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Some text in this article was originally taken from http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm (public domain)
I have tried to find an extra image to better 'explain' the anatomy we are looking at. Showing the blood vessels and synapses which criss-cross the subarachnoid space, maybe highlight where infection can get in - File:Gray769.png is the best I can find in commons at the moment, but looks a bit 'stale' to me, I was hoping to find something more 3d. Any thoughts -? LeeVJ ( talk) 16:29, 9 March 2009 (UTC)
"Rarely, migraine may cause meningitis, but this diagnosis is usually only made when other causes have been eliminated.[2]" This is confusing to me since migraine is a name given to a constellation of symptoms, not some well-defined pathophysiology. I'm not sure how migraine can cause meningitis. Xasodfuih ( talk) 03:21, 10 March 2009 (UTC)
The source cited says no such thing either; the only time it mentions migraine is in this context: "Migraine may rarely present with fever, symptoms suggestive of meningo-encephalitis, and CSF pleocytosis, but this must be a diagnosis of exclusion." This seems to be a criteria for differential diagnosis. I'm at a loss how this got interpreted as a causal relationship. Xasodfuih ( talk) 03:26, 10 March 2009 (UTC)
Regarding the series of recent edits [2] [3] [4] etc: evaluation of meningitis is a medical emergency, and reliable sources make this clear. Some sources properly note that viral meningitis may be treated at home - but the evaluation to establish cause is done as an emergency. -- Scray ( talk) 17:03, 11 March 2009 (UTC)
I think you misunderstood my comments, and I wish you'd be slightly more careful before invoking WP:OWN and terms like "pissing match". Rather, disagreements should be resolved on the talk page, which is something we have now finally started doing. I'm with Scray that from the perspective of a layperson reading this article, symptoms suggesting meningitis should be regarded as an emergency. If a clinician then downgrades that on the basis of a careful assessment, then that is his professional responsibility, much like you'd regard a head injury with two subsequent self-terminating seizures as a medical emergency until a clinician has made an assessment.
Could I take this opportunity to request that you find a replacement for the source you added ( http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm). This is a non-peer reviewed source that is less than ideal from the perspective of WP:MEDRS. If I find an alternative I will replace it myself. Also, could you get into the habit of using {{ cite web}} for online sources? JFW | T@lk 18:53, 11 March 2009 (UTC)
Thanks for that guys :/ Urpunkt ( talk) —Preceding undated comment added 02:01, 2 April 2009 (UTC).
I am not offended by this picture, but I am also not offended by pictures of genitals or murder victims and other potentially offensive things that may appear in several articles, but would NOT be posted on the front page of Wikipedia. That is great if this baby is a famous survivor, but that doesn't change the fact that millions of people view this page everyday, many of them children and some of them might find this a very disturbing image. If people wish to view this image, let them do so by clicking on the article. This picture MUST be removed from the front page, PLEASE. —Preceding unsigned comment added by 99.224.208.60 ( talk) 08:17, 2 April 2009 (UTC)
The photo has been removed from the Main Page per a consensus that it isn't appropriate for the Main Page. However, given that the photo was removed from this article due to the mistaken belief that the subject didn't suffer from meningitis, could the photo now be restored here? Cheers,
This flag once was red
propaganda
deeds 12:16, 2 April 2009 (UTC)Photo has been restored to this article.
This flag once was red
propaganda
deeds 12:21, 2 April 2009 (UTC)
"and in 2002 evidence emerged that treatment with steroids could improve the prognosis of bacterial meningitis"
Are we limiting this statement to adults or mortality? It was shown nicely, http://content.nejm.org/cgi/content/abstract/319/15/964, (prospective, double-blinded, controls, 14% vs 1%) 14 years earlier that dexamethasone would reduce hearing loss in children. Any reason first not to mention this study and then not to adjust the history statement in some way? -- MartinezMD ( talk) 03:15, 2 April 2009 (UTC)
These are two distinct (but related) conditions with distinct symptoms. The dead injured baby on the front page had meningococcal disease NOT meningitis. It's inappropriate and incorrect to use this picture in the article, especially to illustrate it on the front page. --
68.111.221.83 (
talk) 06:29, 2 April 2009 (UTC)
There have been case reports of a delay in the diagnosis and treatment of meningitis in scuba divers due to the similarity in symptoms that can also be present in decompression sickness.
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The article currently says "Meningitis must be treated promptly with antibiotics and sometimes antiviral drugs." Well, yes, that is good medical practice. But WP is an encyclopedia. A statement like that could maybe appear in a section entitled "Treatment of meningitis" but it isn't otherwise encyclopedic in tone. Otherwise the reader simply asks "who says?", "or else what?". What does the "must" mean? Is that a legal admonishment? This is but one example of incorrect tone here - the article reads as if it is advice from a medical treatment book, not an encyclopedia. Paul Beardsell ( talk) 16:26, 2 April 2009 (UTC)
Here is a nice pathology image of bacterial meningitis on http://wiki.medpedia.co/Meningitis Wondering if we should use it?-- Doc James ( talk · contribs · email) 03:48, 30 May 2009 (UTC)
Nosocomial meningitis - http://content.nejm.org/cgi/content/short/362/2/146 - review article. JFW | T@lk 00:11, 14 January 2010 (UTC)
what is the most injury done to a victim of meningitis? —Preceding unsigned comment added by 98.14.193.179 ( talk) 00:12, 14 May 2010 (UTC)
The following content was added. I do not know the source, and I'm not sure how informative it is.
