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Meningismus is a set of symptoms that mimic those of meningitis (such as headache, neck stiffness, and fever) but are not caused by inflammation of the meninges. It can be caused by conditions such as migraines, tension headaches, or viral infections, and may resolve on its own once the underlying cause is treated.
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What are the symptoms of chemical meningitis?
AnswerIdentical of those of bacterial meningitis SymptomsFever and chillsSevere headacheNausea and vomitingStiff neck (meningismus)Sensitivity to light (phytophobia)Additional symptoms that may be associated with this disease:Decreased ConcienciesnousRapid breathing(severe neck stiffness, ultimately resulting in a characteristic arched posture-seen in infants or small children)Bulging fontanelles (the soft spots in a baby's skull may bulge)Poor feeding or irritability in childrenSevere pain in legs and/or handspale skin and blueish lips
Meningitis?
DefinitionMeningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord. This inflammation causes changes in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.See also:Aseptic meningitisMeningitis - gram-negativeMeningitis - H. influenzaeMeningitis - meningococcalMeningitis - pneumococcalMeningitis - staphylococcalMeningitis - tuberculousCauses, incidence, and risk factorsThe most common causes of meningitis are viral infections that usually get better without treatment. However, bacterial meningitis infections are extremely serious, and may result in death or brain damage even if treated.Meningitis is also caused by:Chemical irritationDrug allergiesFungiTumorsTypes include:Aseptic meningitisCryptococcal meningitisGram negative meningitisnullH. influenzameningitisMeningitis due to cancer (carcinomatous meningitis)Meningococcal meningitisPneumococcal meningitisStaphylococcal meningitisSyphilitic aseptic meningitisTuberculous meningitisAcute bacterial meningitis is a true medical emergency, and requires immediate treatment in a hospital.Viral meningitis is milder and occurs more often than bacterial meningitis. It usually develops in the late summer and early fall, and often affects children and adults under age 30. Most infections occur in children under the age of 5. Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.Many other types of viruses can cause meningitis. For example, viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpes (although people with cold sores or genital herpes are not at a greater risk of developing herpes meningitis).Recently, West Nile virus, spread by mosquito bites, has become a cause of viral meningitis in most of the United States.SymptomsFever and chillsMental status changesNausea and vomitingSensitivity to light (photophobia)Severe headacheStiff neck (meningismus)Other symptoms that can occur with this disease:AgitationBulging fontanellesDecreased consciousnessOpisthotonosPoor feeding or irritability in childrenRapid breathingMeningitis is an important cause of fever in newborn children.Signs and testsBlood cultureChest x-rayHead CT scanGram-stain and culture of CSF (cerebral spinal fluid)Lumbar puncture("spinal tap") with CSF glucose measurement and CSF cell countTreatmentDoctors prescribe antibiotics for bacterial meningitis. The type will vary depending on the bacteria causing the infection. Antibiotics are not effective in viral meningitis.Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock, and seizures. Some people may need to stay in the hospital, depending on the severity of the illness and the treatment needed.Expectations (prognosis)Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications.ComplicationsBrain damageHearing loss or deafnessHydrocephalusLoss of visionCalling your health care providerIf you feel that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.PreventionHaemophilus vaccine (HiB vaccine) in children will help prevent one type of meningitis.The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics to avoid becoming infected themselves.The meningococcal vaccination is recommended for:Adolescents ages 11 - 12 and adolescents entering high school (about age 15) who have not already received the vaccination.All college freshmen who have not been vaccinated and are living in dorms.Children age 2 and older who do not have their spleen or who have other problems with their immune system.Those traveling to countries where diseases caused by meningococcus are very common (ask your doctor).Some communities conduct vaccination campaigns after an outbreak of meningococcal meningitis.ReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
Meningitis - staphylococcal?
