Meningitis - National Library of Medicine - PubMed Health Intraventricular antibiotics for bacterial meningitis in neonates Infection of the membranes and the fluid surrounding the brain (meningitis) and of the fluid‐filled spaces in the brain (ventriculitis) may be caused by bacteria, especially gram‐negative bacteria. This type of infection is difficult to eradicate using safe doses of antibiotics given into the blood stream. In theory, intraventricular administration of antibiotics (administration of antibiotics into the fluid‐filled spaces in the centre of the brain) would produce higher antibiotic concentrations in the fluid in the brain than intravenous administration alone, and eliminate the bacteria more quickly. However, taps of the fluid‐filled spaces may cause harm as the needle has to penetrate the brain tissue. Only one trial was identified. In this trial enrolling infants with gram‐negative meningitis and ventriculitis, the use of intraventricular antibiotics in addition to intravenous antibiotics resulted in a three‐fold increased risk for mortality compared to standard treatment with intravenous antibiotics alone. Based on this result, intraventricular antibiotics should be avoided. Further trials comparing these interventions are not justified in newborn infants.

Treatment of acute cryptococcal meningitis in HIV infected adults, with an emphasis on resource‐limited settings Despite the advent and increasingly wide availability of antiretroviral therapy for people with HIV/AIDS, cryptococcal meningitis remains a significant cause of death and illness amongst individuals with HIV infection in resource‐limited settings (poor countries). The ideal way to manage cryptococcal meningitis remains unclear. The main aim of this review was to determine the best treatment for cryptococcal meningitis in resource‐limited settings. In these settings, usually only Amphotericin and fluconazole are available. The authors didn't find any suitable studies that compared these two drugs. Because Flucytosine, which works well with Amphotericin, is often not available in poor countries, policy makers and government officials should consider using this drug for HIV treatment programmes. Future research into the management of cryptococcal meningitis in resource‐limited settings should focus on the most effective use of medications that are available in these settings. Newer, third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis Acute bacterial meningitis is a life‐threatening illness. Currently the evidence suggests that old and new antibiotics offer the same level of treatment.

Bacteria which cause meningitis are often thought to be resistant to conventional (older) antibiotics, and so doctors often prescribe newer antibiotics (called third generation cephalosporins). Commencing treatment early is vitally important and the choice of antibiotic is often made without any knowledge of possible drug resistance. This review examined 19 studies with 1496 participants to see whether there is a difference in effectiveness between conventional and newer antibiotics. This review found no differences. Adverse effects in both approaches were similar, except for diarrhoea, which was more common in the cephalosporin group. Only three studies dealt with adults; the remaining studies recruited participants aged 15 years and younger. Therefore, we believe that the results probably pertain more to children. Conventional and newer antibiotics seem reasonable options for initial, immediate treatment. The choice may depend on availability, affordability and local policies. Intraventricular antibiotics for bacterial meningitis in neonates Infection of the membranes and the fluid surrounding the brain (meningitis) and of the fluid‐filled spaces in the brain (ventriculitis) may be caused by bacteria, especially gram‐negative bacteria.

This type of infection is difficult to eradicate using safe doses of antibiotics given into the blood stream. In theory, intraventricular administration of antibiotics (administration of antibiotics into the fluid‐filled spaces in the centre of the brain) would produce higher antibiotic concentrations in the fluid in the brain than intravenous administration alone, and eliminate the bacteria more quickly. However, taps of the fluid‐filled spaces may cause harm as the needle has to penetrate the brain tissue. Only one trial was identified. In this trial enrolling infants with gram‐negative meningitis and ventriculitis, the use of intraventricular antibiotics in addition to intravenous antibiotics resulted in a three‐fold increased risk for mortality compared to standard treatment with intravenous antibiotics alone. Based on this result, intraventricular antibiotics should be avoided. Further trials comparing these interventions are not justified in newborn infants. Treatment of acute cryptococcal meningitis in HIV infected adults, with an emphasis on resource‐limited settings Despite the advent and increasingly wide availability of antiretroviral therapy for people with HIV/AIDS, cryptococcal meningitis remains a significant cause of death and illness amongst individuals with HIV infection in resource‐limited settings (poor countries).

The ideal way to manage cryptococcal meningitis remains unclear. The main aim of this review was to determine the best treatment for cryptococcal meningitis in resource‐limited settings. In these settings, usually only Amphotericin and fluconazole are available. The authors didn't find any suitable studies that compared these two drugs. Because Flucytosine, which works well with Amphotericin, is often not available in poor countries, policy makers and government officials should consider using this drug for HIV treatment programmes. Future research into the management of cryptococcal meningitis in resource‐limited settings should focus on the most effective use of medications that are available in these settings. Newer, third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis Acute bacterial meningitis is a life‐threatening illness. Currently the evidence suggests that old and new antibiotics offer the same level of treatment. Bacteria which cause meningitis are often thought to be resistant to conventional (older) antibiotics, and so doctors often prescribe newer antibiotics (called third generation cephalosporins). Commencing treatment early is vitally important and the choice of antibiotic is often made without any knowledge of possible drug resistance.

This review examined 19 studies with 1496 participants to see whether there is a difference in effectiveness between conventional and newer antibiotics. This review found no differences. Adverse effects in both approaches were similar, except for diarrhoea, which was more common in the cephalosporin group. Only three studies dealt with adults; the remaining studies recruited participants aged 15 years and younger. Therefore, we believe that the results probably pertain more to children. Conventional and newer antibiotics seem reasonable options for initial, immediate treatment. The choice may depend on availability, affordability and local policies. Meningitis | definition of meningitis by Medical dictionary Meningitis | definition of meningitis by Medical dictionary Related to meningitis: meningococcal meningitis Meningitis Definition Meningitis is a serious inflammation of the meninges, the thin, membranous covering of the brain and the spinal cord. Meningitis is most commonly caused by infection (by bacteria, viruses, or fungi), although it can also be caused by bleeding into the meninges, cancer , diseases of the immune system, and an inflammatory response to certain types of chemotherapy or other chemical agents.

