• Inflammation of membrane covering brain and spinal cord
• Caused by Neisseria meningitidis
• Person to person transmission
• Infect body parts - spread through bloodstream to nervous
• Incubation period: 2 to 10 days
• Death and serious complication
Figure 1: Neisseria meningitidis
Figure 2 : Difference between normal & abnormal meninges
• Highest case reported in area of sub-Saharan Africa
• In 2009, 14 African country reported with 88199
suspected cases and 5352 deaths
• Largest number since 1996 epidemic
1. Imaging Test (X-rays & CT scans)
• to create pictures of the head, including the skull, brain,
eye sockets, and sinuses.
• reveal swelling or inflammation
2. Blood culture
• Check for the type of bacteria in blood sample
• Type of media: BAP or CAP
• Growth of germs observed
• Gram stain- gram-ve diplococci
Figure 5. N. meningitidis colonies on a BAP
• Young colonies-round, smooth, moist, glistening, and convex
• Some colonies appear to coalesce with other nearby colonies
Figure 6. N. meningitidis in Gram staining method
3. WBC count
• blood test to measure the number of white blood cells
• Normal range: 4,500-10,000 WBC per microliter (mcL)
• Affected patients : increased WBC (>10,000 mcL)
4. Lumbar puncture (Spinal tap)
• insertion of a needle into an area in lower spine to drain
cerebrospinal fluid (CSF)
• 5-10mL collected
• CSF - clear fluid (normal)
- cloudy (bacteria present)
• Doctor may recommend a broad-spectrum antibiotic until
exact cause of the meningitis determine
(a) Intravenous: ceftriaxone / penicillin
(b) Oral: ciproflaxin / rifampin
• If patient allergic to penicillin - chloramphenicol may be
• Steroid – used to prevent hearing loss
• Surgery – to remove accumulated fluid around brain
• All family and close contacts of infected person should
receive antibiotic treatment
• Wash your hands – before handling with foods and after
• Cover your mouth - when you need to cough or sneeze
(a) Meningococcal polysaccharide vaccines - to control the
(b) Vaccine that provide combined protection against A and C
given to travelers.
(c) Meningococcal B Immunisation for children-to achieve
• Meningitis is a serious diseases- causing inflammation and
swelling of meninges
• 2 types:
(a) bacterial meningitis-more severe, lead to death
(b) viral meningitis- less severe, most people recover fully
• Its present in saliva, commonly transmitted through close
• Vaccines available to treat and prevent the infection
• Immediate treatment needed- to reduce the severity
• A man – 21 year old
• Construction site worker and he had travelled to China a
few days before his illness.
• Fever for one day
• Patient’s BP was 109/50, pulse rate was 115
• Temperature was 38.1 C
• Fully conscious and clinically stable
• Headache, vomiting for three times and severe
• No rash was noted by him
• Generalised maculo-papular rash and a patch of purpura
on the dorsum of the right hand
• Suboccipital lymph node was negative.
• No neck rigidity.
• Chest, cardiac and abdominal examination did not reveal
• Showed white cell count of 29.1 with neutrophilia.
• Raised CSF protein of 5.45 g/L.
• Decreased CSF glucose of 0.1 mmol/L.
• CSF was turbid with predominating polymorphs.
• Gram Stain was negat ive but culture grew Neisseria
• Was sensitive to cefotaxime, ceftriaxone, chloramphenicol,
ciprofloxacin, penicillin and rifampicin.
• Blood culture grew the same pathogen.
• Intravenous antibiotic including penicillin G and
cefotaxime were administered
• He recovered without any neurological sequelae.
• Anonymous, (2013), introduction, viewed on 22nd January 2013,
• Anonymous, (2012), introduction and symptoms, viewed on 22nd
• WHO, (2013), statistics, viewed on 22nd January 2013,
• Anonymous, (2013), symptoms, viewed on 22nd January 2013,
• Anonymous, (2006), symptoms, viewed on 22nd January 2013,
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meningococcal meningitis. Hong Kong Journal of Emergency
• Anonymous, (2007),prevention of meningitis, Viewed on 22nd
January 2013, http://www.southerncross.co.nz/HealthResources
• Anonymous, (2012),prevention, Viewed on 22nd January 2013,
• Anonymous, (2012),test and diagnosis, Viewed on 22nd January
2013, http://www. mayoclinic.com/health/meningitis
• Anonymous, (2008),treatment and prognosis, Viewed on 24th
• Anonymous, (2011),test and diagnosis, Viewed on 24th January
• Anonymous, (2013),test and diagnosis, Viewed on 25th January