DefinitionStaphylococcal meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges).See also:Aseptic meningitisMeningitis - cryptococcalMeningitis - gram-negativeMeningitis -nullH. influenzaeMeningitis - meningococcalMeningitis - pneumococcalMeningitis - tuberculousAlternative NamesStaphylococcal meningitisCauses, incidence, and risk factorsMeningitis is caused by Staphylococcus bacteria. When it is caused by Staphylococcus aureus or Staphylococcus epidermidis bacteria, it usually develops as a complication of a surgical procedure, or as an infection spread by the blood from another site.Risk factors include:Infections of heart valvesPast infection of the brainPast meningitis associated with spinal fluid shuntsRecent brain surgerySymptomsChange in mental status (confusion)FeverNausea and vomitingRashSensitivity to light (photophobia)Severe headacheStiff neckSigns and testsA physical exam may show:Fast heart rateLow blood pressureStiff neckFor any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which a sample of spinal fluid (known as cerebrospinal fluid, or CSF) is taken and sent to the lab for testing.Tests may include:Blood cultureSpinal fluid cultureWhite blood cell countTreatmentAntibiotic therapy should be started as soon as possible to decrease the chances of serious illness or death. Often, treatment will include a search for, and removal of, possible sources of bacteria in the body. These include shunts or artificial heart valves.Expectations (prognosis)This form of infection can be very serious in people with suppressed immune systems. It often leads to death. Recognizing the symptoms of meningitis is very important to prevent serious illness.Staphylococcal meningitis often improves more quickly, with better results, if the source of the infection is removed. The source may include shunts, hardware in joints, or artificial heart valves.ComplicationsPatients may develop a brain infection or staph infections at other parts of the body. Serious bleeding and shock may develop.Calling your health care providerGo to the emergency room or call the local emergency number (such as 911) if you have symptoms of meningitis. This disease can be life-threatening.PreventionIn high-risk people, taking preventive antibiotics before diagnostic or surgical procedures may help reduce the risk. Discuss this with your doctor.ReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
Meningitis - gram-negative?
DefinitionGram-negative meningitis is an infection of the membranes covering the brain and spinal cord (meninges) caused by bacteria that turn pink when exposed to a special stain (gram-negative bacteria).See also:Aseptic meningitisMeningitis - cryptococcalMeningitis -nullH. influenzaeMeningitis - meningococcalMeningitis - pneumococcalMeningitis - staphylococcalMeningitis - tuberculousAlternative NamesGram-negative meningitisCauses, incidence, and risk factorsAcute bacterial meningitis can be caused by gram-negative bacteria. Bacteria causing gram-negative meningitis include:Acinetobacter baumanniiEnterobacter aerogenesEscherichia coliKlebsiella pneumoniaePseudomonas aeruginosaGram-negative meningitis is much more common in infants than adults.Risk factors in adults and children include:Local infectionRecent brain surgeryRecent injury to the headSpinal abnormalitiesSpinal fluid shunt placement after brain surgeryUrinary tract abnormalitiesUrinary tract infectionSymptomsFeverMental status changesNausea and vomitingSensitivity to light (photophobia)Severe headacheStiff neckSymptoms of a bladder, kidney, intestine, or lung infectionSigns and testsA physical examination may show:Fast heart rateLow blood pressureStiff neckFor any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.Tests include:Blood cultureCSF cultureCT scan of the brainWhite blood cell countSpinal fluid tests for white blood cells, glucose, proteinSpecial stain of the spinal fluidTreatmentAntibiotic treatment through a vein (IV) usually starts right away. If you have a shunt, it may be removed to get rid of the infection.Expectations (prognosis)It is important to recognize the symptoms of this meningitis, and seek treatment as soon as possible. Early treatment may prevent serious illness or death.Many people recover completely, but a large number of people have permanent brain damage or die from this type of meningitis. Between 40% and 80% of patients with gram-negative meningitis do not survive, although these numbers may be improving. The likelihood of survival depends on:How quickly the infection is treatedOther medical conditions that may be presentThe patient's ageComplicationsBrain abscessBrain damageSeizuresShock with organ damageCalling your health care providerGo to the emergency room or call the local emergency number (such as 911) if you notice symptoms of meningitis. This condition can be very serious and needs immediate treatment.PreventionPrompt treatment of related infections may reduce the risk of meningitis.ReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
Meningitis - tuberculous?