The most serious and difficult-to-treat types of meningitis tend to be those caused by bacteria. In some cases, meningitis can be a potentially fatal condition. Description Meningitis is a particularly dangerous infection because of the very delicate nature of the brain. Brain cells are some of the only cells in the body that, once killed, will not regenerate themselves. Therefore, if enough brain tissue is damaged by an infection, serious, life-long handicaps will remain. In order to learn about meningitis, it is important to have a basic understanding of the anatomy of the brain. The meninges are three separate membranes, layered together, which encase the brain and spinal cord: The dura is the toughest, outermost layer, and is closely attached to the inside of the skull. The middle layer, the arachnoid, is important because of its involvement in the normal flow of the cerebrospinal fluid (CSF), a lubricating and nutritive fluid that bathes both the brain and the spinal cord. The innermost layer, the pia, helps direct blood vessels into the brain. The space between the arachnoid and the pia contains CSF, which helps insulate the brain from trauma.

Many blood vessels course through this space. CSF, produced within specialized chambers deep inside the brain, flows over the surface of the brain and spinal cord. This fluid serves to cushion these relatively delicate structures, as well as supplying important nutrients for brain cells. CSF is reabsorbed by blood vessels located within the meninges. A careful balance between CSF production and reabsorption is important to avoid the accumulation of too much CSF. Because the brain is enclosed in the hard, bony case of the skull, any disease that produces swelling will be damaging to the brain. The skull cannot expand at all, so when the swollen brain tissue pushes up against the skull's hard bone, the brain tissue becomes damaged and may ultimately die. Furthermore, swelling on the right side of the brain will not only cause pressure and damage to that side of the brain, but by taking up precious space within the tight confines of the skull, the left side of the brain will also be pushed up against the hard surface of the skull, causing damage to the left side of the brain as well. Another way that infections injure the brain involves the way in which the chemical environment of the brain changes in response to the presence of an infection.

The cells of the brain require a very well-regulated environment. Careful balance of oxygen, carbon dioxide, sugar (glucose), sodium, calcium, potassium, and other substances must be maintained in order to avoid damage to brain tissue. An infection upsets this balance, and brain damage can occur when the cells of the brain are either deprived of important nutrients or exposed to toxic levels of particular substances. The cells lining the brain's tiny blood vessels (capillaries) are specifically designed to prevent many substances from passing into brain tissue. This is commonly referred to as the blood-brain barrier. The blood-brain barrier prevents various substances that could be poisonous to brain tissue (toxins), as well as many agents of infection, from crossing from the blood stream into the brain tissue. While this barrier is obviously an important protective feature for the brain, it also serves to complicate treatment in the case of an infection by making it difficult for medications to pass out of the blood and into the brain tissue where the infection is located. Causes and symptoms The most common infectious causes of meningitis vary according to an individual's age, habits, living environment, and health status.

While nonbacterial types of meningitis are more common, bacterial meningitis is the more potentially life-threatening. Three bacterial agents are responsible for about 80% of all bacterial meningitis cases. These bacteria are Haemophilus influenzae type b, Neisseria meningitidis (causing meningococcal meningitis), and Streptococcus pneumoniae (causing pneumococcal meningitis). In newborns, the most common agents of meningitis are those that are contracted from the newborn's mother, including Group B streptococci (becoming an increasingly common infecting organism in the newborn period), Escherichia coli, and Listeria monocytogenes. The highest incidence of meningitis occurs in babies under a month old, with an increased risk of meningitis continuing through about two years of age. Older children are more frequently infected by the bacteria Haemophilus influenzae, Neisseria meningitidis, and Streptococci pneumoniae. Adults are most commonly infected by either S. pneumoniae or N. meningitidis, with pneumococcal meningitis the more common.

Certain conditions predispose to this type of meningitis, including alcoholism and chronic upper respiratory tract infections (especially of the middle ear, sinuses, and mastoids). N. meningitidis is the only organism that can cause epidemics of meningitis. In particular, these have occurred when a child in a crowded day-care situation or a military recruit in a crowded training camp has fallen ill with meningococcal meningitis. Viral causes of meningitis include the herpes simplex virus, the mumps and measles viruses (against which most children are protected due to mass immunization programs), the virus that causes chicken pox, the rabies virus, and a number of viruses that are acquired through the bites of infected mosquitoes. A number of medical conditions predispose individuals to meningitis caused by specific organisms. Patients with AIDS (acquired immune deficiency syndrome) are more prone to getting meningitis from fungi, as well as from the agent that causes tuberculosis . Patients who have had their spleens removed, or whose spleens are no longer functional (as in the case of patients with sickle cell disease ) are more susceptible to other infections, including meningococcal and pneumococcal meningitis.

The majority of meningitis infections are acquired by blood-borne spread. A person may have another type of infection (of the lungs, throat, or tissues of the heart) caused by an organism that can also cause meningitis. If this initial infection is not properly treated, the organism will continue to multiply, find its way into the blood stream, and be delivered in sufficient quantities to invade past the blood brain barrier. Direct spread occurs when an organism spreads to the meninges from infected tissue next to or very near the meninges. This can occur, for example, with a severe, poorly treated ear or sinus infection. Patients who suffer from skull fractures possess abnormal openings to the sinuses, nasal passages, and middle ears. Organisms that usually live in the human respiratory system without causing disease can pass through openings caused by such fractures, reach the meninges, and cause infection. Similarly, patients who undergo surgical procedures or who have had foreign bodies surgically placed within their skulls (such as tubes to drain abnormal amounts of accumulated CSF) have an increased risk of meningitis. Organisms can also reach the meninges via an uncommon but interesting method called intraneural spread.

This involves an organism invading the body at a considerable distance away from the head, spreading along a nerve, and using that nerve as a kind of ladder into the skull, where the organism can multiply and cause meningitis. Herpes simplex virus is known to use this type of spread, as is the rabies virus. The most classic symptoms of meningitis (particularly of bacterial meningitis) include fever , headache, vomiting, sensitivity to light (photophobia), irritability, severe fatigue (lethargy), stiff neck, and a reddish purple rash on the skin. Untreated, the disease progresses with seizures, confusion, and eventually coma . A very young infant may not show the classic signs of meningitis. Early in infancy, a baby's immune system is not yet developed enough to mount a fever in response to infection, so fever may be absent. Some infants with meningitis have seizures as their only identifiable symptom. Similarly, debilitated elderly patients may not have fever or other identifiable symptoms of meningitis. Damage due to meningitis occurs from a variety of phenomena. The action of infectious agents on the brain tissue is one direct cause of damage.