Opinions invited. JFW | T@lk 18:29, 27 October 2010 (UTC)
doi:10.1186/cc9395 - CSF lactate possibly better than any other marker in identifying bacterial meningitis. Systematic review. JFW | T@lk 13:39, 12 January 2011 (UTC)
doi:10.1128/CMR.00044-08 - CMR article on eosinophilic meningoencephalitis that may be better than our current sources. JFW | T@lk 22:57, 6 June 2011 (UTC)
GenOrl ( talk · contribs) added a paragraph on MenAfriVac, a new vaccine against meningococcus type A. From the edit, I am not entirely clear why it is different from or better than the previous MenA vaccines. The first edit also included a lot of technical detail about the vaccine. I am not averse to discussing the vaccine as long as we can be clear whether it constitutes a major improvement. JFW | T@lk 09:10, 16 August 2011 (UTC)
Thanks Scray for taking the time to clarify this. The sources we now have are reliable medical sources as defined by our consensus guidelines. JFW | T@lk 18:11, 16 August 2011 (UTC)
doi:10.1128/CMR.00070-09 may perhaps be useful to generate some updates. JFW | T@lk 00:27, 11 December 2011 (UTC)
References
I found a 2018 secondary source: https://doi.org/10.1016/S1474-4422(18)30387-9 Dan88888 ( talk) 10:24, 26 April 2022 (UTC)
The following was added by 75.72.192.61 ( talk · contribs):
“ | Fungal meningitis can occur in persons living with immune deficiencies such as with organ transplantation or HIV/AIDS. The most common fungal meningitis is cryptococcal meningitis due to Cryptococcus neoformans. In Africa, cryptococcal meningitis is the most common cause of meningitis, being more common than all causes of bacterial meningitis combined. [1] Cryptococcal meningitis accounts for 20-25% of AIDS-related deaths in Africa. [2] | ” |
The first source ( doi:10.1186/1471-2334-10-67) is a primary source, while the second one ( doi:10.1097/QAD.0b013e328322ffac) seems more suitable for the epidemiology section. It would be a better idea to provide a high-quality secondary source on the clinical aspects of fungal meningitis, and perhaps add a sentence to the "epidemiology" section about crypto. JFW | T@lk 00:11, 12 August 2012 (UTC)
“ | There are a number of risk factors for fungal meningitis including the use of immunosupressents such as with organ transplantation, HIV/AIDS [3] and lose of immunity with aging. [4] It however can still occur in those with a normal immune system. [5] Symptom onset is typically more gradual with headaches and fever being present for at least a couple of weeks before diagnosis. [4] The most common fungal meningitis is cryptococcal meningitis due to Cryptococcus neoformans. [6] In Africa, cryptococcal meningitis is estimated to be the most common cause of meningitis overall [7] where it accounts for 20-25% of AIDS-related deaths in Africa. [8] | ” |
Doc James ( talk · contribs · email) (if I write on your page reply on mine) 00:47, 12 August 2012 (UTC)
References
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May be of use http://www.nice.org.uk/nicemedia/live/13027/49339/49339.pdf Doc James ( talk · contribs · email) (if I write on your page reply on mine) 19:30, 24 September 2012 (UTC)
Does this belong in the article? Specifically Wikipedia is not really a news source.
"====U.S. outbreak==== On October 4, 2012, patients in nearly two dozen states that received steroid shots for back pain may have been infected with fungal meningitis. The shots were given between July and September of 2012 and hundreds to thousands of people could have gotten the shot. As of October 5th, 35 people in six states: Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana have contracted the disease of which five have died, according to the Centers for Disease Control and Prevention. The product was also sent to: California, Connecticut, Georgia, Idaho, Illinois, Michigan, Minnesota, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Texas, and West Virginia where no cases had been reported. The pharmacy involved in manufacturing the drug is the New England Compounding Center of Framingham, Massachusetts. [1] [2]" Doc James ( talk · contribs · email) (if I write on your page reply on mine) 20:39, 5 October 2012 (UTC)
As of 5 October 2012 [update], 47 cases had been reported in seven states, with five deaths. The outbreak was attributed to fungal contamination of an injectable steroid used to treat back pain. The contamination was reported to have occurred at a compounding pharmacy in Massachusetts that supplied the drug to clinics througout the United States. Because fungal meningitis is slow to develop, more cases are almost certain." Doc James ( talk · contribs · email) (if I write on your page reply on mine) 09:43, 6 October 2012 (UTC)
Given [6] I would think a current events header or box would be appropriate, especially since this is expected to persist for months? Paum89 ( talk) 06:44, 25 October 2012 (UTC)
No, there should not be a hatnote. This is an isolated event that will eventually merge into all other isolated events. It gets newsprint/-bytes coverage because it happened to Yanks (as opposed to Nigerians or Ghanese). Could I recommend a sense of perspective? Would you expect an encyclopedia to reflect current events? No. The article already mentions the event in context with a WP:MEDRS-compatible source, rather than with a hatnote. JFW | T@lk 22:11, 25 October 2012 (UTC)
People who search for that information will hopefully see what the CDC and the New England Journal of Medicine have published. Wikipedia is an enclyclopedia, and every attempt to turn it into a news outlet reflects a misunderstanding of its purpose. When a very large outbreak of bacterial meningitis in West Africa was recently documented, it was added to this article in context, without a noisy hatnote. Using search traffic to determine encyclopedia content has no precedent at all. JFW | T@lk 22:27, 25 October 2012 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Should the Meningitis article include a hatnote reading:
for the duration of the outbreak, considering the relative number of people apparently searching for that article, WP:NOTNEWS, and WP:NOTPAPER? 23:15, 25 October 2012 (UTC)
Zad
68
17:49, 26 October 2012 (UTC)
Zad
68
01:32, 28 October 2012 (UTC)
Zad
68
16:54, 28 October 2012 (UTC)References
Every doctor I've talked to says you have to go to a hospital to get a spinal tap if you have meningitis symptoms. The hospital says it's a 3 night stay after a spinal tap because of various concerns. That sounds like certain bankruptcy to me.
