- Meningococcal meningitis
- Acute Pyogenic Meningitis
- Tuberculous Meningitis
- Viral Meningitis
- Benign Lymphocytic Meningitis
- Treatment with appropriate antibiotics must be started without delay, as the disease is rapidly progressive.
- If the patient is unable to swallow, the medication is administered by the intravenous or intramuscular route.
- General measures for the treatment of fever must also be carried out, special attention being paid to the maintenance of hydration (fluids) and to kidney function.
- Analgesia for the relief of pain and headache may also be required.
- In Meningococcal disease the antibiotic of choice is Benzylpenicillin (alternative being Cefotaxime).
Meningococcal disease is acute in onset, and rapidly progressive, and therefore requires early diagnosis and treatment to avoid death and long- term complications.
Treatment with the appropriate antibiotic, depending on the results of culture and antibiotic sensitivity tests of the organism should be started immediately, and continued until the cerebrospinal fluid has returned to normal, and the temperature has been normal for at least two days.
Antibiotics used are:
- Uknown pyogenic: Cefotaxime (alternative being Benzylpenicillin plus chloramphenicol)
- Pneumococcus: Cefotaxime (alternative is Penicillin)
- Haemophilus: Cefotaxime (alternative is Chloramphenicol)
Treatment should be commenced as soon as possible with standard triple antituberculous therapy, (which may include Rifampicin, Isoniazid, Pyrazinamide or Ethambutol) and Prednisolone. During the acute stage of the illness skilled nursing is essential, and measures should be taken to maintain adequate hydration and nutrition.
There is no specific treatment, and the disease is usually short-lived, patients making a full recovery within a few weeks. There are usually no long term complications or disability.
The patient is kept at rest in bed on symptomatic treatment until the temperature has returned to normal. Complete recovery is the rule in acute lymphocytic meningitis.