Other types of damage may be due to the mechanical effects of swelling and compression of brain tissue against the bony surface of the skull. Swelling of the meninges may interfere with the normal absorption of CSF by blood vessels, causing accumulation of CSF and damage from the resulting pressure on the brain. Interference with the brain's carefully regulated chemical environment may cause damaging amounts of normally present substances (carbon dioxide, potassium) to accumulate. Inflammation may cause the blood-brain barrier to become less effective at preventing the passage of toxic substances into brain tissue. Diagnosis A number of techniques are used when examining a patient suspected of having meningitis to verify the diagnosis. Certain manipulations of the head (lowering the head, chin towards chest, for example) are difficult to perform and painful for a patient with meningitis. The most important test used to diagnose meningitis is the lumbar puncture (commonly called a spinal tap). Lumbar puncture (LP) involves the insertion of a thin needle into a space between the vertebrae in the lower back and the withdrawal of a small amount of CSF. The CSF is then examined under a microscope to look for bacteria or fungi. Normal CSF contains set percentages of glucose and protein.

These percentages will vary with bacterial, viral, or other causes of meningitis. For example, bacterial meningitis causes a greatly lower than normal percentage of glucose to be present in CSF, as the bacteria are essentially "eating" the host's glucose, and using it for their own nutrition and energy production. Normal CSF should contain no infection-fighting cells (white blood cells), so the presence of white blood cells in CSF is another indication of meningitis. Some of the withdrawn CSF is also put into special lab dishes to allow growth of the infecting organism, which can then be identified more easily. Special immunologic and serologic tests may also be used to help identify the infectious agent. In rare instances, CSF from a lumbar puncture cannot be examined because the amount of swelling within the skull is so great that the pressure within the skull (intracranial pressure) is extremely high. This pressure is always measured immediately upon insertion of the LP needle. If it is found to be very high, no fluid is withdrawn because doing so could cause herniation of the brain stem.

Herniation of the brain stem occurs when the part of the brain connecting to the spinal cord is thrust through the opening at the base of the skull into the spinal canal. Such herniation will cause compression of those structures within the brain stem that control the most vital functions of the body (breathing, heart beat, consciousness). Death or permanent debilitation follows herniation of the brain stem. Treatment Antibiotic medications (forms of penicillin and cephalosporins , for example) are the most important element of treatment against bacterial agents of meningitis. Because of the effectiveness of the blood-brain barrier in preventing the passage of substances into the brain, medications must be delivered directly into the patient's veins (intravenously, or by IV), at very high doses. Antiviral drugs (acyclovir) may be helpful in shortening the course of viral meningitis, and antifungal medications are available as well. Other treatments for meningitis involve decreasing inflammation (with steroid preparations) and paying careful attention to the balance of fluids, glucose, sodium, potassium, oxygen, and carbon dioxide in the patient's system. Patients who develop seizures will require medications to halt the seizures and prevent their return.

Prognosis Viral meningitis is the least severe type of meningitis, and patients usually recover with no long-term effects from the infection. Bacterial infections, however, are much more severe, and progress rapidly. Without very rapid treatment with the appropriate antibiotic, the infection can swiftly lead to coma and death in less than a day's time. While death rates from meningitis vary depending on the specific infecting organism, the overall death rate is just under 20%. The most frequent long-term effects of meningitis include deafness and blindness, which may be caused by the compression of specific nerves and brain areas responsible for the senses of hearing and sight. Some patients develop permanent seizure disorders, requiring life-long treatment with anti-seizure medications. Scarring of the meninges may result in obstruction of the normal flow of CSF, causing abnormal accumulation of CSF. This may be a chronic problem for some patients, requiring the installation of shunt tubes to drain the accumulation regularly. Prevention Prevention of meningitis primarily involves the appropriate treatment of other infections an individual may acquire, particularly those that have a track record of seeding to the meninges (such as ear and sinus infections).

Preventive treatment with antibiotics is sometimes recommended for the close contacts of an individual who is ill with meningococcal or H. influenzae type b meningitis. A meningococcal vaccine exists, and is sometimes recommended to individuals who are traveling to very high risk areas. A vaccine for H. influenzae type b is now given to babies as part of the standard array of childhood immunizations. Resources American Academy of Neurology. 1080 Montreal Ave., St. Paul, MN 55116. (612) 695-1940. Meningitis Foundation of America. 7155 Shadeland Station, Suite 190, Indianapolis, IN 46256-3922. (800) 668-1129. 〈〉. meningitis [men″in-ji´tis] (pl. meningi´tides) inflammation of the meninges, usually by either a bacterium (bacterial m.) or a virus (viral m.).

When it affects the dura mater it is termed pachymeningitis ; when the arachnoid and pia mater are involved, it is called leptomeningitis . The term meningitis does not refer to a specific disease entity but rather to the pathologic condition of inflammation of the tissues of the meninges. The etiologic agent can be anything that activates an inflammatory response , including both pathogenic and nonpathogenic organisms, such as bacteria, viruses, and fungi; chemical toxins such as lead and arsenic; contrast media used in myelography; and metastatic malignant cells. Enteroviruses are the most common causes of aseptic meningitis. Bacterial Meningitis. This form occurs when pathogenic bacteria enter the subarachnoid space and cause a pyogenic inflammatory response . The most common causes are Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, which are responsible for approximately 70 per cent of all cases. The incidence is age-related. In adults, S. pneumoniae and N.

meningitidis cause most of the cases; in children aged 1 month to 15 years, N. meningitidis and H. influenzae predominate; in neonates less than 1 month old, the disease is usually a nosocomial infection with gram-negative enteric bacilli. Almost all bacterial infections of the meninges enter the nervous system after having invaded and infected another region of the body and then are spread by local extension, as from the sinuses, or through the blood, as in septicemia. The organisms gain access to the ventriculosubarachnoid spaces and the cerebrospinal fluid where they cause irritation of the tissues bathed by the fluid. Bacterial meningitis typically begins with headache, nausea and vomiting, stiff neck (nuchal rigidity), and chills and fever. Irritability and confusion occur early in the course of the disease, and convulsive seizures occur in about 25 per cent of patients. As the disease progresses the patient becomes less rational, has decreasing levels of consciousness, and lapses into coma.

Inability to straighten the knee when the hip is flexed (a positive kernig's sign ) and involuntary flexing of the hip and knee when the neck is flexed forward (a positive brudzinski's sign ) are indicative of meningeal irritation. A diagnosis of bacterial meningitis is verified by isolation of the organism from a specimen of cerebrospinal fluid obtained by lumbar puncture. Treatment with the appropriate antibacterial agent is begun at once to reduce the numbers of proliferating bacteria attacking the central nervous system. Supportive measures include rest, maintenance of fluid and electrolyte balance, and prevention or control of convulsions with anticonvulsant drugs. The prognosis is generally good, especially for meningococcal meningitis in which residual neurologic deficits and persistent convulsive seizures are rare. Pneumococcal meningitis and meningitis due to Haemophilus influenzae are more likely to be complicated by these sequelae as well as by septic shock and hydrocephalus. Benign Viral Meningitis. This term encompasses a group of disorders in which there is some meningeal irritation but no pyogenic organism can be found in the cerebrospinal fluid.