How is that not relevant to the diagnosis discussion? POV editors are wrecking people's lives by sending them into bankruptcy, where they can lose a home and job. — Preceding unsigned comment added by 108.18.250.35 ( talk • contribs)
The only soapbox here is hospitals trying to take money from people. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:06, 9 November 2012 (UTC)
Zad
68
15:09, 9 November 2012 (UTC)So your main point is that in a country with socialized insurance, the taxpayer picks up the $20,000 bill. That doesn't make it any less costly. The point is that doctors get concerned when they see meningitis symptoms, and they send people into very expensive diagnoses because of it, and usually the result is benign or negative anyway. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:12, 9 November 2012 (UTC)
Zad
68
15:17, 9 November 2012 (UTC)I called my hospital. 3-night stay required. Must keep patient on antibiotics and monitoring. What, you expect the hospital to write this in an advertisement? — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:19, 9 November 2012 (UTC)
If the article cannot demonstrate that diagnosis is a simple office procedure, then it is ominously incomplete. Evidence of POV trolling by hospital fans.
Zad
68
15:26, 9 November 2012 (UTC)It CAN be serious, yes. But an ordinary flu can swell the meninges. If you go to the doctor, he might panic and send you to the hospital. It's only a matter of time before a journalist will call a hospital and posit as having meningites symptoms, and realize that the hospitals DO tend to want to monitor/treat people suspected of having meningitis, for multiple days. Even when it turns out it's just a flu. Think of how many people get the flu, and that's a lot of money the hospitals can make. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:33, 9 November 2012 (UTC)
Zad
68
15:47, 9 November 2012 (UTC)If you're sick enough to have meningitis in the differential diagnosis, then consider the alternative of going to hospital. I cannot confirm that for suspected meningitis a 3-day stay is required. Many will advise a period of bed rest after a lumbar puncture (in the absence of decent evidence), but the sample can be processed within hours and if otherwise well the owner of said CSF can be discharged home if no abnormalities are detected. Lumbar punctures for other indications (e.g. in the diagnosis of MS) are often performed on a day case basis. JFW | T@lk 22:03, 12 November 2012 (UTC)
This image is available for use in the article. — Preceding unsigned comment added by CFCF ( talk • contribs)
doi:10.1001/jamainternmed.2014.2918 - updated systematic review. JFW | T@lk 06:34, 8 July 2014 (UTC)
Meta-analysis of treatment outcomes and prognosis: has to be integrated doi:10.1016/S1473-3099(14)70852-7 JFW | T@lk 22:21, 27 September 2014 (UTC)
Fluid therapy is an important component of management of acute bacterial meningites.An updated Cochrane Systematic review is available in 2014 regarding the evidence available for it http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004786.pub4/abstract . I am an author of this review and hence would not like to edit this article in Wikipedia. ( Drsoumyadeepb ( talk) 15:27, 7 October 2014 (UTC))
Hello JFWGreat; Looking forward to the edits.( Drsoumyadeepb ( talk) 06:13, 10 October 2014 (UTC))
doi:10.1016/j.jinf.2016.01.007 - the UK specialist societies guideline, which will update the now rather outdated guideline.
The IDSA ( http://www.idsociety.org/Organ_System/) is also working on an update. JFW | T@lk 06:32, 2 March 2016 (UTC)
It strikes me that the present wording of the article does not sufficiently convey to the reader the urgency of rapid treatment. By contrast this CDC ref makes it clear in the second sentence: "Death can occur in as little as a few hours." and reinforces it later with "Later symptoms of bacterial meningitis can be very serious (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible" (emphasis in original). In light of this recent news we should be conscious that readers need to understand that delay is dangerous, and reflect that in the article. LeadSongDog come howl! 15:23, 27 April 2016 (UTC)
I am with User:Looie496 on this one. We already say in the lead "The first treatment in acute meningitis consists of promptly giving antibiotics and sometimes antiviral drugs.[2][6] ... Meningitis can lead to serious long-term consequences such as deafness, epilepsy,hydrocephalus, or cognitive deficits, especially if not treated quickly.[1][3]" This makes it perfectly clear the importance of early treatment. Nothing more is needed. Doc James ( talk · contribs · email) 18:40, 28 April 2016 (UTC)
Zad
68
16:56, 29 April 2016 (UTC)"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.[1][5]" That surely is good enough? Been in the article for ages. JFW | T@lk 13:07, 25 May 2016 (UTC)
doi:10.1016/S0140-6736(16)30654-7 JFW | T@lk 08:28, 2 September 2016 (UTC)
I think it would be appropriate to include a section on the Meningitis Wikipedia page entitled 'Awareness' as awareness is in many cases, the key to prevention. Many people don’t know the warning signs of meningitis or that many types of meningitis are vaccine-preventable. [1] In this section, I would recommend the mention of World Meningitis Day, held on the 24th of April each year. The piece I had previously added: "Each year, World Meningitis Day is celebrated on the 24th April. This is an opportunity for people all over the world to raise their voices against meningitis, through telling patient stories, raising awareness of the signs and symptoms of the disease and increasing knowledge of available vaccines. The campaign is organised by the Confederation of Meningitis Organisations (CoMO), a global community of over 45 meningitis organisations, which was founded in 2004 at the World Conference of Meningitis Organisations."
