Meningitis is a serious or a severe infection caused by a brain inflammation of the membrane covering both the spinal-cord and brain. Non-bacterial meningitis is often referred to as aseptic meningitis. Much more serious bacterial meningitis is also a common medical condition.
A viral infection may result in viral spinal meningitis which normally gets better without any medical treatment. However, bacterial infections are extremely serious. In fact, severe bacterial spinal meningitis may cause death or severe brain damage, even if treated. Most common and important meningitis disease causes and risk factors are from mosquito bites, fungi, some chemicals, genital herpes, drug allergies, certain types of tumors and cancers.
Symptoms of Meningitis
High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness.
In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect. Infants with meningitis may appear slow or inactive, have vomiting, be irritable, or be feeding poorly.
As the disease progresses, patients of any age may have seizures.
Symptoms usually come on quickly, and may include:
- Fever and chills
- Mental status changes
- Nausea and vomiting
- Sensitivity to light (photophobia)
- Severe headache
- Stiff neck (meningismus)
Other symptoms that can occur with this disease:
- Bulging fontanelles
- Decreased consciousness
- Poor feeding or irritability in children
- Rapid breathing
- Unusual posture, with the head and neck arched backwards (opisthotonos)
Meningitis is an important cause of fever in children and newborns.
People cannot tell if they have bacterial or viral meningitis by how they feel, so they should seek prompt medical attention.
Signs and tests for Meningitis
Physical examination will usually show:
- Fast heart rate
- Mental status changes
- Stiff neck
For any patient who is suspected of having meningitis, it is important to perform a lumbar puncture (” spinal tap”), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.
Tests that may be done include:
- Blood culture
- Chest x-ray
- CSF examination for cell count, glucose, and protein
- CT scan of the head
- Gram stain, other special stains, and culture of CSF
Treatment for Meningitis
Doctors prescribe antibiotics for bacterial meningitis. The type will vary depending on the bacteria causing the infection. Antibiotics are not effective in viral meningitis.
Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock, and seizures. Some people may need to stay in the hospital, depending on the severity of the illness and the treatment needed.
Expectations / Prognosis for Meningitis
Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications.
Complications of Meningitis
- Brain damage
- Buildup of fluid between the skull and brain (subdural effusion)
- Hearing loss
When to Call your Health Care Provider
If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.
Prevention of Meningitis
The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.
Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics to avoid becoming infected themselves.
The meningococcal vaccination is recommended for:
- Adolescents ages 11 – 12 and adolescents entering high school (about age 15) who have not already received the vaccination.
- All college freshmen who have not been vaccinated and are living in dorms.
- Children age 2 and older who do not have their spleen or who have other problems with their immune system.
- Those traveling to countries where diseases caused by meningococcus are very common (ask your doctor).
- Some communities conduct vaccination campaigns after an outbreak of meningococcal meningitis