It is, therefore, called also aseptic meningitis complex, which is somewhat misleading because the meningeal irritation often follows infection with the mumps virus or with one of the picornaviruses. The patient with this disorder typically complains of headache and signs characteristic of meningeal irritation, intolerance to light, and pain when the eyes are moved from side to side. Most of the symptoms are mild, and treatment is largely supportive and symptomatic; the disease is self-limiting. Patient Care. Assessment of the patient with meningitis includes monitoring vital signs, neurologic status, and fluid and electrolyte status. The plan of care should include provisions for rest and relief from discomfort, a quiet and nonstimulating environment, protection from injury during convulsions, control of elevated body temperature, and isolation precautions as indicated by the specific causative organism. In general, enteric precautions are indicated for patients with aseptic meningitis caused by an enterovirus. Fungal and meningococcal meningitis require respiratory precautions. Antibiotics must be given precisely as ordered so as to avoid further damage to the central nervous system.

Early signs of increased intracranial pressure from brain edema are reported promptly so that measures to reduce pressure can be taken as soon as possible. During the acute phase and convalescence the patient is watched for signs of complications such as septic shock, vascular collapse, and hydrocephalus. Nutritional status must be maintained throughout the course of illness to reinforce the patient's natural resources for combating infection and recovering from its deleterious effects. Portals of entry resulting in meningitis, meningoencephalitis, and intracranial mass lesions. From Mahon and Manuselis, 2000. aseptic meningitis any of several mild types of meningitis, most of which are caused by viruses; see viral meningitis . bacterial meningitis meningitis caused by bacteria; common pathogens are Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and Mycobacterium tuberculosis. Some types may be serious, acute, or even fulminating. See also viral meningitis . cerebrospinal meningitis an inflammation of the brain and spinal cord; it may be caused by any of numerous different organisms.

epidemic cerebrospinal meningitis an acute infectious disease with seropurulent inflammation of the membranes of the brain and spinal cord, due to infection by Neisseria meningitidis (meningococcus). It usually occurs in epidemics, and symptoms are those of acute cerebral and spinal meningitis. There is also usually an eruption of erythematous, herpetic, or hemorrhagic spots on the skin. The fulminating or malignant form is known as Waterhouse-Friderichsen syndrome . spinal meningitis inflammation of the meninges of the spinal cord. viral meningitis meningitis due to any of various viruses, such as a coxsackievirus or the mumps virus , with lymphocytes in the cerebrospinal fluid. It usually has a short uncomplicated course characterized by malaise, fever, headache, stiffness of neck and back, and nausea. See also aseptic meningitis . men·in·gi·tis men·in·git·i·des (men'in-jī'tis, -jit'i-dēz), /men·in·gi·tis/ (men″in-ji´tis) pl.

meningi´tides [Gr.] inflammation of the meninges.meningit´ic basilar meningitis that affecting the meninges at the base of the brain. cerebral meningitis inflammation of the membranes of the brain. cerebrospinal meningitis inflammation of the membranes of the brain and spinal cord. chronic meningitis a variable syndrome of prolonged fever, headache, lethargy, stiff neck, confusion, nausea, and vomiting, with pleocytosis; due to a variety of infectious and noninfectious causes. cryptococcal meningitis cryptococcosis in which the meninges are invaded by Cryptococcus . eosinophilic meningitis meningitis characterized by an increase in lymphocytes and a high percentage of eosinophils in the cerebrospinal fluid, usually due to Angiostrongylus cantonensis infection.

• Herpes simplex virus meningitis Neurology A condition characterized by potentially fatal meningeal inflammation Pathogenesi Infants, Streptococcus agalactiae, E coli, Klebsiella-Enterobacter, Pseudomonas, Serratia, Listeria monocytogenes, Citrobacter diversus; children, H influenzae, S pneumoniae, Neisseria meningitidis Workup CT, MRI, EEG–rarely performed, CBC & CSF–↑ WBCs/PMNs, ↑ CSF protein Management Neonates ampicillin ±ceftriaxone ±gentamicin; older children, ceftriaxone, cefotaxime. See Aseptic meningitis , Bacterial meningitis , Cryptococcal meningitis , Eosinophilic meningitis, Gram negative meningitis, H influenzae meningitis, Lymphocytic choriomeningitis , Meningococcal meningitis , Mollaret's meningitis , Neoplastic meningitis, Pneumococcal meningitis , Pseudomeningitis, Purulent meningitis , Staphylococcal meningitis , Tuberculous meningitis .

Meningitis, clinical findings by age Neonates Irritation, respiratory distress, altered sleep patterns, vomiting, lethargy, labile temperature, shock bulging fontanelles Pre-toddlers Irritation, altered sleep patterns, vomiting, lethargy, fever, shock, nuchal rigidity, coma, shock Toddlers Headache, stiff neck, photophobia, myalgia, lethargy, fever, shock, nuchal rigidity, coma, shock men·in·gi·tis (men-en-jit'is) (-jit'i-dez?) plural.meningitides [ meningo- + -itis] MENINGITIS: Streptococcus pneumoniae in cerebrospinal fluid (Orig. mag. ×400) Inflammation of the membranes of the spinal cord or brain, usually but not always caused by an infectious illness. Bacterial meningitis is a medical emergency that must be treated and diagnosed quickly to obtain the best outcome. It is fatal in 10% to 40% of cases, even with optimal therapy, and may result in persistent neurological injury in about 10% of patients who survive the initial infection.

In the U.S., bacterial meningitis formerly affected infants and children more than adults; the demographics of the disease changed in the 1990s after vaccines against Haemophilus influenzae were introduced into pediatric care. Infectious meningitis now is largely a disease of adults and usually is caused by Streptococcus pneumoniae or Neisseria meningitidis, although other microbes may be responsible. Intravenous steroids (such as dexamethasone) given at the beginning of therapy decreases the risk of death and disability. illustration; meningitic (men-en-jit'ik), adjective Etiology Meningitis may result from infection with bacteria, viruses, mycobacteria, fungi, amebas, or noninfectious sources, such as chemical irritation. Occasionally, infectious meningitis follows head trauma or sinus or ear infection. It also may result from the spread of blood-borne infection. Symptoms The symptoms of meningitis include fever, chills, headache, stiff neck, altered mental status, vomiting, and photophobia. Many patients with meningitis present with only two or three of these clinical indicators.