I understand that this might be considered a COI. However, I would argue that we are just wishing to raise awareness of World Meningitis Day and to acknowledge the importance of Meningitis Awareness. Please let me know your thoughts. Of course, we would be happy with minor changes made to the piece to fit the guidelines of Wikipedia. Would it be more appropriate to exclude the external link to our website?
Kind Regards, JoinHands ( talk) 09:33, 18 November 2016 (UTC)JoinHands
Thank you for including World Meningitis Day; however, I do not feel that it's placement is adequate in 'history'. I would appreciate it if you could review this, bearing in mind the placement and mention for other World Health days eg. World Pneumonia day is listed under Society and Culture: ( /info/en/?search=Pneumonia#Society_and_culture) Kind Regards, JoinHands ( talk) 12:54, 23 November 2016 (UTC)JoinHands.
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I am looking for some help when performing a Cochrane update on the Meningitis article. The Meningitis article presently reads: "In children routine intravenous fluids for two days may improve outcomes in those who arrive at hospital after being sick for some time.[61][needs update] " The new version of the Cochrane review states that: "The quality of evidence regarding fluid therapy in children with acute bacterial meningitis is low to very low and more RCTs need to be conducted. There is insufficient evidence to guide practice as to whether maintenance fluids should be chosen over restricted fluids in the treatment of acute bacterial meningitis." Meningitis Meningitis I am not familiar with present clinical guidelines and wanted to check on here to see if anyone has anything to add before I make any changes to the article.
Thanks. JenOttawa ( talk) 02:48, 6 September 2017 (UTC)
doi:10.1007/s00134-019-05901-w JFW | T@lk 15:13, 2 March 2020 (UTC)
This journal article, which is briefly referenced in the current article (#48) would appear to have important relevance to the section on fungal meningitis as well. I am willing to make this edit but am not expert in this field so am seeking another opinion prior to making this edit.
Thank you BDD user ( talk) 15:14, 17 March 2020 (UTC)
References
Hello, I moved some of the material around in the diagnosis section before I remembered that this is a featured article. I noticed that information on lumbar puncture was shared in two different places in this section and I also added an intro sentence to diagnosis using https://www.aafp.org/afp/2017/0901/p314.html and https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012824.pub2/full. I would like to propose adding in a short sentence that shares conclusions from the cochrane review on "accuracy of jolt accentuation for headache in acute meningitis in the emergency setting". I will wait a few days in case someone has other suggestions for improving the article or disagrees with my improvements. Thanks! JenOttawa ( talk) 14:36, 18 October 2020 (UTC)
References
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cite journal}}
: CS1 maint: PMC format (
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This entry currently claims that viral meningitis "cannot be spread by only breathing the air where a person with meningitis has been". But in support of this it cites a CDC page that seems to be making such a claim only about bacterial meningitis (rather than viral meningitis). This entry does not seem to mention airborne transmission otherwise, despite the fact that, according to the Airborne transmission entry, enterovirus (the most common cause of viral meningitis) can spread via airborne transmission. Am I missing something? — Preceding unsigned comment added by User91348 ( talk • contribs) 13:50, 1 February 2021 (UTC)
I'm making edits to replace primary research sources with the appropriate secondary sources. Where I cannot find suitable sources I will flag this for possible removal. I will put details of my edits below.— Preceding unsigned comment added by Simon A Johnston ( talk • contribs) 12:49, 26 April 2022 (UTC)
I'm also making some changes for factual inaccuracy and clarity — Preceding unsigned comment added by Simon A Johnston ( talk • contribs) 12:49, 26 April 2022 (UTC)
Hello, thank you for this well balanced article. I was wondering if the position (looks somehow squeezed in the see also section) would be better off on the very bottom of the page. That you for your time. Lotje ( talk) 05:30, 1 October 2022 (UTC)
The article is huge but the onset moment and period after contraction isn't discussed. Would appreciate if someone expands it. AXONOV (talk) ⚑ 20:14, 28 December 2022 (UTC)
The page mentions that the death rate from bacterial infections is less than 15% with a reference. I could not find that information in the reference. I did find a WHO page on the topic that says it is 1 in 6. I do not know how to add a reference to a web page, so if somebody that knows how can update the data and the reference, I'd appreciate the help.
