Talk:Meningitis

From Wikipedia, the free encyclopedia

You have new messages (last change).
This article is a candidate for the Medicine Collaboration of the Week. Please visit that page to support or comment on the nomination.

Someone needs to repair the OP. Some jackass deleted it and replaced it with slander.


 This article has been selected for Version 0.5 and the next release version of Wikipedia. This Natsci article has been rated B-Class on the assessment scale.

Some text in this article was originally taken from http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm (public domain)

Contents

[edit] Ethics

While looking at this article, it occurred to me that people may be using this and an emergency source of information (e.g. a worried mother who supects her child has contracted the disease). So i suggest that the inportant information in diagnosis be included first - in bullet point veiw - and the the infected brain be moved towards the end of the artcle, or replaced by a picture of visual symptoms in a live patient. Just thinking of morality, that's all.

Wikipedia does not profess to be an emergency medical manual, and we have a medical disclaimer. The intro should clearly mention the most important telltale signs (fever, neck stiffness, photo- and phonophobia and petechiae), as should be the case in all medical articles. The remainder should remain unchanged.
I agree the infected brain should be lower down in the article.
I dispute that Wikipedia has a moral duty beyond its stated objective to provide unbiased, sourced and verifiable information. JFW | T@lk 22:34, 29 October 2005 (UTC)
I agree that the tell tale signs should be listed at the top of the page - it would be useful for one (and yes I did just come here looking for them, not a true emergency but it'd be nice if that information was on wikipedia) 137.222.10.58 00:45, 8 February 2006 (UTC)
I added the most common signs/symptoms and (imho) the most relevant and important things about meningitis in the heading. Hopefully it will be more helpful. --Andrewr47 04:16, 26 June 2006 (UTC)

[edit] Suggestions

I'm completely out of my league with this article, and thus I'm not going to edit it. But I am aware of a few things that seem to be missing from this article:

1. What is meningococemia?

2. How long is the vacination effective? (i.e. is it once per lifetime, or yearly boost, or...?)

--Sdfisher 14:58, 26 Jan 2005 (UTC)

  • Just got a meningitis shot. The nurse said it was effective for 10 years. 72.230.61.217 23:52, 16 June 2006 (UTC)


Answers:

  1. Meningococcemia is also known as meningococcal septicemia ie blood-borne infection with considerably higher mortality rate than the meningitis disease.
  2. Duration of effect depends on what vaccine you had - i.e. for which bacteria, and in the case of meningococcus, which strain of the bacteria. Also depends upon one's age (young children mount less of a response and so often need multiple courses to provoke a full protection. See Vaccination schedule for full details
    • Haemophilus influenzae vaccination (HiB) is routinely given as 3 shots to infants in UK, adults needing protection (eg asplenia following splenectomy) need just one dose for lifetime cover
    • Meningococcus - the Men A&C strain mix used for travel vaccinations lasts just 3 years.
    • Conjugated Meningococcus C (conj Men C) - given thrice to infants in UK, but for adults (again for asplenia but also in the catch up program to cover all school leavers), just a single dose is thought to give perminant protection ("perminant" is as yet somewhat ill defined)
    • There are other vaccines for other strains of Meningococcus - but I can't advise as to their duration of effects. David Ruben Talk 01:35, 17 June 2006 (UTC)

[edit] CT before lumbar puncture

Removed the advise to make a CT scan before all lumbar punctures. Evidence for this: PMID 10597758 PMID 11742046 PMID 8448711 PMID 16010480 --WS 01:23, 1 August 2005 (UTC)

[edit] Treatment of Viral meningitis

I'm not going to edit this article, as medicine is way out of my league, but the article seems to suggest the treatment for meningitis is always the use of broad spectrum antibiotics. Clearly, that can't be the case with viral meningitis.

On the Meningitis Foundation of America website, they state:

Unfortunately, there is no specific treatment for viral meningitis at this time. Medical Doctors recommend plenty of rest, relaxation, fluids, and medicine to relieve a fever or headache.

[1]

This seems to be a pretty important point for an article for the general public. Mmmbeer 14:06, 25 September 2005 (UTC)