Acute bacterial meningitis and meningitis caused by some fungi and amebas may also cause rapid deterioration in mental status, seizures, shock, and death. Diagnosis Cerebrospinal fluid (CSF) must be examined. A cell count to assess the level of inflammation, a Gram stain to look for infectious organisms, measurement of spinal fluid pressure, and levels of bacterial antigens, glucose, lactate, and protein are typically obtained. CSF may appear milky-white due to the large numbers of white blood cells present. Prevention All children in the U.S. are now vaccinated against H. influenzae type b (Hib) and pneumococcus (Prevnar) as primary prevention against the disease. Meningococcal polysaccharide vaccines are highly effective in preventing the disease during epidemic outbreaks with this organism. Close family contacts of patients with meningococcal meningitis, day care center contacts of infected children, or any persons (including health care workers) with direct contact with the saliva of infected patients are to be treated with antibiotics to prevent disease transmission.

Treatment Definitive treatment depends on identification of the underlying causes, but empirical therapies for infectious meningitis must be given immediately, hours before the causative agent is identified. Dexamethasone is administered intravenously before starting antibiotic therapy for best response to reduce the incidence of deafness in children (a common complication) and to help prevent death in adults with pneumococcal meningitis. The evolution of penicillin-resistant strains of pneumococci has altered traditional empirical treatments. Third-generation cephalosporins, ampicillin and gentamicin, chloramphenicol, or vancomycin plus rifampin have been given, depending on the patient's age, level of immune function, or clinical presentation. Antibiotic therapy is usually administered intravenously for 2 weeks, then orally for a prescribed period for bacterial infections. Viral meningitis treatment is supportive; recovery usually is complete (within 7 to 10 days). Antipyretic analgesics relieve headache and fever. Patient care Specific measures for coexisting conditions and for shock and other complications (disseminated intravascular coagulation, metabolic acidosis, or seizures) should be initiated when indicated.

Supportive therapies include bed rest, a dimly lit room, and reduced sensory stimulation. Standard precautions apply, and airborne/droplet precautions are initiated if nasal cultures are positive. Neurologic function is closely monitored for changes in level of consciousness, signs of increasing intracranial pressure (ICP), and indications of cranial nerve involvement. Fluid and electrolyte balance is monitored, and fluids are provided in quantities to prevent or treat dehydration while avoiding fluid overload and resultant cerebral edema. The patient is assessed for adverse effects of antibiotic therapy with peak and trough blood levels assessed to ensure therapeutic levels and avoid toxic overdose. The patient is repositioned carefully and assisted with range-of-motion exercises to prevent skin, muscle, and joint complications. Frequent mouth care is provided and adequate nutrition and elimination are maintained. Small frequent meals, nasogastric or parenteral feedings are provided as required. Constipation is prevented by stool softeners or mild laxatives to prevent straining, which could increase ICP. Basic explanations, realistic reassurance, and support are provided, with reorientation if delirium or confusion is present. Questions from the patient and family should be answered honestly, with reassurance that behavioral changes usually resolve.

The patient with infectious meningitis may need monitoring in an ICU. Patients with neurologic deficits that appear to be continuing should be referred to a rehabilitation program once the acute phase of illness has ended. To help prevent meningitis, patients with chronic sinusitis or other chronic infectious or inflammatory illnesses should be taught the importance of proper hand hygiene and of following through with prescribed treatments. Sterile techniques should be strictly enforced when treating patients with head wounds, skull fractures, or lumbar puncture, ventricular shunting, or other invasive therapies. MENINGITIS acute aseptic meningitis A nonpurulent form of meningitis often due to viral infection. It usually runs a short, benign course, marked by fever and headache and ending with recovery. illustration aseptic meningitis Meningitis without obvious evidence of bacterial infection. It typically results from a viral infection (such as coxsackievirus or other enteroviruses) although frequently no causative organism is identified. Symptoms Meningitis resulting from trauma to the meninges. tuberculous meningitis Meningitis resulting from the spread of Mycobacterium tuberculosis to the central nervous system, usually from a primary focus of infection in the lungs.

viral meningitis A form of aseptic meningitis due to infection with adenovirus, coxsackievirus, echovirus, HIV, mumps virus, lymphocytic choriomeningitis virus, polio viruses, and others. Patients report fever, headache, and stiff neck. Lumbar puncture reveals an excessive number of lymphocytes, typically without a decrease in cerebrospinal fluid glucose levels. illustration meningitis Inflammation of the MENINGES . This can be caused by many different organisms, especially the HERPES SIMPLEX virus, the VARICELLA-ZOSTER virus that causes CHICKEN POX and SHINGLES , the meningococcus, the POLIO virus, the echo virus, the COXSACKIE virus and the MUMPS virus. Meningitis may also complicate LYME DISEASE , LEPTOSPIROSIS , TYPHUS , TUBERCULOSIS and other infections. Viral meningitis may be a minor illness but can be acute, with headache, stiff neck, fever and drowsiness progressing rapidly to deep coma.

There may be weakness or paralysis of the muscles, speech disturbances, double vision, loss of part of the field of vision and epileptic fits. Most patients recover completely, but some have residual nervous system damage. There is no specific treatment for most virus infections, but herpes meningitis responds to the drug ACYCLOVIR. See also MENINGOCOCCAL MENINGITIS . meningitis inflammation of the MENINGES caused by infection, normally by bacteria such as Neisseria meningitidis or STREPTOCOCCUS pneumoniae or viruses such as MUMPS virus. meningitis (me·nin·jīˑ·tis), n an infection or inflammation of the membranes that cover the spinal cord and brain because of a virus or a bacterium. Bacterial infection is usually more life-threatening and is indicated by the sudden onset of a stiff neck, headache, fever, and vomiting; may cause stupor, confusion, and convulsions if untreated. Antibiotics for the specific causative agent are prescribed to treat bacterial meningitis. Meningitis.

