Posted by Ben Lees, Partner
How does meningitis lead to limb loss, and can limb loss be prevented?
Meningitis is generally caused by either a virus or bacteria (although fungi can cause meningitis in an individual with a compromised immune system). Viral meningitis is the most common form of meningitis and, luckily, rarely causes septicaemia and limb loss.
Bacterial meningitis is a rare, but very serious, form of meningitis. It is most commonly caused by the meningococcal bacteria in the UK, although other bacteria including pneumococcal bacteria can also cause meningitis.
How meningitis leads to amputation
Once the meningococcal bacteria enters the bloodstream it can cause septicaemia (a serious blood stream infection) by multiplying and releasing toxins. These toxins can then damage blood vessels, reducing the flow of oxygen to organs and skin tissue.
The body tends to prioritise (and try to maintain blood supply to) vital organs, often at the expense of the extremities. Because of the damage to blood vessels, extremities can then be starved of blood and oxygen, at which point underlying tissues begin to die. It is this process that leads to the amputation of fingers, toes and limbs.
Recent research into preventing limb loss from meningitis
There has been some encouraging research in recent years into the mechanism of the runaway blood clotting that is typical in severe meningococcal disease. Scientists in one study found that, when meningococcal bacteria bind to the lining of blood vessels, a molecule called ADAM10 becomes active and prevents the body’s natural ability to stop uncontrollable clotting. It is hoped that this discovery will lead to new therapies.
However, for the time being, the best way to combat bacterial meningitis is rapid referral, diagnosis and treatment with IV antibiotics (as well as oxygen and corticosteroids depending upon how advanced the disease is). The right antibiotics will root out and kill the harmful bacteria, and prevent this bacteria from multiplying and releasing toxins. If this is done in a timely fashion, the risk of limb loss is greatly reduced.
Once a diagnosis is made, treatment tends to take place quickly. Worryingly however, delays are often at the diagnostic stage. A report in 2018 undertaken by the Meningitis Research Foundation found that, in 134 accounts taken from parents whose children displayed symptoms of meningitis, 103 were sent home with reassurances that it was a milder condition. In 23 of these cases, the child died, whilst others suffered serious injuries including amputations.
Bacterial meningitis is a serious condition that can have devastating life-long consequences, including limb loss, if the disease is allowed to proliferate without timely intervention. There seems to be some evidence that up-skilling in primary care and A&E triage settings needs to take place, however just raising awareness so that patients are able to identify potentially sinister symptoms in themselves and their children is part of the battle.
If you have any questions for our specialist medical negligence and limb loss team, please contact us today.
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