Delayed Diagnosis of Meningitis
The launch of a nationwide audit of the management of meningitis in the UK raises questions as to the need for rapid recognition, diagnosis and treatment.
The impact of meningitis
The NICE guidelines on the management of meningitis states the following:
"All suspected cases of meningitis are medical emergencies requiring immediate hospital admission".
A failure to diagnose and treat meningitis can lead to permanent disability for the patient including the following:
- Epileptic seizures
- Hearing loss
- Sight loss
- Co-ordination and balance problems
- Memory and concentration problems
- Loss of a limb
In the worst cases, meningitis can cause the death of the patient.
Unfortunately, according to the Meningitis Research Foundation, there is room for improvement. According to their website, 'guidelines have not always been well adhered to in the UK and there is inappropriate use of brain scans and delays in lumbar puncture - the essential investigation needed to determine the cause of the illness.'
What is meningitis?
Meningitis is an infection of the lining of the brain (the meninges). It can be caused by both a viral and a bacterial infection. Meningitis caused by a viral infection generally clears up easily. Bacterial meningitis can cause severe, long-term health problems due to brain damage and requires immediate medical intervention.
Bacterial meningitis needs to be treated urgently in hospital with intravenous antibiotics, fluids and, in some circumstances, oxygen.
The UK's National Institute for Health and Care Excellence states that, worldwide, between 30 and 50% of those people who suffer and survive bacterial meningitis, will suffer permanent neurological effects.
Diagnosing meningitis
Clearly, a swift and accurate diagnosis of meningitis is crucial to the long-term outcome for the patient.
Although meningitis is fairly rare and many doctors may not be particularly familiar with the condition, some of its symptoms should raise the possibility of a meningitis diagnosis.
Early symptoms such as a headache, nausea and a high temperature, may be shared with a number of other conditions, but more specific symptoms such as a stiff neck, a rash and an altered mental state, should alert a medical practitioner to the possibility that the patient is developing meningitis.
Testing delays
Research by the University of Liverpool, funded by the Meningitis Research Foundation has found that the essential lumbar puncture test for meningitis is frequently delayed by unnecessary CT brain scans despite guidelines recommending that a lumbar puncture take place within one hour of suspected diagnosis. Furthermore, the research found that a prompt lumbar puncture could lead to a quicker identification of the cause of the illness and patients experiencing a shorter stay in hospital.
Substandard care
A failure to recognise or investigate possible symptoms of meningitis leading to a poor outcome for the patient may be considered to have been substandard medical care. Inappropriate management of patients with suspected meningitis causing a delay in treatment may also be considered to be medically negligent.
TB meningitis
TB (tuberculous) meningitis is caused by the mycobacterium tuberculosis bacteria. It is fairly rare in the UK with only 150 to 200 people per year thought to develop it. Nonetheless, for those who do develop TB meningitis, the prognosis is poor and an urgent diagnosis and emergency treatment are vital. According to 'Meningitis Now', up to 30% of people who contract the illness will die from it despite treatment, and up to a further 20% will be left with severe complications due to the illness. Early treatment can make a significant difference to the patient's outcome.
Although the illness is hard to diagnose, certain groups are at greater risk of developing the disease and this should be taken into account, alongside an assessment of their symptoms when considering meningitis as a diagnosis.
At-risk factors include the following:
- People who already have a weakened immune system, whether due to another condition or due to medical treatment
- People with HIV or AIDS
- People with diabetes
- People with a history of alcohol abuse
Medical negligence
Hospital-based treatment with a combination of antibiotics is required as a matter of emergency.
A failure to refer patients exhibiting possible symptoms of TB meningitis may lead to a fatal outcome. If the patient survives, they may be left with brain damage and a range of associated problems.
A failure on the part of medical professionals to investigate possible signs of meningitis may be considered to be substandard care.
Speak to a solicitor
If you or a loved one have suffered the shocking outcome of a late diagnosis of meningitis, contact us now to talk to a specialist medical negligence solicitor. It may be appropriate to make a claim for compensation.
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