DRG Category: 75

Mean LOS: 7.3 days

Description MEDICAL: Viral Meningitis with CC or Major CC

DRG Category: 98

Mean LOS: 8.0 days

Description MEDICAL: Non-Bacterial Infect of Nervous System Except Viral Meningitis with CC

classification section:



Meningitis is an acute or subacute inflammation of the meninges (lining of the brain and spinal cord). The bacterial or viral pathogens responsible for meningitis usually come from another site, such as those that lead to an upper respiratory infection, sinusitis, or mumps. The organisms can also enter the meninges through open wounds. Bacterial meningitis is considered a medical emergency because the outcome depends on the interval between the onset of disease and the initiation of antimicrobial therapy. In contrast, the viral form of meningitis is sometimes called aseptic or serous meningitis. It is usually self-limiting and, in contrast to the bacterial form, is often described as benign.

In the bacterial form, bacteria enter the meningeal space and elicit an inflammatory response. This process includes the release of a purulent exudate that is spread to other areas of the brain by the cerebrospinal fluid (CSF). If it is left untreated, the CSF becomes thick and blocks the normal circulation of the CSF, which may lead to increased intracranial pressure (ICP) and hydrocephalus. Long-term effects of the illness are predominantly caused by a decreased cerebral blood flow because of increased ICP or toxins related to the infectious exudate. If the infection invades the brain tissue itself, the disease is then classified as encephalitis. Other complications include visual impairment, cranial nerve palsies, deafness, chronic headaches, paralysis, and even coma.

Of the bacteria that cause meningitis, pneumococcal meningitis has the highest rates of mortality at 21%. If severe neurological impairment is seen at the time of initial assessment or very early in the clinical course, the mortality rate is 50% to 90% even when therapy is instituted immediately.