DefinitionTuberculous meningitis is an infection of the the membranes covering the brain and spinal cord (meninges).See also:MeningitisMeningitis - cryptococcalMeningitis - gram-negativeMeningitis -nullH. influenzaeMeningitis - meningococcalMeningitis - pneumococcalMeningitis - staphylococcalAlternative NamesTubercular meningitis; TB meningitisCauses, incidence, and risk factorsTuberculous meningitis is caused by Mycobacterium tuberculosis, the bacteria that causes tuberculosis. The bacteria spreads to the brain from another site in the body.Risk factors include a history of:AIDSExcessive alcohol useOther disorders that compromise the immune systemPulmonary tuberculosisTuberculous meningitis is a very rare disorder.SymptomsThe symptoms usually begin gradually, and may include:FeverListlessnessLoss of appetiteLoss of consciousnessNausea and vomitingSeizuresSensitivity to light (photophobia)Severe headacheStiff neckSigns and testsFor any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which doctors take a sample of spinal fluid (known as cerebrospinal fluid, or CSF) and send it for lab tests.When the health care provider suspects tuberculosis, there may be a need to get many CSF samples over time to increase the chance of a diagnosis. This may require many lumbar punctures.The following tests help diagnose tuberculous meningitis:Biopsy of the brain or meningesCSF cultureCSF stainCSF test of protein, glucose (sugar) level, and lymphocytesPolymerase chain reaction (PCR)Skin test for tuberculosis (PPD)TreatmentTreatment involves several antitubercular drugs at the same time, as it does for pulmonary tuberculosis. Treatment usually lasts for at least 12 months. Systemic steroids may also be used.Expectations (prognosis)Tuberculous meningitis is life-threatening if untreated. Long-term follow-up is needed to detect repeated infections (recurrences).ComplicationsBrain damage resulting from the infection may cause:Abnormal behaviorMental impairmentMotor paralysisSeizuresCalling your health care providerGo to the emergency room or call 911 if you suspect you or your child may have any form of meningitis. This condition can rapidly cause disability or death.Call your health care provider if symptoms worsen or do not improve with treatment, or if new symptoms develop.PreventionIn areas where tuberculosis is more common, the BCG vaccine may help prevent severe forms of tuberculosis, such as meningitis, in very young children.Treating people who have evidence of a non-active (dormant) tuberculosis infection can prevent the spread of tuberculosis. A dormant infection can be detected by a positive PPD.ReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
Meningitis - meningococcal?
DefinitionMeningococcal meningitis is an infection that causes swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.See also:Aseptic meningitisMeningitisMeningitis - cryptococcalMeningitis - gram-negativeMeningitis -nullH. influenzaeMeningitis - pneumococcalMeningitis - staphylococcalMeningitis - tuberculousAlternative NamesMeningococcal meningitisCauses, incidence, and risk factorsMeningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus).Most cases of meningococcal meningitis occur in children. Meningococcus is the most common cause of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.The infection occurs more often in winter or spring. It may cause local epidemics at boarding schools, college dormitories, or military bases.Risk factors include recent exposure to meningococcal meningitis and a recent upper respiratory infection.SymptomsThe disease may come on quickly, and may start with an upper respiratory infection or sore throat.Symptoms include:High feverMental status changesNauseaPurple, bruise-like areas (purpura)Rash, pinpoint red spots (petechiae)Sensitivity to light (photophobia)Severe headacheSevere general ill feeling (malaise)Stiff neckVomitingSigns and testsPhysical examination will show:Fast heart rateLow blood pressurePossible rashStiff neckFor any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.Tests may include:Blood cultureCSF cultureCT scan of the brainSpecial stains of spinal fluidWhite blood cell (WBC) countTreatmentAntibiotics such as ceftriaxone are prescribed and given through the arm by IV (intravenous line). Other medicines may be used to treat the complications from increased spinal fluid pressure.Sometimes steroid medication is used, more often in children than adults.People in close contact with someone with meningococcal meningitis should be given antibiotics to prevent infection. Such people include:Household membersRoommates in dormitoriesThose who come into close contact with an infected personExpectations (prognosis)Early diagnosis and treatment is extremely important to prevent serious illness or death. The death rate ranges from 5% - 15%. Young children and adults over 50 have the highest risk of death.ComplicationsBrain damageDeafnessHydrocephalusIncreased spinal fluid pressureMental retardationMyocarditisParalysis of various musclesShockCalling your health care providerGo to an emergency room or call the local emergency number (such as 911) if:You notice symptoms of meningitisSymptoms get worse or do not improve with treatmentYou think you have been exposed to someone with meningitisMeningitis can quickly become life-threatening.PreventionAll family and close contacts (especially in health care or school settings) of people with this type of meningitis should begin antibiotic treatment as soon as possible to prevent spread of the infection. Ask your health care provider about this during the first visit.Close contacts in the same household, school, or day care center should be watched for early signs of the disease as soon as the first case is diagnosed. Always use good hygiene habits, such as washing hands before and after changing a diaper, or after using the bathroom.Vaccines are effective for controlling epidemics. They are currently recommended for:College studentsMilitary recruitsTravelers to certain parts of the worldReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 437.
Meningitis - H. influenzae?
