DRHOOK- bacterial meningitis: Why you want to diagnose quickly

the handsome doctor John Hong of Charlottesville

College is supposed to be the best four years of your life. I don't think that applies to me. I'm going to my 21st year class reunion (Black Jack!), and yet I still have dreams of going to back to college.

Most folks dream they really haven't graduated because they didn't finished a class. In my dreams, (which fortunately aren't like the ones on the NBC show Medium), I already have my degrees, but I'm back for a 5th year... just for fun!

 So as I'm looking for my Denison dorm room, I realize, "I have to share a room with three other guys? This stinks!" 

 Can living with other young people in close quarters be deadly? UVA is on high alert after a case of a fourth-year male student, admitted to the University hospital with bacterial meningitis, was announced March 26.

 Meningococcal meningitis is the #1 cause of bacterial meningitis in the USA. It strikes mostly in children and young adults. Fortunately, it is not very common, about 3,000 cases a year. Unfortunately, because it is rare, it is often not diagnosed in time, and about 13 percent die.

 Neisseria meningococcus is the bacterium that wreaks havoc in the body. It is carried in the nasopharynx (upper part of the throat behind the nose) so is spread airborne or by things like sneezing. The spinal cord and brain are covered by a three-layered sheath call the meninges. When infected, it is called meningitis. And, girlfriend, it can really hurt.

 Neck pain and stiffness can result from the inflammation of the meninges. Change in mental status can occur with infection going to the brain. Fevers usually result from the infection. However, as with Wall Street, things often don't present like they should. Maybe only 27 percent of meningococcal meningitis present with these signs. 

 Making the diagnosis even trickier, meningococcal meningitis usually occurs in late winter– coinciding with influenza! So having a sudden onset of fever, headache, and body aches might seem like the flu.

Muscle aches from the flu are pretty bad, but folks with meningococcal meningitis say the body aches are ZEE VORST, and they think they are going to die.

 Sore throat can occur and be confused with strep throat. But the nausea, vomiting, and decreased ability to concentrate are signs of brain infection, and should be an alert for meningococcal meningitis.

 A petechial rash (tiny dot bruises from platelet dysfunction) usually appears, and by this time 89 percent of people with have more of the meningitis signs. The tiny rash can change into major bruises called purpura, to make you look like an extra from The Wrestler. 

 The time frame between feeling initially ill to severe systemic illness is very short. On average, admission to the hospital is within 22 hours. 

 Sepsis is when the bacteria are streaming through the blood, and it causes things like low blood pressure, fast heart rate, fever, and immune cells can go wild. So peripheral blood flow can decrease to lead to cold hands and feet with mottled or pale skin and leg pain. 

 Before the age of antibiotics, about 70-90 percent of those inflicted with meningococcal meningitis died. Treatment should be initiated within 30 minutes of seriously suspecting meningococcal meningitis.

 Prevention to those who have been in close contact to a person with meningococcal meningitis is recommended. The good news is only about 1 in 250 persons in close contact are at risk for infection. What is a close contract? (It is not what you put in your eyes instead of wearing glasses.) It is like a roommate, office worker, household member. Those with brief exposure aren't usually given prophylactic antibiotics.

 The meningoccal vaccine is recommended for college students, and most students are vaccinated.

 If I have another dream about returning to college, I am going to stay away from students are who are a pain in the neck. It just isn't worth it!