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Diseases & Conditions

Meningitis

What is meningitis?

Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. Meningitis can be caused by a bacterial, fungal, or viral infection. Meningitis can be acute, with a quick onset of symptoms; it can be chronic--lasting a month or more; or it can be mild or aseptic. Anyone experiencing symptoms of meningitis should see a doctor immediately.

Bacterial meningitis

Acute bacterial meningitis is the most common form of meningitis. Approximately 80 percent of all cases are acute bacterial meningitis. Bacterial meningitis can be life-threatening. The infection can cause tissues around the brain to swell. In turn, the swelling interferes with blood flow and can result in paralysis or even stroke.

What causes bacterial meningitis?

The bacteria most often responsible for bacterial meningitis can be found in the environment. In addition, they can be found in your nose and respiratory system without causing harm.

Meningitis can occur for no known reason. At other times, it appears after a head injury or following an infection when your immune system is weakened.

Who gets bacterial meningitis?

Children between the ages of one month and to years are the most susceptible to bacterial meningitis.

Adults with certain risk factors are also susceptible. You are at higher risk if you:

  • Abuse alcohol
  • Have chronic nose and ear infections
  • Have pneumococcal pneumonia
  • Have a weakened immune system
  • Have had your spleen removed
  • Have a sickle cell disease
  • Have had a head injury or brain or spinal injury
  • Have had a widespread blood infection

What are the symptoms of bacterial meningitis?

You want to watch for high fever, headaches, and an inability to lower your chin to your chest due to stiffness in the neck.

In older children and adults, you may see confusion, irritability, and increasing drowsiness. Seizures and stroke may occur.

In young children, the fever may cause vomiting. Young children may refuse to eat, become irritable and cry, and may have seizures. Because the fluid around the head may become blocked, the heads of young children may swell.

The onset of symptoms is fast within 24 hours. If allowed to progress, bacterial meningitis may be fatal.

How is bacterial meningitis diagnosed?

It is important that you seek immediate medical assistance if you suspect meningitis.

Your doctor will conduct a physical examination. He or she will look for a purple or red rash on the skin. He or she will also check your neck for stiffness and will examine hip and knee flexion.

Your doctor will have to decide if the cause is bacterial, viral, or fungal and will have to analyze your spinal fluid. For this, a spinal tap procedure is needed. Your doctor may also order tests to analyze your blood, urine, and the mucus from your nose and throat.

How is bacterial meningitis treated?

Bacterial meningitis is treated with antibiotics. Your doctor may prescribe a general intravenous antibiotic with a corticosteroid to reduce inflammation even before all the test results are in. When the specific bacteria are identified, your doctor may decide to change antibiotics. It will also be important to replenish fluids lost from sweating, vomiting, diarrhea, and loss of appetite.

Can bacterial meningitis be cured?

Despite a 10% death rate from bacterial meningitis, most people recover if the disease is diagnosed correctly and treated early enough.

Are there complications?

Unfortunately, if treatment is not undertaken immediately, there may be permanent damage. Seizures, mental impairment, and paralysis may be life-long.

Is bacterial meningitis contagious?

You should encourage anyone with whom you have come into close contact to seek preventive treatment. Casual contact should not result in passing on the disease.

Is there a vaccine to protect against bacterial meningitis?

Yes, a vaccine is available. The Centers for Disease Control and Prevention (CDC) has specific guidelines regarding who should receive the vaccine. The CDC recommends the meningococcal vaccine for:

  • All children and adolescents aged 11 through years
  • College freshmen living in dormitories
  • Military recruits
  • Scientists routine exposed to meningococcal bacteria
  • Anyone traveling to or living in a part of the world where the disease is common, such as Africa
  • Anyone with a damaged spleen or who has had his or her spleen removed
  • Anyone who has terminal complement component deficiency (an immune system disorder)

The CDC does not recommend the vaccine for anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of meningococcal vaccine or who has had a severe reaction to any component of the vaccine. You should tell your doctor if you have any severe allergies.

The CDC recommends that the following individuals wait before receiving the vaccine or talk further with their doctor about the need for the vaccine:

  • Anyone who is moderately or severely ill at the time of their scheduled appointment to receive the vaccine should wait until they recover.
  • Anyone who has ever had Guillain-Barre syndrome should discuss getting the vaccine with his or her doctor.
  • Pregnant women should only get the vaccine if it is clearly needed. Discuss the need with your doctor.

Chronic meningitis

Chronic meningitis, unlike acute bacterial meningitis, develops over weeks and months. It affects people with immune systems that have been weakened by AIDS, cancer, drugs used in the treatment of cancer, or long-term use of drugs like prednisone.

What are the symptoms of chronic meningitis?

The symptoms of chronic meningitis are similar to those of acute bacterial meningitis except that the onset is not as fast, and the symptoms are not as severe. Symptoms may include:

  • Fever
  • Headache
  • Confusion
  • Facial numbness
  • Some paralysis

How is chronic meningitis diagnosed?

Your doctor will want to eliminate the possibilities of other illness and will probably order a spinal tap, a magnetic resonance imaging (MRI) scan, or computed tomography (CT) scan.

How is chronic meningitis treated?

Treatment will depend on whether you have an infectious type of chronic meningitis or a non-infectious type. Prednisone is often prescribed when the cause of the chronic meningitis is non-infectious. Anti-fungal drugs will be prescribed if the cause is fungal. If the cause is viral, symptoms may clear up without treatment.

Viral meningitis

Viral, or aseptic, meningitis is an infection of the membranes of the brain and spinal cord caused by a virus.

What are the symptoms of viral meningitis?

The symptoms of viral meningitis are similar to bacterial and fungal meningitis: headache, fever, vomiting, weakness, and stiff neck.

How is viral meningitis diagnosed?

Your doctor will want to eliminate the possibilities of other illness and will probably order a spinal tap, a magnetic resonance imaging (MRI) scan, or computed tomography (CT) scan. The spinal tap will analyze the spinal fluid for an increase in white blood cells and the presence of any bacteria.

How is viral meningitis treated?

If your symptoms are severe, your doctor may prescribe antiviral medications. If your symptoms are not severe, your doctor may decide not to treat the disease and to let it run its course without treatment.

Where can I learn more about meningitis?

CDC Hotline: 1.800.232.4636.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 05/04/2010…#14600