Meningitis

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Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord.

Symptoms

It’s easy to mistake the early signs and symptoms of meningitis for the flu (influenza). Meningitis signs and symptoms may develop over several hours or over one or two days.

The signs and symptoms that may occur in anyone older than age of 2 include:

  • Sudden high fever
  • Severe headache that isn’t easily confused with other types of headache
  • Stiff neck
  • Vomiting or nausea with headache
  • Confusion or difficulty concentrating
  • Seizures
  • Sleepiness or difficulty waking up
  • Sensitivity to light
  • Lack of interest in drinking and eating
  • Skin rash in some cases, such as in meningococcal meningitis

Signs in newborns

Newborns and infants may not have the classic signs and symptoms of headache and stiff neck. Instead, signs of meningitis in this age group may include:

  • High fever
  • Constant crying
  • Excessive sleepiness or irritability
  • Inactivity or sluggishness
  • Poor feeding
  • A bulge in the soft spot on top of a baby’s head (fontanel)
  • Stiffness in a baby’s body and neck

Infants with meningitis may be difficult to comfort, and may even cry harder when picked up.

When to see a doctor

Seek medical care right away if you or someone in your family has signs or symptoms of meningitis, such as:

  • Fever
  • Severe, unrelenting headache
  • Confusion
  • Vomiting
  • Stiff neck

Causes

Meningitis usually results from a

  • viral infection
  • bacterial infection
  • Less commonly fungal infection

Bacterial infections are the most serious and can be life-threatening, identifying the source of the infection is an important part of developing a treatment plan.

Risk factors

Risk factors for meningitis include:

  • Skipping vaccinations.
  • Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis commonly affects people under 20, especially those living in community settings.
  • Living in a community setting.
  • Pregnancy.
  • Compromised immune system.

Complications

The complications of meningitis can be severe. The longer you or your child has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including:

  • Hearing loss
  • Memory difficulty
  • Learning disabilities
  • Brain damage
  • Gait problems
  • Seizures
  • Kidney failure
  • Shock
  • Death

Tests and diagnosis

You or your child may undergo the following diagnostic tests:

  • Blood cultures.
  • X-rays and computerized tomography (CT) scans of the head, chest or sinuses may reveal swelling or inflammation.
  • Spinal tap (lumbar puncture).

Treatments and drugs

The treatment depends on the type of meningitis you or your child has.

Bacterial meningitis

Acute bacterial meningitis requires prompt treatment with intravenous antibiotics and, more recently, cortisone medications, to ensure recovery and reduce the risk of complications, such as brain swelling and seizures.

Viral meningitis

Antibiotics can’t cure viral meningitis, and most cases improve on their own in several weeks. Treatment of mild cases of viral meningitis usually includes:

  • Bed rest
  • Plenty of fluids
  • Over-the-counter pain medications to help reduce fever and relieve body aches

If the cause of your meningitis is a herpes virus, an antiviral medication is available.

Other types of meningitis

If the cause of your meningitis is unclear, your doctor may start antiviral and antibiotic treatment while a cause is being determined.

Prevention

These steps can help prevent meningitis:

  • Wash your hands.
  • Practice good hygiene.
  • Stay healthy.
  • Cover your mouth.
  • If you’re pregnant, take care with food.

Immunizations

Some forms of bacterial meningitis are preventable with the following vaccinations:

  • Haemophilus influenzae type b (Hib) vaccine.
  • Pneumococcal conjugate vaccine (PCV7).
  • Neisseria meningitidis serogroup B meningococcal vaccine (MenB).
  • Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y vaccine (Hib-MenCY).
  • Pneumococcal polysaccharide vaccine (PPSV).
  • Meningococcal conjugate vaccine (MCV4).