18 Effects of Meningitis on the Body Joint Pain 18 Effects of Meningitis on the Body Meningitis is swelling of the membranes around the brain and spinal cord. There are different types of meningitis, but most are caused by viruses or bacteria. Viral meningitis can make you very sick, but it often doesn’t leave lingering effects. Bacterial meningitis is more serious. It progresses rapidly and can cause permanent damage or even become life-threatening. Quick diagnosis and treatment can help prevent some of the potential long-term side effects. If you have symptoms of meningitis, see your doctor without delay. Anyone can get meningitis, but it’s more common in babies, children, and adolescents. Central Nervous System The central nervous system is made up of the brain, spinal cord, and nerves. Meningitis is an infection that causes the protective membranes of the nervous system to swell. Inflammation of the brain and spinal cord can affect every part of your body. Fever and other symptoms can come on suddenly and progress very quickly, causing devastating effects. Headache can be an early warning sign of meningitis. Residual headaches may be a problem for some time.

Inflammation of the brain can cause a wide range of problems, including cognitive issues and seizures. Trouble with memory and concentration may last well after the illness has passed. Children may be left with lingering learning difficulties. Swelling in the brain can also interfere with the senses. It can cause ringing in the ears (tinnitus), partial hearing loss, or deafness. It may cause speech problems. Light sensitivity, eye pain, and loss of vision are possible. Inflammation and fever can cause loss of appetite. Sick stomach, nausea, and vomiting are common. Infants and young children may become fussy, irritable, and difficult to comfort. And excessive sleepiness is a symptom of meningitis, so it may be hard to wake a sleeping child. Untreated, meningitis can lead to coma. Poor coordination, dizziness, and clumsiness may remain for some time after a bout with meningitis. Children may have emotional problems following the illness, including clinginess, moodiness, and sleep disturbances. Diagnostic testing may include brain imaging and spinal fluid analysis (spinal tap). Circulatory System As bacteria multiply in your bloodstream, they may release toxins (septicemia). Septicemia is a life- threatening condition.

Bleeding under the skin starts off looking like a mild rash. As blood pressure falls and circulation slows, blood vessels become damaged. The rash spreads and darkens to a deep red or dark purple. The lungs and kidneys may deteriorate, and poor circulation puts the fingers, toes, arms, and legs at risk of amputation. Diagnostic testing may include analyzing the blood for evidence of bacteria. If hospitalized, intravenous fluids, steroids, or antibiotics may be given as part of your treatment. Skin (Integumentary System) With the onset of fever, the skin may look flushed. If septicemia sets in and blood vessels become damaged, you’ll see evidence on the skin. At first, your skin may just look a little blotchy. You might mistake symptoms of septicemia for tiny scratches or a minor rash. The rash can appear anywhere on the body. As the infection worsens, the rash spreads and gets darker, eventually resembling large bruises. In some cases, the rash can cause permanent scarring. The “glass test” can be used to test for meningitis. If you press a drinking glass against a rash, it should fade. If it’s meningitis, you’ll still be able to view the rash clearly through the glass.

Keep in mind that the glass test isn’t 100 percent accurate. It’s best to check with your doctor. Skeletal and Muscular Systems Stiff neck and back are common in meningitis. It may become difficult to turn your neck at all. In severe cases, the head, neck, and spine become painfully rigid and arched (opisthotonos). Babies and young children are more likely to experience opisthotonos than older people. A baby with meningitis may produce a high-pitched scream when you try to pick them up. Joint stiffness may continue long after the illness clears up, and arthritis can also be an after effect. For infants, a tight or bulging fontanel (the soft spot on top of a baby’s head) is a sign of inflammation of the brain. If your infant shows this symptom, seek medical attention immediately. Muscle weakness is a common symptom of meningitis, both during the illness and in the months that follow. Muscle spasms, body aches, or generalized weakness in some parts of the body may occur. Recommended for You Video: Meningitis Awareness Meningitis is a rare but very serious condition that results from a bacterial infection.

It usually causes swelling and inflammation in the tissues surrounding the brain and spinal cord. Grand mal seizure Treatments and drugs - Mayo Clinic Rufinamide (Banzel) Perampanel (Fycompa) Finding the right medication and dosage can be challenging. Your doctor likely will first prescribe a single drug at a relatively low dosage, and then increase the dosage gradually until your seizures are well-controlled. Many people with epilepsy are able to prevent seizures by taking only one drug, but others require more than one. If you've tried two or more single-drug regimens without success, your doctor may recommend trying a combination of two drugs. To achieve the best seizure control possible, take medications exactly as prescribed. Always call your doctor before adding other prescription medications, over-the-counter drugs or herbal remedies. And never stop taking your medication without talking to your doctor. Mild side effects of anti-seizure medications can include: Fatigue Speech problems Extreme fatigue In addition, the drug Lamictal has been linked to an increased risk of aseptic meningitis, an inflammation of the protective membranes that cover the brain and spinal cord that's similar to bacterial meningitis. Pregnancy and seizures Women who've had previous seizures usually are able to have healthy pregnancies.

Birth defects related to certain medications can sometimes occur. In particular, valproic acid has been associated with cognitive deficits and neural tube defects, such as spina bifida. The American Academy of Neurology recommends that women avoid using valproic acid during pregnancy because of risks to the baby. Discuss these risks with your doctor. Because of the risk of birth defects, and because pregnancy can alter medication levels, preconception planning is particularly important for women who've had seizures. In some cases, it may be appropriate to change the dose of seizure medication before or during pregnancy. Medications may be switched in rare cases. Contraception and anti-seizure medications It's also important to know that some anti-seizure medications can alter the effectiveness of oral contraceptive (birth control) medication. If contraception is a high priority, check with your doctor to evaluate whether your medication interacts with your oral contraceptive, and if other forms of contraception need to be considered. Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. Accessed March 11, 2014. Tonic-clonic seizures. Epilepsy Foundation. Accessed March 11, 2014. Schachter SC.

Evaluation of the first seizure in adults. Accessed March 11, 2014. Seizure disorders. The Merck Manuals: The Merck Manual for Health Care Professionals. Accessed March 11, 2014. Schmidt D, et al. Drug treatment of epilepsy in adults. British Medical Journal. 2014;348:g254. FDA Drug safety communication: Aseptic meningitis risk with use of seizure drug Lamictal. U.S. Food and Drug Administration. Accessed March 12, 2014. Ahmed R, et al. Epilepsy in pregnancy. Australian Family Physician. 2014;43:112. Products and Services FDA Lamictal® Warning | Meningitis, Stevens-Johnson Syndrome & Death Side Effects FDA Issues Warning On Anti-Seizure Drug Lamictal® What’s the problem? The U.S. Food and Drug Administration said in August 2010 that Lamictal, a medicine used to treat seizures in children, can cause aseptic meningitis, an inflammation of the protective membranes that cover the brain and spinal cord.