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Some text in this article was originally taken from http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm (public domain)
I have tried to find an extra image to better 'explain' the anatomy we are looking at. Showing the blood vessels and synapses which criss-cross the subarachnoid space, maybe highlight where infection can get in - File:Gray769.png is the best I can find in commons at the moment, but looks a bit 'stale' to me, I was hoping to find something more 3d. Any thoughts -? LeeVJ ( talk) 16:29, 9 March 2009 (UTC)
"Rarely, migraine may cause meningitis, but this diagnosis is usually only made when other causes have been eliminated.[2]" This is confusing to me since migraine is a name given to a constellation of symptoms, not some well-defined pathophysiology. I'm not sure how migraine can cause meningitis. Xasodfuih ( talk) 03:21, 10 March 2009 (UTC)
The source cited says no such thing either; the only time it mentions migraine is in this context: "Migraine may rarely present with fever, symptoms suggestive of meningo-encephalitis, and CSF pleocytosis, but this must be a diagnosis of exclusion." This seems to be a criteria for differential diagnosis. I'm at a loss how this got interpreted as a causal relationship. Xasodfuih ( talk) 03:26, 10 March 2009 (UTC)
Regarding the series of recent edits [2] [3] [4] etc: evaluation of meningitis is a medical emergency, and reliable sources make this clear. Some sources properly note that viral meningitis may be treated at home - but the evaluation to establish cause is done as an emergency. -- Scray ( talk) 17:03, 11 March 2009 (UTC)
I think you misunderstood my comments, and I wish you'd be slightly more careful before invoking WP:OWN and terms like "pissing match". Rather, disagreements should be resolved on the talk page, which is something we have now finally started doing. I'm with Scray that from the perspective of a layperson reading this article, symptoms suggesting meningitis should be regarded as an emergency. If a clinician then downgrades that on the basis of a careful assessment, then that is his professional responsibility, much like you'd regard a head injury with two subsequent self-terminating seizures as a medical emergency until a clinician has made an assessment.
Could I take this opportunity to request that you find a replacement for the source you added ( http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm). This is a non-peer reviewed source that is less than ideal from the perspective of WP:MEDRS. If I find an alternative I will replace it myself. Also, could you get into the habit of using {{ cite web}} for online sources? JFW | T@lk 18:53, 11 March 2009 (UTC)
Thanks for that guys :/ Urpunkt ( talk) —Preceding undated comment added 02:01, 2 April 2009 (UTC).
I am not offended by this picture, but I am also not offended by pictures of genitals or murder victims and other potentially offensive things that may appear in several articles, but would NOT be posted on the front page of Wikipedia. That is great if this baby is a famous survivor, but that doesn't change the fact that millions of people view this page everyday, many of them children and some of them might find this a very disturbing image. If people wish to view this image, let them do so by clicking on the article. This picture MUST be removed from the front page, PLEASE. —Preceding unsigned comment added by 99.224.208.60 ( talk) 08:17, 2 April 2009 (UTC)
The photo has been removed from the Main Page per a consensus that it isn't appropriate for the Main Page. However, given that the photo was removed from this article due to the mistaken belief that the subject didn't suffer from meningitis, could the photo now be restored here? Cheers,
This flag once was red
propaganda
deeds 12:16, 2 April 2009 (UTC)Photo has been restored to this article.
This flag once was red
propaganda
deeds 12:21, 2 April 2009 (UTC)
"and in 2002 evidence emerged that treatment with steroids could improve the prognosis of bacterial meningitis"
Are we limiting this statement to adults or mortality? It was shown nicely, http://content.nejm.org/cgi/content/abstract/319/15/964, (prospective, double-blinded, controls, 14% vs 1%) 14 years earlier that dexamethasone would reduce hearing loss in children. Any reason first not to mention this study and then not to adjust the history statement in some way? -- MartinezMD ( talk) 03:15, 2 April 2009 (UTC)
These are two distinct (but related) conditions with distinct symptoms. The dead injured baby on the front page had meningococcal disease NOT meningitis. It's inappropriate and incorrect to use this picture in the article, especially to illustrate it on the front page. --
68.111.221.83 (
talk) 06:29, 2 April 2009 (UTC)
There have been case reports of a delay in the diagnosis and treatment of meningitis in scuba divers due to the similarity in symptoms that can also be present in decompression sickness.
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The article currently says "Meningitis must be treated promptly with antibiotics and sometimes antiviral drugs." Well, yes, that is good medical practice. But WP is an encyclopedia. A statement like that could maybe appear in a section entitled "Treatment of meningitis" but it isn't otherwise encyclopedic in tone. Otherwise the reader simply asks "who says?", "or else what?". What does the "must" mean? Is that a legal admonishment? This is but one example of incorrect tone here - the article reads as if it is advice from a medical treatment book, not an encyclopedia. Paul Beardsell ( talk) 16:26, 2 April 2009 (UTC)
Here is a nice pathology image of bacterial meningitis on http://wiki.medpedia.co/Meningitis Wondering if we should use it?-- Doc James ( talk · contribs · email) 03:48, 30 May 2009 (UTC)
Nosocomial meningitis - http://content.nejm.org/cgi/content/short/362/2/146 - review article. JFW | T@lk 00:11, 14 January 2010 (UTC)
what is the most injury done to a victim of meningitis? —Preceding unsigned comment added by 98.14.193.179 ( talk) 00:12, 14 May 2010 (UTC)
The following content was added. I do not know the source, and I'm not sure how informative it is.
