticing the infection. A special feature is infection with a specific bacterium, meningococci, where the incubation period can last up to 10 days. As a result, the infection often takes a very severe course, which can be life-threatening.

With viral infection, the disease usually takes a milder course. Depending on the virus, the period until the first symptoms appear varies greatly (incubation period). The incubation period varies between 2 and 14 days.

Subsequently, the course of the disease is typically characterized by mild fever, headache and neck stiffness for a few hours to several days. In patients with a functional immune system, the symptoms then subside without further therapy. A special feature is the course of meningitis when infected with tuberculosis bacteria. The incubation period is between 2 and 8 weeks. The infection begins over several weeks with recurrent fever attacks.

What are the consequences of meningitis?

The consequences of meningitis depend on the pathogen and the time of treatment. Without treatment, there is a risk of the pathogen spreading further to brain tissue and through the bloodstream throughout the body. If the pathogen spreads to the brain tissue (meningoencephalitis), disturbances of consciousness up to coma and psychological symptoms such as general restlessness and seizures are possible.

Due to the risk of damage to the cranial nerves, hearing disorders may occur, among other things. While in the case of a viral infection the disease usually takes a milder course, often heals on its own and has hardly any consequences for the patient, in the case of a bacterial infection there is the risk of spreading throughout the body. Without treatment, meningitis caused by bacteria is often fatal.

In the case of treatment with antibiotics, the further course depends on the general condition, the state of the immune system and the age of the patient. Different pathogens can be transmitted by ticks, leading to different human diseases. On the one hand, the transmission of the TBE virus (early summer meningo-encephalitis) is possible.

The TBE virus can spread to the central nervous system in the first few days after the appearance of flu symptoms. There is a risk of meningitis, an inflammation of the meninges with an attack on the brain substance. Without further treatment, there is a risk of neurological deficits (e.g. paralysis) due to damage to the nerve cells and fibers.

For this reason, vaccination against the TBE virus is recommended in large parts of Germany. On the other hand, borreliosis can also be transmitted by ticks. After typical reddening and infection of the skin in the area of the point of entry after a few days to weeks, the pathogens can also spread here into the central nervous system.

After several weeks to months, the occurrence of meningitis with damage to the cranial nerves is possible without treatment with antibiotics. Herpes viruses are the most common infectious cause of meningitis. Herpes viruses spread along nerve fibers. In addition to the typical blister formation in the area where the nerve is supplied, there is also the danger that the virus spreads in the direction of the central nervous system. This can lead to meningitis, damage to affected brain nerves and an attack on the brain substance.