The FDA said it was revising Lamictal’s drug label to warn about the meningitis risk as well as the medication guide that is given to patients. In a statement, Glaxo said it agreed to the label change. “Aseptic meningitis is a rare but serious side-effect of Lamictal use,” said Russell Katz, director of the FDA’s neurology-products division. Patients who experience symptoms “should consult their health-care professional immediately,” he said. The FDA said its decision to revise the Lamictal label is based on 40 cases of aseptic meningitis reported in patients taking Lamictal from December 1994 to November 2009. Of the 40 patients, 35 were hospitalized. In most cases, the patients’ symptoms were resolved after Lamictal was discontinued. In 15 cases, symptoms returned when patients restarted Lamictal, according to the FDA.

Click here to read the official FDA warning letter Related Content on our Website CDC gives update on fungal meningitis CDC gives update on fungal meningitis Updated: October 9, 2012 â 8:15 AM EDT 215-854-4506 The Centers for Disease Control and Prevention said Monday the fungal meningitis outbreak attributed to a Massachusetts compounding pharmacy amounted to 105 cases in nine states with eight deaths, but allowed for the possibility that 13,000 patients might have received products from the company. The company, New England Compounding Pharmacy, Inc. - also known as New England Compounding Center (NECC) - ceased operations over the weekend and recalled all of its products. The CDC summarized the situation this way: "CDC is coordinating a multistate investigation of meningitis among patients who received epidural steroid injections (medication injected into the spine). Several of these patients have had strokes related to the meningitis. In several patients, the meningitis was found to be caused by a fungus that is common in the environment but rarely causes meningitis. This form of meningitis is not contagious.

The source of the fungus has not yet been identified, and the cause of infections in the other patients is still being assessed." The CDC's general information is here: Is the source of the outbreak known? CDC is investigating medications and products that are associated with this outbreak of meningitis. At this point, there is not enough evidence to determine the original source of the outbreak, however there is a link to an injectable steroid medication. The lots of medication that were given to patients have been recalled by the manufacturer. What are the states that received the implicated product? California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas, and West Virginia What is meningitis? Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection frequently with a bacteria or virus, but meningitis can also be caused by less common pathogens such as fungi. The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.

What is fungal meningitis? Fungal meningitis occurs when the protective membranes that cover the brain and spinal cord are infected with a fungus. Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body, as a result of the fungus being introduced directly into the central nervous system, or by direct extension from an infected body site next to the central nervous system. Is fungal meningitis common after epidural injections? Epidural injections are generally very safe procedures, and complications are rare. Fungal meningitis is an extremely rare cause of meningitis overall, including after epidural injections. The type of epidural medication given to patients affected by this outbreak is not the same type of medication as that given to women during childbirth. What are the symptoms of fungal meningitis? Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, however they often appear more gradually and can be very mild at first. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms. The CDC link is here .

Published: Meningitis - NHS Choices Meningitis Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning (septicaemia) and result in permanent damage to the brain or nerves. A number of vaccinations are available that offer some protection against meningitis. This page covers: Symptoms of meningitis develop suddenly and can include: a high temperature (fever) over 37.5C (99.5F) being sick a headache a blotchy rash that doesn't fade when a glass is rolled over it (this won't always develop) a dislike of bright lights drowsiness or unresponsiveness Read more about the symptoms of meningitis . When to get medical help You should get medical advice as soon as possible if you're concerned that you or your child could have meningitis. Trust your instincts and don't wait until a rash develops.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you think you or your child might be seriously ill. Call NHS 111 or your GP surgery for advice if you're not sure if it's anything serious or you think you may have been exposed to someone with meningitis. How meningitis is spread Meningitis is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis. Infections that cause meningitis can be spread through: sneezing kissing sharing utensils, cutlery and toothbrushes Meningitis is usually caught from people who carry these viruses or bacteria in their nose or throat but aren't ill themselves. It can also be caught from someone with meningitis, but this is less common. Read more about the causes of meningitis . Vaccinations against meningitis Vaccinations offer some protection against certain causes of meningitis.

These include the: meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year 5-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age pneumococcal vaccine – offered to babies at 8 weeks, 16 weeks and 1 year old meningitis C vaccine – offered at 12 weeks of age, 1 year, and to teenagers and first-time university students MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months meningitis ACWY vaccine – offered to teenagers, sixth formers and "fresher" students going to university for the first time Read more about meningitis vaccinations . Treatments for meningitis People with suspected meningitis will usually have tests in hospital to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection. Bacterial meningitis usually needs to be treated in hospital for at least a week.

Treatments include: antibiotics given directly into a vein fluids given directly into a vein oxygen through a face mask Viral meningitis tends to get better on its own within 7 to 10 days and can often be treated at home. Getting plenty of rest and taking painkillers and anti-sickness medication can help relieve the symptoms in the meantime. Outlook for meningitis Viral meningitis will usually get better on its own and rarely causes any long-term problems. Most people with bacterial meningitis who are treated quickly will also make a full recovery, although some are left with serious, long-term problems. These can include: AMPITRIN 250MG/5ML ORAL SUSPENSION | Drugs.com AMPITRIN 250MG/5ML ORAL SUSPENSION PACKAGE LEAFLET - INFORMATION FOR THE PATIENT AMPICILLIN 125mg/5ml AND 250mg/5ml ORAL SUSPENSION Please read all of this leaflet carefully before you start taking this medicine because it contains important information for you. • Keep this leaflet. You may need to read it again. • If you have further questions, please ask your doctor or pharmacist (chemist).

• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. • If you get any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet. See section 4. WHAT IS IN THIS LEAFLET 1. What Ampicillin Oral Suspension is and what it is used for 2. What you need to know before you take Ampicillin Oral Suspension 3. How to take Ampicillin Oral Suspension 4. Possible side effects 5. How to store Ampicillin Oral Suspension 6. Contents of the pack and other information 1. IS AND WHAT IT IS USED FOR The name of your medicine is Ampicillin Oral Suspension. It belongs to a group of medicines called broad spectrum antibiotics. It is used to kill bacteria that cause infections in your body. These infections include: • Respiratory tract infections (e.g. infections of the nose and throat, pneumonia and bronchitis) • Urinary tract infections (e.g. infections of the bladder and urethra) • Gastro-intestinal infections (e.g.

infections of the intestines) contracted by eating food or drinking water contaminated with Salmonella) • Gynaecological infections and Gonorrhoea (a sexually transmitted disease) • Infections of the blood (Septicaemia) • Skin and soft tissue (e.g. Acne) • To prevent endocarditis (inflammation of the lining of the heart and its valves) after surgery or a dental procedure • Peritonitis (an inflammation of the peritoneum, the tissue that lines the inner wall of the abdomen) • Meningitis (inflammation of the protective membranes covering the brain and spinal cord) 2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE AMPICILLIN ORAL Do not take this medicine if: • You have ever had an allergic reaction to Ampicillin, beta lactam antibiotics or any other penicillin or cephalosporin-type antibiotics (see symptoms in Section 4, Possible side effects) • You have ever had an allergic reaction to any of the other ingredients of this medicine (see list of ingredients in Section 6, Contents of the pack and other information).

