Maintaining adequate fluid and electrolyte balance is also important in treatment. Neonates, infants, and children are prone to developing Syndrome of Inappropriate Antidiuretic Hormone (SIADH) and seizures from electrolyte imbalances. Brain edema can occur if too much fluid is given and decreased cerebral perfusion can occur if too little fluid is given (Miller, Gaur, & Kumar 2008). In SIADH, the posterior pituitary abnormally releases too much antidiuretic hormone (ADH), which signals the kidneys to retain fluid. This can lead to an excess of fluid in the blood and very concentrated urine. Hyponatremia results from the excess circulating fluid which can lead to lethargy, convulsions, and irreversible brain damage (McCance & Huether 2006).
Steroid therapy has shown some positive outcomes when used in treating bacterial meningitis patients (van de Beek, de Gans, & Prasad 2007). When dexamethasone was used early in the treatment regimen there seemed to be an effect in the inflammatory process. There was a decrease in mortality and severe hearing loss in these patients.
Anyone that comes into contact with a person that has bacterial meningitis should be treated prophylactically with antibiotics. According to Miller, Gaur, and Kumar (2008), persons that are in high-risk exposure situations should be treated. High-risk exposure persons are those that live in the same house, childcare contacts during 7 days before the illness, direct exposure (sharing of glasses, kissing, or close social contact), and those that came into contact with the person frequently. The antibiotics of choice for prophylactic treatment of N meningitides are Rifampin, Ceftriaxone, and Ciprofloxin. Ciprofloxin may only be used in individuals greater than 18.
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