DefinitionHaemophilus influenzae meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges).See also:Aseptic meningitisMeningitisMeningitis - cryptococcalMeningitis - gram-negativeMeningitis - meningococcalMeningitis - pneumococcalMeningitis - staphylococcalMeningitis - tuberculousAlternative NamesH. influenzae meningitis; H. flu meningitisCauses, incidence, and risk factorsH. influenzae meningitis is caused by Haemophilus influenzae bacteria. This bacteria should not be confused with the disease influenza, an upper respiratory infection caused by the influenza virus.Before the Hib vaccine became available, H. influenzae was the leading cause of bacterial meningitis in children under 5 years of age. Since the introduction of the vaccine in the U.S., H. influenzae now occurs in less than 2 in 100,000 children. It still causes 5% - 10% of bacterial meningitis cases in adults.H. influenzae meningitis may come after an upper respiratory infection. The infection usually spreads from the respiratory tract to the bloodstream, and then to the meninges. At the meninges, the bacteria produce infection and inflammation, causing serious illness and sometimes death.Risk factors include:Ear infection (otitis media)Family member with an H. influenzae infectionNative American racePlacement in day careSinus infection (sinusitis)Sore throat (pharyngitis)Upper respiratory infectionSymptomsFever (in young infants the temperature may actually be below normal)Irritability, poor feeding in infantsNausea and vomitingPain in back when neck is bent forward and chin is brought toward chest (older children)Sensitivity to light (photophobia)Severe headache(older children)Stiff neck or pain in neckUnusual body positionsSigns and testsSigns include:Bulging of the fontanelles in an infantLying with the back arched, head, back, and chin up (opisthotonos)Mental status changes (such as irritability, reduced consciousness, coma)Poor blood flow (circulation)SeizuresFor any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.Other tests include:Antibodies in blood (serology)Blood cultureSpinal fluid cultureWhite blood cell countTreatmentTreatment must be started as soon as meningitis is suspected. H. influenzae meningitis should be treated with antibiotics given through a vein (IV).Steroid medication may also be used, mostly in children. Steroids are given to reduce hearing loss, which is a common complication of meningitis in children.Expectations (prognosis)The likely outcome is good with early treatment. However, 3 - 5% of patients do not survive.ComplicationsAbnormal speech and language developmentBehavioral problemsHearing lossHydrocephalusLearning disordersMental retardationSeizuresCalling your health care providerContact your health care provider or go to an emergency room if you experience symptoms of H. influenzae or if you notice these symptoms in your child. Meningitis can quickly become life-threatening.PreventionTo protect infants and young children:Hibimmunizations for infants and children are recommended by the American Academy of Pediatrics, the National Institutes of Health, and many other health agencies.Several types of Hib vaccine are available for children ages 2 months and older.To prevent infection after being exposed to H. influenzae meningitis:All family contacts of people with this type of meningitis who have not been vaccinated should begin drug therapy to prevent infection as soon as possible.Ask your health care provider about this treatment during the first visit.ReferencesSwartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
What is the definition of spinal meningitis?
What is Spinal Meningitis?Meningitis is an infection that causes inflammation of the membranes covering the brain and spinal cord. Non-bacterial meningitis is often referred to as "aseptic meningitis." Bacterial meningitis may be referred to as "purulent meningitis."Causes, incidence, and risk factorsThe most common causes of meningitis are viral infections that usually resolve without treatment. However, bacterial infections of the meninges are extremely serious illnesses, and may result in death or brain damage, even if treated. Meningitis is also caused by fungi, chemical irritation, drug allergies, and tumors. Types of Memingitis include:Meningitis - cryptococcalSyphilitic aseptic meningitisMeningitis - H. influenzaMeningitis - meningococcalMeningitis - pneumococcalMeningitis - staphylococcalMeningitis - tuberculosisAseptic meningitisMeningitis gram negativeCarcinomatous meningitis (meningitis due to cancer)Acute bacterial meningitis is a true medical emergency, and requires immediate hospital-based treatment. Bacterial strains that cause meningitis include Streptococcus pneumonia, Haemophilus influenza, Neisseria meningitides (meningococcus), Listeria monocytogenes, and many other types of bacteria. In the U.S. almost 20,000 cases of bacterial meningitis occur yearly.Viral Meningitis is milder and occurs more often than bacterial meningitis. It usually develops in the late summer and early fall, often affects children and adults under 30. Seventy percent of the infections occur in children under the age of 5. Most Viral Meningitis is associated with enteroviruses, which are viruses that commonly cause intestinal illness.However, many other types of viruses can also cause meningitis. For