Talk to your doctor or pharmacist before taking your medicine if: • You suffer from kidney problems as you may require a lower dose than normal • You are suffering from glandular fever or cytomegalovirus (CMV) infection • You are suffering from lymphatic leukaemia, HIV or syphilis. Other medicines and Ampicillin Oral Suspension Your medicine may affect the way other medicines work. Please inform your doctor or your pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without prescription, chloramphenicol (other types of antibiotics) • Anticoagulants e.g. warfarin or phenindione • Cytotoxic drugs e.g. methotrexate (used to treat rheumatoid arthritis, psoriasis, or malignant diseases such as lymphatic leukaemia) • Chloroquine (used for prevention and treatment of malaria) • Oral typhoid vaccine (used to prevent typhoid) • The oral contraceptive pill, Ampicillin may interfere with the action of the contraceptive pill. Therefore additional contraceptive measures should be taken during and for 7 days after taking this medicine. Tests While you are taking Ampicillin, the results of certain medical tests could be affected.

If you are having blood or urine tests, please tell your doctor that you are taking Ampicillin. Pregnancy and breastfeeding If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking any medicine. Important information about some of the ingredients in your medicine This medicine contains up to 1.937g of sucrose (sugar) per 5ml dose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. Ponceau 4R (E124) can cause allergic-type reactions including asthma. Allergy is more common in patients who are allergic to aspirin. 3. HOW TO TAKE AMPICILLIN ORAL SUSPENSION Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Take your medicine on an empty stomach, at least thirty minutes to one hour before meals/food. It is important that you take your medicine at the right times. The dose will depend on the patient and will be decided by your doctor.

However, the usual doses for each illness are: Adults (including the elderly) - 500-750 mg three to four times daily • Typhoid fevers - Acute: 1-2 grams four times daily for 2 weeks - Carriers: 1-2 grams four times daily for 4 to 12 weeks - 2 grams orally with 1 gram of probenecid as a single dose. A repeated dose may be necessary in females. The dosage may be reduced in patients with severe kidney failure. Children usually take half the adult dose. If you take more of your medicine than you should If you (or somebody else) accidentally takes too much of your medicine, speak to your doctor or pharmacist immediately. If you forget to take your medicine If you forget to take a dose, take it as soon as you remember, then carry on as before. Do not take a double dose to make up for the dose you have missed. If you stop taking your medicine Keep taking your medicine until your doctor tells you to stop. Do not stop taking it just because you feel better. If you stop taking the medicine, your infection may return or get worse.

If you are still unwell after taking all the medicine, go and see your doctor. Like all medicines, ampicillin can cause side effects, although not everybody gets them. If they occur, they are likely to be temporary, and not serious. However, some may be serious and need medical attention. If you experience any of the following events STOP taking your medicine and tell your doctor or go to your nearest hospital immediately: • Hypersensitivity or severe allergic reaction called anaphylaxis, which causes difficulty breathing • Swelling of the lips, cheeks, tongue and eyelids • Skin rash, itching or any other skin trouble, such as blisters and swollen red patches or hives. These reactions may occur if you have glandular fever, cytomegalovirus (CMV) infection, lymphatic leukaemia or HIV infection • Yellowing of the whites of the eyes and skin • Difficulty or discomfort in passing urine, having blood in the urine or lower back pain (may be a sign of kidney inflammation) • Pseudomembranous colitis (severe diarrhoea which may contain blood or mucous). The following symptoms are less serious but you may wish to discuss them with your doctor or pharmacist if they last a long time.

Common side effects (i.e. have been reported in more than 1 in 100 people taking it) include: • Diarrhoea • Nausea and vomiting (feeling and being sick). 5. HOW TO STORE AMPICILLIN ORAL SUSPENSION Do not use this medicine after the expiry date shown on the label. KEEP THIS MEDICINE OUT OF THE SIGHT AND REACH OF CHILDREN. Store in its original container and keep the bottle tightly closed in order to protect from light and moisture. Dry powder: Store below 25°C. Reconstituted suspension: Store for 7 days at 2°C - 8°C in a refrigerator. Return any left-over medicine to the pharmacist. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment. CONTENTS OF THE PACK AND OTHER INFORMATION What Ampicillin Oral Suspension contains Ampicillin Oral Suspension is available in two strengths containing either 125mg/5ml or 250mg/5ml of the active ingredient ampicillin as ampicillin trihydrate.

The suspensions also contain colloidal anhydrous silica, sodium benzoate (E211), croscarmellose sodium, sodium citrate anhydrous, ponceau 4R (E124), cherry flavour and sucrose. Please see further information on ingredients in section 2. What Ampicillin Oral Suspension looks like and contents of the pack Dry powder: an off white granular powder with a characteristic odour of cherry. Reconstituted suspension: a light pink coloured suspension with a characteristic odour of cherry. The 125mg strength medicine is available in bottles containing 60ml or 100ml of oral suspension while the 250mg strength medicine is available only in packs containing 100ml of oral suspension. The licence holder and manufacturer Athlone Laboratories Limited, This leaflet was last revised April 2014. Very rare side effects (i.e. have been reported in less than 1 in 10,000 people) include: • Fever • Temporary blood disorders that could cause you to have more infections such as fever, severe chills, sore throat, mouth ulcers or bruising more easily.

It can also cause anaemia, this can make your skin pale, cause weakness, breathlessness and tiredness. If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the yellow card scheme at By reporting side effects you can help provide more information on the safety of this medicine. CP.AMP.JNT.Su.AT.V2P3 Expand view ⇕ Source: Medicines and Healthcare Products Regulatory Agency Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist. FDA Consumer Updates

Question: In medicine, what name is given to inflammation of the protective membranes enclosing the brain and spinal cord?
Answer: Meningitis