Opinions invited. JFW | T@lk 18:29, 27 October 2010 (UTC)
doi:10.1186/cc9395 - CSF lactate possibly better than any other marker in identifying bacterial meningitis. Systematic review. JFW | T@lk 13:39, 12 January 2011 (UTC)
doi:10.1128/CMR.00044-08 - CMR article on eosinophilic meningoencephalitis that may be better than our current sources. JFW | T@lk 22:57, 6 June 2011 (UTC)
GenOrl ( talk · contribs) added a paragraph on MenAfriVac, a new vaccine against meningococcus type A. From the edit, I am not entirely clear why it is different from or better than the previous MenA vaccines. The first edit also included a lot of technical detail about the vaccine. I am not averse to discussing the vaccine as long as we can be clear whether it constitutes a major improvement. JFW | T@lk 09:10, 16 August 2011 (UTC)
Thanks Scray for taking the time to clarify this. The sources we now have are reliable medical sources as defined by our consensus guidelines. JFW | T@lk 18:11, 16 August 2011 (UTC)
doi:10.1128/CMR.00070-09 may perhaps be useful to generate some updates. JFW | T@lk 00:27, 11 December 2011 (UTC)
References
I found a 2018 secondary source: https://doi.org/10.1016/S1474-4422(18)30387-9 Dan88888 ( talk) 10:24, 26 April 2022 (UTC)
The following was added by 75.72.192.61 ( talk · contribs):
“ | Fungal meningitis can occur in persons living with immune deficiencies such as with organ transplantation or HIV/AIDS. The most common fungal meningitis is cryptococcal meningitis due to Cryptococcus neoformans. In Africa, cryptococcal meningitis is the most common cause of meningitis, being more common than all causes of bacterial meningitis combined. [1] Cryptococcal meningitis accounts for 20-25% of AIDS-related deaths in Africa. [2] | ” |
The first source ( doi:10.1186/1471-2334-10-67) is a primary source, while the second one ( doi:10.1097/QAD.0b013e328322ffac) seems more suitable for the epidemiology section. It would be a better idea to provide a high-quality secondary source on the clinical aspects of fungal meningitis, and perhaps add a sentence to the "epidemiology" section about crypto. JFW | T@lk 00:11, 12 August 2012 (UTC)
“ | There are a number of risk factors for fungal meningitis including the use of immunosupressents such as with organ transplantation, HIV/AIDS [3] and lose of immunity with aging. [4] It however can still occur in those with a normal immune system. [5] Symptom onset is typically more gradual with headaches and fever being present for at least a couple of weeks before diagnosis. [4] The most common fungal meningitis is cryptococcal meningitis due to Cryptococcus neoformans. [6] In Africa, cryptococcal meningitis is estimated to be the most common cause of meningitis overall [7] where it accounts for 20-25% of AIDS-related deaths in Africa. [8] | ” |
Doc James ( talk · contribs · email) (if I write on your page reply on mine) 00:47, 12 August 2012 (UTC)
References
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May be of use http://www.nice.org.uk/nicemedia/live/13027/49339/49339.pdf Doc James ( talk · contribs · email) (if I write on your page reply on mine) 19:30, 24 September 2012 (UTC)
Does this belong in the article? Specifically Wikipedia is not really a news source.
"====U.S. outbreak==== On October 4, 2012, patients in nearly two dozen states that received steroid shots for back pain may have been infected with fungal meningitis. The shots were given between July and September of 2012 and hundreds to thousands of people could have gotten the shot. As of October 5th, 35 people in six states: Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana have contracted the disease of which five have died, according to the Centers for Disease Control and Prevention. The product was also sent to: California, Connecticut, Georgia, Idaho, Illinois, Michigan, Minnesota, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Texas, and West Virginia where no cases had been reported. The pharmacy involved in manufacturing the drug is the New England Compounding Center of Framingham, Massachusetts. [1] [2]" Doc James ( talk · contribs · email) (if I write on your page reply on mine) 20:39, 5 October 2012 (UTC)
As of 5 October 2012 [update], 47 cases had been reported in seven states, with five deaths. The outbreak was attributed to fungal contamination of an injectable steroid used to treat back pain. The contamination was reported to have occurred at a compounding pharmacy in Massachusetts that supplied the drug to clinics througout the United States. Because fungal meningitis is slow to develop, more cases are almost certain." Doc James ( talk · contribs · email) (if I write on your page reply on mine) 09:43, 6 October 2012 (UTC)
Given [6] I would think a current events header or box would be appropriate, especially since this is expected to persist for months? Paum89 ( talk) 06:44, 25 October 2012 (UTC)
No, there should not be a hatnote. This is an isolated event that will eventually merge into all other isolated events. It gets newsprint/-bytes coverage because it happened to Yanks (as opposed to Nigerians or Ghanese). Could I recommend a sense of perspective? Would you expect an encyclopedia to reflect current events? No. The article already mentions the event in context with a WP:MEDRS-compatible source, rather than with a hatnote. JFW | T@lk 22:11, 25 October 2012 (UTC)
People who search for that information will hopefully see what the CDC and the New England Journal of Medicine have published. Wikipedia is an enclyclopedia, and every attempt to turn it into a news outlet reflects a misunderstanding of its purpose. When a very large outbreak of bacterial meningitis in West Africa was recently documented, it was added to this article in context, without a noisy hatnote. Using search traffic to determine encyclopedia content has no precedent at all. JFW | T@lk 22:27, 25 October 2012 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Should the Meningitis article include a hatnote reading:
for the duration of the outbreak, considering the relative number of people apparently searching for that article, WP:NOTNEWS, and WP:NOTPAPER? 23:15, 25 October 2012 (UTC)
Zad
68
17:49, 26 October 2012 (UTC)
Zad
68
01:32, 28 October 2012 (UTC)
Zad
68
16:54, 28 October 2012 (UTC)References
Every doctor I've talked to says you have to go to a hospital to get a spinal tap if you have meningitis symptoms. The hospital says it's a 3 night stay after a spinal tap because of various concerns. That sounds like certain bankruptcy to me.
