This is a bizarre case of meningococcal meningitis in a 4 year old girl. Meningitis causes the covering of the brain and spinal cord to swell (inflammation). There are numerous of highlights that lead to the conclusion of this disease. The usual symptoms of an infected individual often starts as a upper respiratory tract infection, as in this case, it began with a 2 day history of drowsiness, listlessness, anorexia, sore throat, pain on the left side of neck, nasal congestion and drooling. Most, but not all develop a rash, in this case the rash was absent, but approximately half of the patients who are diagnosed with meningococcal meningitis do not develop this symptom. The first hospital visit resulted in the diagnosis of rhinitis, which is an inflammation of the nasal mucous membranes, and bilateral conjunctivitis, which is inflammation or redness of the lining of the white part of the eye and eyelid. She was prescribed antibiotics and sent home.
She returned the next day with more severe complaints, increased temperature, changes of behavior, insomnia, and refusing to drink, tests where ran the results were negative for drugs in urine and the brain was within normal limits. Meningitis should always be considered in the diagnosis of a patient with an unexplained change in mental status. The unexpected took place and she had a seizure which led to a decrease in her heart rate, then a state of unconsciousness, the antimicrobial drugs ceftriaxone and acyclovir was administered to the young girl to stop the unknown at that time.Ceftriaxone is used to treat a broad range of bacterial infections, the drug stops the growth of bacteria, including meningitis. Acyclovir is used to minister infections caused by certain types of viruses, yet is not a cure for the infections, it decreases the length of an outbreaks. The young girl deceased later that afternoon.
Her family members mention a possible exposure to a bat. Her autopsy revealed massive cerebral edema, an immense amount of water in the brain, and intracytoplasmic inclusions which are both results from a head injury. Meningitis can result from a number of causes, typically from bacteria or viruses, but meningitis can also be caused by physical injury, (which may have triggered the disease in this case) cancer, or certain drugs. To detect the presence of microorganisms, there are two fluorescent antibody techniques used; indirect and direct. Both techniques tests for antigen using a fluorescent antibody. Direct technique, is when immunoglobulin conjugate with a fluorescent dye is added to tissue and combines with a particular antigen. Indirect, is when unlabeled immunoglobulin is added to tissue and combines with a certain antigen, afterwards the antigen-antibody complex may be labeled with a fluorescent antibody. In this case the direct technique was performed by skin biopsy and the results were positive for causative organism.
It is extremely important to know the specific cause of meningitis in order to treat correctly and immediately. Bacterial meningitis is usually the most severe than viral, fungal, or parasitic meningitis. Viral meningitis infections are normally caused by common viruses and are most common amongst individuals. The symptoms are very similar to the flu and makes progress within a week. Bacterial meningitis can be caused by three bacterias Haemophilus influenza (HIB), Pneumococcus, and Meningococcus. According to webmd.com, HIB can infect the blood, bones, joints, and covering of the heart. It can also cause pneumonia, sore throat, blindness, deafness, mental retardation, learning disabilities, and death if left untreated or diagnosed too late. Pneumococcus causes an elevated fever, serious headache, accompanied with nausea and vomiting, stiff neck, and sometimes sensitivity to light and mental confusion.
Meningococcal symptoms creep up on the individual suddenly. Within a couple hours, an infected person can experience an increase in fever, headache, stiff neck, nausea, vomiting, confusion, and sleepiness. Often times, the symptoms sneak in slowly, with signs showing up over a couple days which is the exact same symptoms and time frame the young girl was experiencing. Majority of the cases are fatal or result in permanent hearing loss, mental retardation, loss of limbs, or other serious problems. According to cdc.com, Niesseria Meningitis is identified as the probable organism in this case. Neisseria meningitidis is a heterotrophic, gram-negative, diplococcal bacterium, this means that there is little or no peptidoglycan in the cell wall and it resides in the mucous membranes of humans as a parasite. Meningitis is considered contagious and spreads through the exchange of respiratory and throat secretions of an infected person. This includes coughing and sneezing, however casual contact is not included unless the individual was in a prolonged contact with the infected patient such as a nurse, people in the same household, daycare center or anyone with direct contact with a patient's oral secretions has an increased risk of catching the disease.
When an uninfected person comes in contact with this, then rubs their mouth, nose, or eyes meningitis has found its entry path. People who are considered close contacts of a person with meningitis caused by Neisseria meningitidis should receive antibiotics to prevent them from getting the disease. This is why immunoprophylaxis, the administration of vaccines, takes place for possible exposure of this disease that came in contact with the patient which included 72 persons in this situation. Prophylaxis refers to medical or public health procedures taken in order to avoid diseases or health problems. Giving Prophylaxis controls an outbreak of the disease, or reduces the symptoms of someone who has been exposed to a disease or virus.
To determine the cause of a disease (etiology) Kochs Postulate is a very popular method used. This starts the treatment process and the prevention, once the unknown is identified. Mice is usually the animal used for assistance when growing the microorganism and collecting the outcome or data. The process begins with removing the microorganism from a diseased subject, The microorganisms are grown and identified in the lab, the microorganisms are injected into a healthy lab animal, the exact same disease is produced in the lab animal, the microorganism are then removed from the animal, grown in the lab again and identified as the identical microorganism. Although this disease can be very serious, bacterial meningitis can be treated with antibiotics that can prevent severe illness and reduce the spread of infection from person to person but it is highly important, that treatment be started immediately in the course of the disease to prevent the same outcome as the young girl in this case.