Meningitis : Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or othermicroorganisms, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. TREATMENT Short-term antibiotic prophylaxis is another method of prevention, particularly of meningococcal meningitis. In cases of meningococcal meningitis, prophylactic treatment of close contacts with antibiotics (e.g.rifampicin, ciprofloxacin or ceftriaxone) can reduce their risk of contracting the condition, but does not protect against future infections. Resistance to rifampicin has been noted to increase after use, which has caused some to recommend considering other agents. While antibiotics are frequently used in an attempt to prevent meningitis in those with a basilar skull fracture there is insufficient evidence to determine whether this is beneficial or harmful. This applies to those with or without a CSF leak. Hydrocephalus (obstructed flow of CSF) may require insertion of a temporary or long-term drainage device, such as a cerebral shunt. Antibiotics - Empiric antibiotics (treatment without exact diagnosis) should be started immediately, even before the results of the lumbar puncture and CSF analysis are known. The choice of initial treatment depends largely on the kind of bacteria that cause meningitis in a particular place and population. For instance, in the United Kingdom empirical treatment consists of a third-generation cefalosporin such as cefotaxime or ceftriaxone. In the USA, where resistance to cefalosporins is increasingly found in streptococci, addition of vancomycin to the initial treatment is recommended. Chloramphenicol, either alone or in combination with ampicillin, however, appears to work equally well. Empirical therapy may be chosen on the basis of the person's age, whether the infection was preceded by a head injury, whether the person has undergone recent neurosurgery and whether or not a cerebral shunt is present. In young children and those over 50 years of age, as well as those who are immunocompromised, the addition of ampicillin is recommended to cover Listeria monocytogenes. ; some antibiotics have inadequate penetrance and therefore have little use in meningitis. Most of the antibiotics used in meningitis have not been tested directly on people with meningitis inclinical trials. Rather, the relevant knowledge has mostly derived from laboratory studies in rabbits. Tuberculous meningitis requires prolonged treatment with antibiotics. While tuberculosis of the lungs is typically treated for six months, those with tuberculous meningitis are typically treated for a year or longer. Steroids Adjuvant treatment with corticosteroids (usually dexamethasone) has shown some benefits, such as a reduction of hearing loss, Adjuvant corticosteroids have a different role in children than in adults. Though the benefit of corticosteroids has been demonstrated in adults as well as in children from high-income countries, their use in children from low-income countries is not supported by the evidence; the reason for this discrepancy is not clear. Even in high-income countries, the benefit of corticosteroids is only seen when they are given prior to the first dose of antibiotics, and is greatest in cases of H. influenzae meningitis, the incidence of which has decreased dramatically since the introduction of the Hib vaccine. Thus, corticosteroids are recommended in the treatment of pediatric meningitis if the cause is H. influenzae, and only if given prior to the first dose of antibiotics; other uses are controversial. Viral meningitis typically only requires supportive therapy; most viruses responsible for causing meningitis are not amenable to specific treatment. Viral meningitis tends to run a more benign course than bacterial meningitis. Herpes simplex virus and varicella zoster virus may respond to treatment with antiviral drugs such as aciclovir, but there are no clinical trials that have specifically addressed whether this treatment is effective. Mild cases of viral meningitis can be treated at home with conservative measures such as fluid, bedrest, and analgesics. Fungal meningitis, such as cryptococcal meningitis, is treated with long courses of high dose antifungals, such as amphotericin B and flucytosine. Raised intracranial pressure is common in fungal meningitis, and frequent (ideally daily) lumbar punctures to relieve the pressure are recommended,or alternatively a lumbar drain.


Sepsis : Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail. SYMPTOMS In general, symptoms of sepsis can include: • Chills • Confusion or delirium • Fever or low body temperature (hypothermia) • Light-headedness due to low blood pressure • Rapid heartbeat • Shaking • Skin rash • Warm skin TREATMENT Antibiotics are usually given through a vein (intravenously). Oxygen and large amounts of fluids are given through a vein. Other medical treatments include: • Medications that increase blood pressure • Dialysis if there is kidney failure • A breathing machine (mechanical ventilation) if there is lung failure


Urinary tract infection : A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract including: • Bladder -- an infection in the bladder is also called cystitis or a bladder infection. • Kidneys -- an infection of one or both kidneys is called pyelonephritis or a kidney infection. • Ureters -- the tubes that take urine from each kidney to the bladder are only rarely the site of infection. • Urethra -- an infection of the tube that empties urine from the bladder to the outside is called urethritis. Causes Most urinary tract infections are caused by bacteria that enter the urethra and then the bladder. The infection most commonly develops in the bladder, but can spread to the kidneys. Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI. The following also increase your chances of developing a UTI: • Diabetes • Advanced age and conditions that affect personal care habits (such as Alzheimer's disease and delirium) • Problems emptying the bladder completely • Having a urinary catheter • Bowel incontinence • Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine • Kidney stones • Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture) • Pregnancy • Surgery or other procedure involving the urinary tract Symptoms The symptoms of a bladder infection include: • Cloudy or bloody urine, which may have a foul or strong odor • Low fever in some people • Pain or burning with urination • Pressure or cramping in the lower abdomen or back • Strong need to urinate often, even right after the bladder has been emptied If the infection spreads to your kidneys, symptoms may include: • Chills and shaking or night sweats • Fatigue and a general ill feeling • Fever above 101 degrees Fahrenheit • Pain in the side, back, or groin • Flushed, warm, or reddened skin • Mental changes or confusion (in the elderly, these symptoms often are the only signs of a UTI) • Nausea and vomiting • Very bad abdominal pain (sometimes) Treatment • A simple UTI can be treated with a short course of oral antibiotics. You should also remember to drink plenty of liquids, especially around the time of a UTI. • If the UTI is a complicated UTI, then a longer period of antibiotics is given and usually is started intravenously in the hospital. After a short period of intravenous antibiotics, then the antibiotics are given by mouth for a period up to several weeks. Kidney infections have usually been treated as a complicated UTI.