How is that not relevant to the diagnosis discussion? POV editors are wrecking people's lives by sending them into bankruptcy, where they can lose a home and job. — Preceding unsigned comment added by 108.18.250.35 ( talk • contribs)
The only soapbox here is hospitals trying to take money from people. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:06, 9 November 2012 (UTC)
Zad
68
15:09, 9 November 2012 (UTC)So your main point is that in a country with socialized insurance, the taxpayer picks up the $20,000 bill. That doesn't make it any less costly. The point is that doctors get concerned when they see meningitis symptoms, and they send people into very expensive diagnoses because of it, and usually the result is benign or negative anyway. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:12, 9 November 2012 (UTC)
Zad
68
15:17, 9 November 2012 (UTC)I called my hospital. 3-night stay required. Must keep patient on antibiotics and monitoring. What, you expect the hospital to write this in an advertisement? — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:19, 9 November 2012 (UTC)
If the article cannot demonstrate that diagnosis is a simple office procedure, then it is ominously incomplete. Evidence of POV trolling by hospital fans.
Zad
68
15:26, 9 November 2012 (UTC)It CAN be serious, yes. But an ordinary flu can swell the meninges. If you go to the doctor, he might panic and send you to the hospital. It's only a matter of time before a journalist will call a hospital and posit as having meningites symptoms, and realize that the hospitals DO tend to want to monitor/treat people suspected of having meningitis, for multiple days. Even when it turns out it's just a flu. Think of how many people get the flu, and that's a lot of money the hospitals can make. — Preceding unsigned comment added by 108.18.250.35 ( talk) 15:33, 9 November 2012 (UTC)
Zad
68
15:47, 9 November 2012 (UTC)If you're sick enough to have meningitis in the differential diagnosis, then consider the alternative of going to hospital. I cannot confirm that for suspected meningitis a 3-day stay is required. Many will advise a period of bed rest after a lumbar puncture (in the absence of decent evidence), but the sample can be processed within hours and if otherwise well the owner of said CSF can be discharged home if no abnormalities are detected. Lumbar punctures for other indications (e.g. in the diagnosis of MS) are often performed on a day case basis. JFW | T@lk 22:03, 12 November 2012 (UTC)
This image is available for use in the article. — Preceding unsigned comment added by CFCF ( talk • contribs)
doi:10.1001/jamainternmed.2014.2918 - updated systematic review. JFW | T@lk 06:34, 8 July 2014 (UTC)
Meta-analysis of treatment outcomes and prognosis: has to be integrated doi:10.1016/S1473-3099(14)70852-7 JFW | T@lk 22:21, 27 September 2014 (UTC)
Fluid therapy is an important component of management of acute bacterial meningites.An updated Cochrane Systematic review is available in 2014 regarding the evidence available for it http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004786.pub4/abstract . I am an author of this review and hence would not like to edit this article in Wikipedia. ( Drsoumyadeepb ( talk) 15:27, 7 October 2014 (UTC))
Hello JFWGreat; Looking forward to the edits.( Drsoumyadeepb ( talk) 06:13, 10 October 2014 (UTC))
doi:10.1016/j.jinf.2016.01.007 - the UK specialist societies guideline, which will update the now rather outdated guideline.