  • I disagree, although fully agreeing with your logical reading of the artice that such information is currently missing :-) - I would point out that the "general public" never themselves make a decision, or should even have suggested to them, on how to self-treat viral meningitis. All cases exibiting signs of meningism need to be urgently admitted to hospital, on the basis that there may be a progressive bacterial cause. UK guidelines are that any General Practitioner seeing a suspected case of menigitis should give an antibiotic injection even before the ambulance transports the patient to the hospital - such is the rapid risk of fatality from bacterial cases and the importance of early treatment being started. Of course, if subsequent lumbar puncture tests suggest a viral cause then further antibiotics need not be given and suitable advice can be given, but it should be remembered that whilst usually not fatal, viral meningitis very occassionally may be.
  • Like all internet/book articles on medical topics, it is legally (and ethically) not possible to make diagnosis or give precise advice on an individual's treatment. Readers do and will erroneously interpret advice given, whatever disclaimers & cautions might be given. Therefore WP needs to take great care with this article (in particular) not to suggest that "Mild" symptoms might correlate with less serious causes of meningitis and thereby in anyway delay people from taking the necessary action, namely that all suspected cases, however mild, need emergency medical attention.
  • I would suggest that the article, whilst mentioning that antibiotics must be promptly given for bacterial causes, does not explicity suggest that no treatment (ie no antibiotic) is needed for viral cases ("treatment" in the public's mind means seeing a doctor for all the things they do, so "no treatment" would be interpreted as "no need to see a doctor")
  • If you can think of a round-about method of mentioning the points you raised, have a go (eg "Following treatment of meningitis cases, people often feel tired for some time for which rest is important and pain-killers for any continuing mild headadache may be advised.") But I think most doctors would be fairly concerned about the wording chosen, most of us will have seen cases that started with a "mild viral-like illness" that soon became something quite different :-) - David Rubentalk 01:10, 26 September 2005 (UTC)
    • Your points are well taken. However, it seems that there are at the very least two things that can be distilled from what you said: 1) clarify that the treatment is for bacterial (you don't have to say that it excludes viral) 2) state in the first sentence all suspected cases, however mild, need emergency medical attention. Just a thought. Mmmbeer 01:40, 26 September 2005 (UTC)

[edit] extreme cold and meningitis

I've read somewhere that extreme cold (like going around without a hat, at -30 C) increases the risk of meningitis? And in the article it says that meningitis is purely viral. Which of the statements is true? --rydel 15:38, 24 January 2006 (UTC)

Well, not purely viral. There are bacterial, viral and parasitic forms of meningitis. Apart from a very rare hereditary condition (CINCA/Muckle-Wells) there is no association between cold exposure and meningitis to my knowledge. JFW | T@lk 16:56, 24 January 2006 (UTC)

[edit] Removal of reference

I've removed: Hill, A. Edward. "Benign Lymphocytic Meningitis." "Caribbean Medical Journal", Vol. XI, No. 1, pp. 34-37. for several reasons. Mostly what has this to do with the current contents of the article ('Benign Lymphocytic Meningitis' is not mentioned) ? I could not find the reference in PubMed - the year of publication would have been helpful, is there on online copy of the article anywhere?

As best as I can tell from a quick search of PubMed [2] for 'Benign Lymphocytic Meningitis', the presence of lymphocytes may be associated with a number of different viruses. In the case of a meningitis outbreak, the quick identification of lymphocytes highlights viral cases from bacterial, given that full viral studies may take some time to undertake. However only a minority of cases with lymphocytes identified seem to be proved to be of any viral cause - "of 208 cases of aseptic lymphocytic meningitis seen over a nine-year period, 24 were diagnosed as viral infections" Becq-Giraudon B, Cremault A, Marechaud R, Abadie JC, Castets M, Sudre Y (1982). "[Viral etiology of aseptic lymphocytic meningitis. Twenty-four cases seen over a nine-year period (author's transl)]". Sem Hop 58 (12): 739-45. PMID 6283647.. David Ruben Talk 01:43, 7 May 2006 (UTC)

[edit] Re-adding the "See also" links

I've re-added the list of "See also" links. Andrewr47 and other editors/contributors, please leave this list on the page. Thank you. -- 201.78.233.162 16:50, 5 July 2006 (UTC)

[edit] What about amoebic meningitis?

There's no mention at all of this form of meningitis. Anyone able to provide some info on it?

[edit] Diffrences B/w types of meningitis !

Hello...

well although the topic is very good... but i could't find the differences b/w different types of meningitis like Viral,acute bacterial and tuberculous meningitis.... will u plz help me out :) thanx. Jinn

[edit] What is Graham sign?

Article refers to "Graham sign" which is not defined or linked. I can't Google anything about it. Probably should be removed. Gypsydoctor 22:51, 9 November 2006 (UTC)

Think this was just some nonsense applied by an anon editor in these edits - I have now fully reverted back (I had previously only reverted 1 out of their 2 edits).David Ruben Talk 01:27, 10 November 2006 (UTC)

[edit] So...

I've had viral meningitis, the doctor said if I did not come in that day i would have died. I am wondering if there are any long term effects viral meningiis could have had on my brain? SwiftGeneration 22:40, 17 November 2006 (UTC)

Also, I don't see any mention of a symptom I had, dark red splothes under my skin, as if the vessels were filled with dye and you could see them easily and quite clearly

Retrieved from "http://en.wikipedia.org../../../m/e/n/Talk%7EMeningitis_73ba.html"