Steroids
Additional treatment with corticosteroids (usually dexamethasone) has shown some benefits, such as a reduction of hearing loss, and better short term neurological outcomes in adolescents and adults from high-income countries with low rates of HIV. Some research has found reduced rates of death while other research has not. They also appear to be beneficial in those with tuberculosis meningitis, at least in those who are HIV negative.Professional guidelines therefore recommend the commencement of dexamethasone or a similar corticosteroid just before the first dose of antibiotics is given, and continued for four days. Given that most of the benefit of the treatment is confined to those with pneumococcal meningitis, some guidelines suggest that dexamethasone be discontinued if another cause for meningitis is identified. The likely mechanism is suppression of overactive inflammation.Additional treatment with corticosteroids have a different role in children than in adults. Though the benefit of corticosteroids has been demonstrated in adults as well as in children from high-income countries, their use in children from low-income countries is not supported by the evidence; the reason for this discrepancy is not clear. Even in high-income countries, the benefit of corticosteroids is only seen when they are given prior to the first dose of antibiotics, and is greatest in cases of H. influenzae meningitis, the incidence of which has decreased dramatically since the introduction of the Hib vaccine.
One of the most common locations for a foreign body is the alimentary tract. It is possible for foreign bodies to enter the from the mouth, or from the rectum.The objects most commonly swallowed by children are coins. Meat impaction, resulting in esophageal food bolus obstruction is more common in adults. Swallowed objects are more likely to lodge in the esophagus or stomach than in the pharynx or duodenum. Diagnosis
If the person who swallowed the foreign body is doing well, usually an x-ray image will be taken which will show any metal objects, and this will be repeated a few days later to confirm that the object has passed all the way through the digestive system. Also it needs to be confirmed that the object is not stuck in the airways, in the bronchial tree. Treatment
Most objects that are swallowed will, if they have passed the pharynx, pass all the way through the gastrointestinal tract unaided. However, sometimes an object becomes arrested (usually in the terminal ileum or the rectum) or a sharp object penetrates the bowel wall.