Diseases Treatment

What is this condition?

In this disorder, the brain and the spinal cord meninges become inflamed, usually as a result of bacterial infection. Such inflammation may involve all three meningeal membranes: the dura mater, the arachnoid, and the pia mater. The prognosis is good and complications are rare, especially if the disease is recognized early and the infecting organism responds to antibiotics. However, the death rate in untreated disease is 70% to 100%. The prognosis is poorer for infants and elderly people.
What causes it?

Meningitis is almost always a complication of another bacterial infection: bacteremia (especially from pneumonia, pus in a body cavity, osteomyelitis, or endocarditis), sinus or middle ear infection, encephalitis, myelitis, or brain abscess.

This disorder may also follow skull fracture, a penetrating head wound, lumbar puncture, or ventricular shunt insertion. Aseptic inflammation of the brain and spinal cord membranes also may result from a virus or other organism. Sometimes, no causative organism can be found. Inflammation of the brain and spinal cord membranes may progress to congestion of adjacent tissues and destroy some nerve cells.
What are the symptoms of Meningitis?

The cardinal symptoms of this disorder are the same as those of infection (fever, chills, malaise) and of increased intracranial pressure (headache, vomiting and, rarely, swelling of the optic disk). Signs of meningeal irritation include rigidity at the nape of the neck, involuntary knee flexion when the neck is passively flexed, inability to extend the leg completely when sitting, exaggerated and symmetrical deeptendon reflexes, and backward arching of the back and extremities so that the body rests on the head and heels.

Other symptoms are irregular heartbeats, irritability, extreme sensitivity to light, double vision and other visual problems, and delirium, deep stupor, and coma.

An infant may show signs of infection and is often fretful and refuses to eat. Such an infant may vomit a great deal, leading to dehydration.

As this disease progresses, twitching, seizures (in 30% of infants), or coma may develop. Most older children have the same symptoms as adults. In the subacute form, onset may be gradual.
How is it diagnosed?

A lumbar puncture (spinal tap), showing typical cerebrospinal fluid findings, and certain physical exam findings usually establish this diagnosis. The fluid may appear cloudy or milky white, depending on the number of white blood cells present. Protein levels in cerebrospinal fluid tend to be high; sugar levels may be low. (In subacute disease, fluid findings may vary.) Cerebrospinal fluid culture and sensitivity tests usually identifY the infecting organism unless it’s a virus.

To help determine the major sites of infection, the doctor will take cultures of the blood, urine, and nose and throat secretions; a chest X-ray; and an electrocardiogram. An abnormally high level of white blood cells and electrolyte abnormalities also are common. Computed tomography (commonly called a CAT scan) can rule out brain hematoma, hemorrhage, or tumor.
How is it treated?

To treat this disorder, the person receives appropriate antibiotic therapy and vigorous supportive care. Usually, intravenous antibiotics are given for at least 2 weeks, followed by oral antibiotics. Such antibiotics include Bicillin, Omnipen, or Nafcil. However, if the person is allergic to penicillin, Chloromycetin or Kantrex may be given. Other drugs include a cardiac glycoside such as Lanoxin to control irregular heartbeats, Osmitrol to decrease brain swelling, an anti seizure drug (usually given intravenously) or a sedative to reduce restlessness, and aspirin or Tylenol (or another acetaminophen product) to relieve headache and fever.

Supportive measures include bed rest, reduction of body temperature, and measures to prevent dehydration. The person must be isolated if the nasal cultures are positive for certain organisms. Of course, treatment includes appropriate therapy for any coexisting conditions, such as pneumonia.

Some stones thrive in acid urine, others in alkaline. Medicines and special diets, such as an acid ash diet, may help to maintain desired balances and deter future stone formation. There are other medical measures which a doctor can institute from his special knowledge of the patient’s body chemistry and physical condition. It is of immediate importance to remove stones that are causing serious trouble, and this generally requires surgery . Sometimes it is desirable to remove the entire kidney, if its function has been markedly impaired by a large stone or stones, and if the remaining kidney is healthy and quite capable of continuing the labors that it has shouldered anyhow. Naturally, it is far more desirable for a person who is susceptible to stone formation to cooperate with his doctor in regular checkups, with x-rays and other measures, which may keep trouble from progressing and do everything possible to avert eventual surgical removal of a kidney.

Symptoms Of Kidney Stones

Some stones cause no symptoms, at least for a long time. Fine crystals, no larger than grains of sand, may pass down the ureter and to the outside world without the patient’s being aware of it. Some “silent” stones are too large to enter or obstruct the ureter, but they may move about in the kidney and do quiet injury to delicate tissues. Some stones may practically fill the kidney pelvis and take on the irregular shape of the cavity, like a cast. These are called “stag horn” calculi from their antler like appearance. person who experiences it. The agony is caused by a stone which enters the ureter and works its way down, gouging as it goes. The pain is not necessarily felt in the mid-back, in the area memorialized by old-time advertisements for kidney nostrums, but may be referred to the pelvic region. Indeed, pain is not invariably excruciating, and the immediate symptoms may be nausea, vomiting, chills and fever.

Kidney Stones Treatment

If the stone gets stuck in the ureter, and medical measures can do little more than relieve pain, surgery will probably be necessary to remove an obstruction which can cause urine to back up, distend, and injure the tract above it most gravely. Stone-harried kidneys generally are more prone to infections; modern antibacterial drugs afford potent measures of control.

Often a stone passes into the bladder and acute pain subsides. Bladder stones are relatively easy to remove with instruments which leave no operative scar. The surgical instrument is inserted through the urethra, the stone grasped and crushed, and the particles withdrawn. Occasionally, a stone will lodge in the urethra and prevent urination. Its removal is comparatively easy and always an immense relief to the patient.