Inflammation : "A fundamental pathologic process consisting of a dynamic complex of histologically apparent cytologic changes, cellular infiltration, and mediator release that occurs in the affected blood vessels and adjacent tissues in response to an injury or abnormal stimulation caused by a physical, chemical, or biologic agent, including the local reactions and resulting morphologic changes; the destruction or removal of the injurious material; and the responses that lead to repair and healing.
Inflammation is the body's attempt at self-protection; the aim being to remove harmful stimuli, including damaged cells, irritants, or pathogens - and begin the healing process.
When something harmful or irritating affects a part of our body, there is a biological response to try to remove it, the signs and symptoms of inflammation, specifically acute inflammation, show that the body is trying to heal itself. Inflammation does not mean infection, even when an infection causes inflammation. Infection is caused by a bacterium, virus or fungus, while inflammation is the body's response to it.
Acute inflammation - starts rapidly (rapid onset) and quickly becomes severe. Signs and symptoms are only present for a few days, but in some cases may persist for a few weeks.
Examples of diseases, conditions, and situations which can result in acute inflammation include: acute bronchitis, infected ingrown toenail, sore throat from a cold or flu, a scratch/cut on the skin, exercise (especially intense training), acute appendicitis, acute dermatitis, acute tonsillitis, acute infective meningitis, acute sinusitis, or a blow.
Chronic inflammation - this means long-term inflammation, which can last for several months and even years. It can result from:
? Failure to eliminate whatever was causing an acute inflammation
? An autoimmune response to a self antigen - the immune system attacks healthy tissue, mistaking it (them) for harmful pathogens.
? A chronic irritant of low intensity that persists
Examples of diseases and conditions with chronic inflammation include: asthma, chronicpeptic ulcer, tuberculosis, rheumatoid arthritis, chronic periodontitis, ulcerative colitis andCrohn's disease, chronic sinusitis, and chronic active hepatitis cancers, rheumatoid arthritis, atherosclerosis, periodontitis, and hay fever
Drugs Used _ NSAID’S ( Aspirin, Ibuprofen, Diclofenac Sodium, Aceclofenac , Acetaminophen) and Corticosteroids ( Both Mineralocorticoids and Glucocorticoids)
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.
Sinusitis : Sinusitis is inflammation of the sinuses. It occurs as the result of an infection from a virus, bacteria, or fungus.
CAUSES
The sinuses are air-filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes. Healthy sinuses contain no bacteria or other germs. Most of the time, mucus is able to drain out and air is able to flow through the sinuses.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
• Small hairs (cilia) in the sinuses fail to properly to move mucus out. This may be due to some medical conditions.
• Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
• A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
There are two types of sinusitis:
• Acute sinutitis is when symptoms are present for 4 weeks or less. It is caused by bacteria growing in the sinuses.
• Chronic sinusitis is when swelling and inflammation of the sinuses are present for longer than 3 months. It may be caused by bacteria or a fungus.
The following may increase the risk that an adult or child will develop sinusitis:
• Allergic rhinitis or hay fever
• Cystic fibrosis
• Going to day care
• Diseases that prevent the cilia from working properly
• Changes in altitude (flying or scuba diving)
• Large adenoids
• Smoking
• Weakened immune system from HIV or chemotherapy
Symptoms
The symptoms of acute sinusitis in adults usually follow a cold that does not get better or gets worse after 5 - 7 days. Symptoms include:
• Bad breath or loss of smell
• Cough, often worse at night
• Fatigue and general feeling of being ill
• Fever
• Headache -- pressure-like pain, pain behind the eyes, toothache, or tenderness of the face
• Nasal stuffiness and discharge
• Sore throat and postnasal drip
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.
Symptoms of sinusitis in children include:
• Cold or respiratory illness that has been getting better and then begins to get worse
• High fever, along with a darkened nasal discharge, that lasts for at least 3 days
• Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving
MEDICATIONS AND OTHER TREATMENTS
Most of the time, antibiotics are not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time it takes for the infection to go away. Antibiotics may be prescribed sooner for:
• Children with nasal discharge, possibly with a cough, that is not getting better after 2 - 3 weeks
• Fever higher than 102.2° Fahrenheit (39° Celsius)
• Headache or pain in the face
• Severe swelling around the eyes
Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
At some point, your doctor will consider:
• Other prescription medications
• More testing
• Referral to an ear, nose, and throat (ENT) or allergy specialist
Other treatments for sinusitis include:
• Allergy shots (immunotherapy) to help prevent the disease from returning
• Avoiding allergy triggers
• Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies