Meningitis is the term used to indicate an infection of the meninges (the protective membranes that surround the brain and spinal cord). Most cases of meningitis are caused by infection by bacteria or a virus. In rare cases, the infection may be due to fungus such as Cryptococcus neoformans and Candida albicans.
Expected duration of meningitis
Bacterial meningitis: Acute bacterial meningitis is the most common type of meningitis. According to research, about 80 percent of all meningitis cases are acute bacterial meningitis. Bacterial meningitis is considered a medical emergency as it can be life threatening. It is most common in children under five years of age and in particular, one month and two year old babies. It is also common among older children (15 to 19 years old). Bacterial meningitis results in death in about 4 to 10% of children and about 25% of adults with meningitis despite treatment. Timely treatment with appropriate antimicrobial and supportive therapy can improve outcome i.e. decrease mortality and risk of complications. Neurologic problems such as permanent mental impairment, paralysis, seizures and hearing loss due to delay in treatment are life-long sequel. Antibiotics are given for about 2 to 3 weeks in most cases.
Viral meningitis: This is a less serious type of meningitis and may be a self-limiting illness in mild cases. People with mild symptoms are often difficult to diagnose as they are often mistaken for flu. Viral meningitis is most common in children. Most patients with viral meningitis recover with treatment in about 7-10 days, however, the prognosis is not so good in neonates and infants in whom viral meningitis can be fatal or associated with significant morbidity. Similarly, in patients, who develop encephalitis (brain gets infected with the virus) or other complications such as pericarditis and hepatitis risk of complications increase and the outlook becomes guarded.
Fungal meningitis: It is a very rare and life-threatening type of meningitis. A variety of fungi can infect the meninges, but the most common cause includes Cryptococcus neoformans and Candida albicans. Fungal meningitis is mostly a disease that affects people with weakened immune system because of some other disease (such as leukaemia, AIDS or by immunosuppressant drug therapy). Treatment for fungal meningitis is different from that of bacterial or viral meningitis because that latter does not last for a few days (10-14 days).People with fungal meningitis need antifungal medication, often two drugs in combination given intravenously for some weeks to months. Duration of antifungal treatment (both intravenous and oral) is affected by factors such as whether the immune system is weak or not and the type of fungus causing the infection. If the immune system is not weak, treatment often takes several weeks to months, but in cases with lowered immunity, prolonged therapy is needed and this may have to be followed by long-term maintenance on antifungal therapy.
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