The IDSA ( http://www.idsociety.org/Organ_System/) is also working on an update. JFW | T@lk 06:32, 2 March 2016 (UTC)
It strikes me that the present wording of the article does not sufficiently convey to the reader the urgency of rapid treatment. By contrast this CDC ref makes it clear in the second sentence: "Death can occur in as little as a few hours." and reinforces it later with "Later symptoms of bacterial meningitis can be very serious (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible" (emphasis in original). In light of this recent news we should be conscious that readers need to understand that delay is dangerous, and reflect that in the article. LeadSongDog come howl! 15:23, 27 April 2016 (UTC)
I am with User:Looie496 on this one. We already say in the lead "The first treatment in acute meningitis consists of promptly giving antibiotics and sometimes antiviral drugs.[2][6] ... Meningitis can lead to serious long-term consequences such as deafness, epilepsy,hydrocephalus, or cognitive deficits, especially if not treated quickly.[1][3]" This makes it perfectly clear the importance of early treatment. Nothing more is needed. Doc James ( talk · contribs · email) 18:40, 28 April 2016 (UTC)
Zad
68
16:56, 29 April 2016 (UTC)"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.[1][5]" That surely is good enough? Been in the article for ages. JFW | T@lk 13:07, 25 May 2016 (UTC)
doi:10.1016/S0140-6736(16)30654-7 JFW | T@lk 08:28, 2 September 2016 (UTC)
I think it would be appropriate to include a section on the Meningitis Wikipedia page entitled 'Awareness' as awareness is in many cases, the key to prevention. Many people don’t know the warning signs of meningitis or that many types of meningitis are vaccine-preventable. [1] In this section, I would recommend the mention of World Meningitis Day, held on the 24th of April each year. The piece I had previously added: "Each year, World Meningitis Day is celebrated on the 24th April. This is an opportunity for people all over the world to raise their voices against meningitis, through telling patient stories, raising awareness of the signs and symptoms of the disease and increasing knowledge of available vaccines. The campaign is organised by the Confederation of Meningitis Organisations (CoMO), a global community of over 45 meningitis organisations, which was founded in 2004 at the World Conference of Meningitis Organisations."
I understand that this might be considered a COI. However, I would argue that we are just wishing to raise awareness of World Meningitis Day and to acknowledge the importance of Meningitis Awareness. Please let me know your thoughts. Of course, we would be happy with minor changes made to the piece to fit the guidelines of Wikipedia. Would it be more appropriate to exclude the external link to our website?
Kind Regards, JoinHands ( talk) 09:33, 18 November 2016 (UTC)JoinHands
Thank you for including World Meningitis Day; however, I do not feel that it's placement is adequate in 'history'. I would appreciate it if you could review this, bearing in mind the placement and mention for other World Health days eg. World Pneumonia day is listed under Society and Culture: ( /info/en/?search=Pneumonia#Society_and_culture) Kind Regards, JoinHands ( talk) 12:54, 23 November 2016 (UTC)JoinHands.
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I am looking for some help when performing a Cochrane update on the Meningitis article. The Meningitis article presently reads: "In children routine intravenous fluids for two days may improve outcomes in those who arrive at hospital after being sick for some time.[61][needs update] " The new version of the Cochrane review states that: "The quality of evidence regarding fluid therapy in children with acute bacterial meningitis is low to very low and more RCTs need to be conducted. There is insufficient evidence to guide practice as to whether maintenance fluids should be chosen over restricted fluids in the treatment of acute bacterial meningitis." Meningitis Meningitis I am not familiar with present clinical guidelines and wanted to check on here to see if anyone has anything to add before I make any changes to the article.
Thanks. JenOttawa ( talk) 02:48, 6 September 2017 (UTC)
doi:10.1007/s00134-019-05901-w JFW | T@lk 15:13, 2 March 2020 (UTC)
This journal article, which is briefly referenced in the current article (#48) would appear to have important relevance to the section on fungal meningitis as well. I am willing to make this edit but am not expert in this field so am seeking another opinion prior to making this edit.
Thank you BDD user ( talk) 15:14, 17 March 2020 (UTC)
References
Hello, I moved some of the material around in the diagnosis section before I remembered that this is a featured article. I noticed that information on lumbar puncture was shared in two different places in this section and I also added an intro sentence to diagnosis using https://www.aafp.org/afp/2017/0901/p314.html and https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012824.pub2/full. I would like to propose adding in a short sentence that shares conclusions from the cochrane review on "accuracy of jolt accentuation for headache in acute meningitis in the emergency setting". I will wait a few days in case someone has other suggestions for improving the article or disagrees with my improvements. Thanks! JenOttawa ( talk) 14:36, 18 October 2020 (UTC)
References
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This entry currently claims that viral meningitis "cannot be spread by only breathing the air where a person with meningitis has been". But in support of this it cites a CDC page that seems to be making such a claim only about bacterial meningitis (rather than viral meningitis). This entry does not seem to mention airborne transmission otherwise, despite the fact that, according to the Airborne transmission entry, enterovirus (the most common cause of viral meningitis) can spread via airborne transmission. Am I missing something? — Preceding unsigned comment added by User91348 ( talk • contribs) 13:50, 1 February 2021 (UTC)
I'm making edits to replace primary research sources with the appropriate secondary sources. Where I cannot find suitable sources I will flag this for possible removal. I will put details of my edits below.— Preceding unsigned comment added by Simon A Johnston ( talk • contribs) 12:49, 26 April 2022 (UTC)
I'm also making some changes for factual inaccuracy and clarity — Preceding unsigned comment added by Simon A Johnston ( talk • contribs) 12:49, 26 April 2022 (UTC)
Hello, thank you for this well balanced article. I was wondering if the position (looks somehow squeezed in the see also section) would be better off on the very bottom of the page. That you for your time. Lotje ( talk) 05:30, 1 October 2022 (UTC)
The article is huge but the onset moment and period after contraction isn't discussed. Would appreciate if someone expands it. AXONOV (talk) ⚑ 20:14, 28 December 2022 (UTC)
The page mentions that the death rate from bacterial infections is less than 15% with a reference. I could not find that information in the reference. I did find a WHO page on the topic that says it is 1 in 6. I do not know how to add a reference to a web page, so if somebody that knows how can update the data and the reference, I'd appreciate the help.