Meningitis is a severe inflammation of the meninges or inner lining of the brain andspinal cord. This may result from invasion of bacteria or virus into meninges. The infection usually spreads from the base of the brain up over the surface and down the spinal cord . It appears to reach the inside from the throat and nose via the bloodstream. It is perhaps the most serious of all the acute diseases of childhood.

Epidemic meningitis sometimes occurs in densely populated areas during the cold season. It is also known as spotted fever, as rashes appear in meningo coccas meningitis upon the face and body.

Symptoms

In most children who develop meningitis, the source of infection is from throat, nose, ear or lungs. But if they are subjected to damp cold and overcrowded atmosphere, the organism is liable to pass into the blood stream. The incubation period is shorft , ranging between one and five days, and the onset is sudden. Children with this disease usually have a high fever and they may go into convulsions. They have severe headache and pain and stiffness in the neck and back. The child tends to lie in a curled position with the knees drawn up towards the chin and the eyes turn away from light. He becomes drowsy and confused and may become unconscious. There may also be a skin rash and an obstinate constipation. Vomiting is common in meningitis.

Causes

Meningitis usually follows an attack of otitis media ( middle ear disease) or mastoiditis ( infection of bone projecting behind the ear), or brain abscesses or even tonsilittis. Any skull fracture or penetrating head injury may also result in meningitis. Sometimes, tuberculosis may spread to the brain and cause the disease. In case of epidemic meningitis, the germs are apparently spread by persons who have a milk sore throat or cold.

Treatment

The child with meningitis should be placed on complete bed rest and nursed very carefully. He should be given the juice of an orange diluted in a glass of warm water several times daily for the first few days of treatment. This will provide energy, increase urinary output and promote body resistance against infection, thereby fecilitating recovery. Co-operative children should be given warm-water anema daily during this period to cleanse the bowels. If constipation is present and the child is reluctant to take the warm -water enema, he should be given glycerine suppository.

Cold compresses may be applied to the head in case the temperature rises above 103^oF. If this method does not succeed, cold pack may be applied to the whole body. The procedure is to wring out a sheet or other large square piece of linen material in cold water, wrap it twice right rough the body and legs of the patient. This pack should be applied every three hours during the day while temperature is high and kept on for an hour or so each time.

After the temperature has come down to normal and the tongue has cleared, the child may be given liquid foods and fresh juicy fruits like apple, pear, grapes, orange, pineapple, peach and melon for further two or three days. For drinks, unsweetened lemon water or plain water, either hot or cold, may be given. Thereafter, he may be gradually allowed to embark upon a well- balanced diet, according to his age. The emphasis should be on whole grain cereals, fresh fruits and raw or lightly-cooked vegetables. Normal feeding should be restored to only after complete recovery.

The grown-up children should take neutral immersion bath as this bath is very useful in organic diseases of brain and spinal cord, including meningitis. This bath should be taken for 20 to 30 minutes at a water temperature ranging from 26^o to 28^oC ( 92^o to 98^oF) before retiring at night. A cold wet cloth should be applied to the head and forehed before entering the bath. This bath will equalize the circulatin so as to reduce the amount of blood in the brain and spinal cord. Application of hot fomentation to the spine every two hours with spinal ice bag during intervals will also be beneficial in the treatment of meningitis.