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Meningitis

What is meningitis?

Meningitis is a disease caused by an inflammation of the meninges. These are the membranes that surround the brain and spinal cord. The inflammation is usually caused by infection of the fluid surrounding the brain and spinal cord. 

What causes meningitis?

There are 2 types of meningitis, each with different causes:

Viral (caused by a virus)

  • Viral meningitis is more common than bacterial meningitis. It is rarely life threatening. Viral meningitis can be caused by different viruses, and is spread between people by coughing or sneezing, or through poor hygiene. Rarely, certain insects, such as mosquitoes and ticks, are thought to spread these viruses.
  • In a few cases, viral meningitis can be helped by special antiviral medicines that target specific viruses. Full recovery is normal, but headaches, fatigue, and depression may persist.

Bacterial (caused by a bacterium)

  • Bacterial meningitis, although rare, may be fatal.
  • Bacteria may be spread through respiratory and throat secretions, such as from coughing and kissing.
  • Many species of bacteria can cause meningitis. Below are 4 types: 
    • Neisseria meningitis (meningococcus). This is a common cause of bacterial meningitis in children 2 to 18 years of age. It is spread by respiratory droplets and close contact.  Meningococcal meningitis occurs most often in the first year of life, but may also occur in people who lived in close quarters such as a college dorm.
    • Streptococcus pneumoniae (pneumococcus). This is the most common and most serious form of bacterial meningitis. People with weak immune systems are most at risk.
    • Haemophilus influenzae type b. The development of the Haemophilus influenzae type b vaccine has greatly decreased the number of cases in the U.S. Children who do not have access to the vaccine and those in day-care centers are at higher risk of getting Haemophilus meningitis.
    • Listeria monocytogenes. This has become a more frequent cause of meningitis in neonates, pregnant women, people over the age of 60, and in people of all ages who have a weak immune system.

 

Rarely, a fungus or tuberculosis causes meningitis.

What are the symptoms of meningitis?

These are the most common symptoms of meningitis:

  • Fever
  • Headache
  • Nausea and vomiting
  • Stiff neck
  • Sensitivity to bright light
  • Confusion
  • Joint aches or pains
  • Drowsiness
  • Seizures

Symptoms for children may include:

  • Fever
  • High-pitched cry
  • Pale, blotchy skin color
  • Not wanting to eat
  • Vomiting
  • Fretful and fussy
  • Arching back
  • Difficult to wake

These symptoms may not occur all at once. And, not everyone who gets meningitis will have all of these symptoms. The symptoms of meningitis may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is meningitis diagnosed?

Along with a complete medical history and physical exam, your doctor may do one or more of the following tests: 

  • Lumbar puncture (also called spinal tap). A needle is inserted into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can be measured. A small amount of cerebral spinal fluid (CSF) can be removed and tested for infection or other problems. CSF is the fluid that bathes the brain and spinal cord. 
  • Blood testing. Blood is collected and tested for infection.
  • Computed tomography scan (also called a CT or CAT scan). This procedure uses X-rays and a computer to make images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

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How is meningitis treated?

Treatment may include:

  • Bacterial meningitis. Intravenous (IV) antibiotics are used to treat bacterial meningitis. The earlier the treatment is started, the better the outcome. While steroids have been shown to be helpful in treating bacterial meningitis in infants and children, this treatment is used less often in adults. Dexamethasone, a type of steroid, may be given in certain cases of bacterial meningitis, to decrease the inflammatory response caused by the bacteria.
  • Viral meningitis. Treatment for viral meningitis is usually aimed at relieving symptoms. With the exception of the herpes simplex virus, there are no specific medicines to treat the organisms that cause viral meningitis. Sometimes antiviral medicines are used to treat some other specific types of viruses.

While recovering from meningitis, other therapies may be used to improve healing and relieve symptoms. These may include:

  • Bed rest in a dimly lit room
  • Medicines to reduce fever and headache. Avoid aspirin.

Supplemental oxygen or mechanical ventilation (respirator) may be needed if you become very ill and have trouble breathing.

Can meningitis be prevented?

Several vaccines are available to prevent types of bacterial meningitis. These vaccines are recommended for infants and children. Two doses at ages 11 through 18 are also recommended. 

In certain conditions, your healthcare provider may recommend one of the meningitis vaccines. You may need a meningitis vaccine if you have:

  • Chronic lung conditions, such as emphysema or COPD
  • Heart disease
  • Diabetes
  • Chronic kidney failure
  • Travel to countries where meningitis is prevalent
  • Decreased immunity status
  • Certain blood disorders
  • Damaged or removed spleen

If you have questions about prevention, see your healthcare provider.

Key points about meningitis

  • Meningitis is a disease caused by an inflammation of the meninges, the membranes that surround the brain and spinal cord.
  • It's usually caused by a virus, although it can be caused by bacteria, a fungus, or tuberculosis.
  • Treatment for meningitis depends on the specific cause of the disease.
  • Vaccinations can prevent or minimize the incidence of meningitis.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Dozier, Tennille, RN, BSN, RDMS
Online Medical Reviewer: Shelat, Amit, MD
Date Last Reviewed: 8/1/2016
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