example, Viral Meningitis may occur as a complication in people with genital herpes. Recently, West Nile virus spread by mosquito bites has become a cause of Viral Meningitis in most of the U.S. In addition to causing Viral Meningitis, West Nile virus may cause encephalitis in some patients and a polio-like syndrome in others.Spinal Meningitis SymptomsFever and chillsSevere headacheNausea and vomitingStiff neck (meningismus)Sensitivity to light (photophobia)Mental status changesAdditional symptoms that may be associated with this disease:Decreased consciousnessRapid breathingAgitationOpisthotonos (severe neck stiffness, ultimately resulting in a characteristic arched posture-seen in infants or small children)Bulging fontanelles (the soft spots in a baby's skull may bulge)Poor feeding or irritability in childrenMeningitis is an important cause of fever in newborn children. For this reason, a lumbar puncture is often done on newborns who have a fever of uncertain origin.Signs and testsLumbar puncture with CSF glucose measurement and CSF cell countGram-stain and culture of CSF (cerebral spinal fluid)Chest x-ray to look for other sites of infectionHead CT scan looking for hydrocephalus, abscess or deep swellingTreatment of Spinal MeningitisAntibiotics will be prescribed for bacterial meningitis; the type will vary depending on the infecting organism. Antibiotics are not effective in Viral Meningitis. Treatment of secondary symptoms including brain swelling, shock, and seizures will require other medications and intravenous fluids. Hospitalization may be required depending on the severity of the illness and the needed treatment. Expectations (prognosis) of Spinal MeningitisEarly diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological or spinal damage. Viral Meningitis is typically not so serious, and symptoms should disappear within 2-weeks with no residual complications. Complications of Spinal MeningitisHearing loss or deafnessBrain damageLoss of visionHydrocephalusCalling your health care providerIf you feel that you or your child have symptoms suggestive of meningitis, you must seek emergency medical help immediately. Early treatment is key to a good outcome. Prevention of Spinal MeningitisHaemophilus vaccine (HiB vaccine) in children will help prevent one type of meningitis. The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing Pneumococcal Meningitis. It's highly recommended household contacts and people with close contact with individuals with meningococcal meningitis receive preventative antibiotics to avoid becoming infected themselves.Some communities conduct vaccination campaigns following an outbreak of meningococcal meningitis. Military recruits are routinely vaccinated against this form of meningitis because of its high rate of occurrence.The American Academy of Pediatrics and the American College Health Assn encourage college students (particularly freshmen living in dorms) to consider being vaccinated with the meningococcal vaccine.How to Deal with Spinal Meningitis?With the arrival of late summer and early fall Spinal Meningitis raises its ugly head to search for preys, its victims are often children below five and adults below thirty. Spinal Meningitis is a lay-term for inflammation of the meninges-membranes covering the brain and spinal cord. It affects the brain and spine simultaneously.Causes'Purulent Meningitis' refers to the infection caused by bacteria. 'Aseptic meningitis' is non bacterial meningitis- caused by virus, fungi, chemicals and tumors. SymptomsThe symptoms of both bacterial and non bacterial "spinal meningitis symptoms" are very similar. The onslaught of meningitis disease is preceded generally by a splitting headache, fever and chills, severe stiff neck, sensitivity to light, vomiting, loss of appetite, and sweating. Bacterial Meningitis may show some extra symptoms like mental status changes, Dementia, twitching, perturbation, skin rashes and protrusive soft skull spots in case of babies.DiagnosisIf you experience these symptoms seek medical attention right away. Delays can cause incurable secondary defects like blindness, deafness and brain damage or may be life threatening. Common meningitis disease diagnosis tools the doctor uses for spinal meningitis include a Lumbar Puncture to inspect cerebrospinal fluid, bacterial culture, chest X-ray and a CT scan of the brain to locate meningitis disease damage.Medical TreatmentBacterial Meningitis is treated with antibiotics administered orally first and then intraveinously. The earlier the disease is detected and treated the better will be the results. Although rarely seen, this form of Meningitis is more serious that than Viral Meningitis. Antibiotics can't cure Viral Meningitis. The disease usually resolves on its own. Secondary defects can be treated with intravenous fluids. Natural TreatmentGolden Seal is a natural tonic that strengthens the spinal nerves and prevents recurrence of spinal meningitis. Black Cohosh is good for spinal meningitis, but its use is unadvisable for pregnant women. Both these medicines should be taken only for short time periods. Prevention is always better than cure. Thanks to administration of drugs and vaccines like Haemophilus vaccine, Meningococcal vaccine and Pneumococcal conjugate vaccine you can prevent some types of Spinal Meningitis.
