Meningitis

What is meningitis?

Meningitis is an inflammation of the area surrounding your brain and spinal cord (meninges). It’s sometimes called spinal meningitis.

Your meninges protect your brain and spinal cord from injury and provide support and structure. They contain nerves, blood vessels and protective fluid (cerebrospinal fluid).

Infectious diseases, like viruses and bacteria, and non-infectious conditions, like cancer or head injuries, can cause meningitis.

What is spinal meningitis?

Spinal meningitis is another name for meningitis, an inflammation of the meninges surrounding your brain and spinal cord.

What is aseptic meningitis?

Aseptic meningitis is any case of meningitis where the fluid around your brain and spine (CSF) tests negative for bacteria. This means either the bacteria causing meningitis is difficult to grow or that your case of meningitis isn’t caused by bacteria. The most common cause of aseptic meningitis is a viral infection.

What’s the difference between meningitis and encephalitis?

The difference between meningitis and encephalitis is the location of the inflammation. Meningitis is an inflammation of the protective lining of the brain and spinal cord and encephalitis is an inflammation of the brain itself.

What are the types of meningitis?

Types of meningitis are typically named for the cause or for how long you’ve had symptoms. They include:

• Bacterial meningitis.
• Viral meningitis.
• Fungal meningitis.
• Parasitic meningitis. Meningitis caused by certain parasites is called eosinophilic meningitis or eosinophilic meningoencephalitis (EM).
• Primary Amebic Meningitis (PAM). Meningitis can be caused by the ameba Naegleria fowleri.
• Drug-induced aseptic meningitis (DIAM). Rarely, certain medications cause drug-induced aseptic meningitis (DIAM). Non-steroidal anti-inflammatory drugs (NSAIDS) and antibiotics are the most common causes of DIAM.
• Chronic meningitis. When meningitis has lasted a month or more, it’s called chronic meningitis.
• Acute meningitis. Bacterial meningitis is often acute, meaning that symptoms are severe and come on suddenly.

Who is at an increased risk of meningitis?

Your age, where you live or travel and certain health conditions can increase your risk of meningitis.

You’re at higher risk for meningitis if you:

• Are under 5 years old. About 70% of all bacterial meningitis cases affect children under age 5.
• Have a weakened immune system. You might have a weakened immune system if you’re living with HIV or cancer, if you’ve received an organ or bone marrow transplant or if you’re on medications that suppress your immune system.
• Live in a group setting, like in a college dorm.
• Have a CSF leak.
• Don’t have a spleen or have a damaged spleen.
• Live in or travel to places where infectious diseases that cause meningitis are common.
• Have chronic nose and ear infections, pneumococcal pneumonia or a widespread blood infection.
• Have a head injury, traumatic brain injury (TBI) or spinal cord injury.
• Are living with sickle cell disease.
• Are living with alcohol use disorder.

What are the symptoms of meningitis?

Symptoms of meningitis can be different in babies than in children and adults. In bacterial meningitis, fever, headache and neck stiffness can come on suddenly and your condition can worsen rapidly.

Symptoms of meningitis in children and adults

• Neck stiffness.
• Nausea or vomiting.
• Sensitivity to light (photophobia).
• Confusion or altered mental state.
• Lack of energy (lethargy), extreme sleepiness or trouble waking up.
• Lack of appetite.
• Small round spots that look like a rash (petechiae).

Additional symptoms of amebic meningitis

You might experience additional symptoms of amebic meningitis a few days after your initial symptoms:

• Hallucinations.
• Loss of balance.
• Lack of attention or focus.

Meningitis signs and symptoms in babies

Your baby might not experience the same meningitis symptoms as adults (like headache, neck stiffness and nausea) and it can be hard to tell even if they are. Some signs of meningitis you can look for in babies include:

• Bulging “soft spot” (fontanelle) on baby’s head.
• Poor eating.
• Sleepiness or trouble waking up from sleep.
• Low energy or slower responses (lethargy).

How do I know if I've got meningitis?

Only your healthcare provider can diagnose meningitis. If you think you have meningitis, talk to your provider or go to the nearest ER.

How painful is meningitis?

Meningitis can cause severe headaches that can be quite painful. The pain might radiate down your back or to other parts of your body. It also may be almost impossible to move your neck certain ways. Some people have less noticeable symptoms, so don’t wait for severe pain to see your healthcare provider if you have symptoms of meningitis.

What causes meningitis?

Infectious diseases (caused by something harmful from outside of your body) and non-infectious conditions cause meningitis.

Infectious causes are bacteria, viruses, fungi, parasites and the ameba Naegleria fowleri. Non-infectious causes include diseases, certain medications and other conditions.

Causes of bacterial meningitis

• Streptococcus pneumonia.
• Group B Streptococcus.
• Neisseria meningitides.
• Haemophilus influenza.
• Listeria monocytogenes.
• E. coli.
• Mycobacterium tuberculosis.

Causes of viral meningitis

• Non-polio enteroviruses.
• Mumps.
• Herpesviruses (including those that cause mononucleosis, chickenpox and shingles).
• Measles.
• Influenza.
• Arboviruses, such as West Nile virus.
• Lymphocytic choriomeningitis virus.

Causes of fungal meningitis

• Coccidioides.

Causes of parasitic meningitis (eosinophilic meningitis)

• Angiostrongylus cantonensis.
• Baylisascaris procyonis.
• Gnathostoma spinigerum.

Causes of amebic meningitis (PAM)

Naegleria fowleri causes amebic meningitis.

Causes of non-infectious meningitis

• Systemic lupus erythematosus (lupus).
• Certain medications, like NSAIDs and antibiotics.
• Head injuries.
• Brain surgery.

How do you get meningitis?

There are many ways you can get meningitis, depending on whether the cause is infectious or not:

• From a contagious illness passed person-to-person, like a virus or bacteria.
• From food contaminated with something infectious.
• From swimming in or drinking water contaminated with something infectious.
• From fungi in the environment that you breathe in.
• As a complication of non-infectious illnesses, like cancer or lupus.
• As the result of a head injury or brain surgery.
• As a side effect of a medication.

Is meningitis contagious?

Meningitis itself — swelling of the meninges — isn’t contagious, but some of the causes of it are. Most bacterial and viral causes of meningitis can be spread from person to person. You can’t catch other causes of meningitis from another person.

How is meningitis diagnosed?

Your healthcare provider will diagnose meningitis by doing a physical exam, asking you about your symptoms and testing your cerebrospinal fluid (CSF). They may also ask you if you’ve been around anyone with certain illnesses or traveled recently, get a blood or poop (stool) sample, swab your nose or throat or get imaging of your brain.

What tests will be done to diagnose meningitis?

Some tests your healthcare provider may use to diagnose meningitis include:

• Nasal or throat swab. Your provider uses a soft-tipped stick (swab) to take a sample from your nose or throat. A lab will test your sample for signs of infection.
• Lumbar puncture/spinal tap. Your healthcare provider inserts a needle into your lower back to collect a sample of your cerebrospinal fluid (CSF). A lab tests your CSF sample for signs of infection.
• Blood tests. Your provider takes a sample of blood from your arm with a needle. A lab tests your blood for signs of infection.
• Your healthcare provider can use a CT scan or MRI to take pictures of your brain and look for inflammation. This is sometimes called a brain scan.
• Stool sample. You give a sample of your poop (stool) to your provider. A lab will test your stool sample for signs of infection.

How is meningitis treated?

Meningitis treatment depends on the cause. Antibiotics are used to treat bacterial meningitis and antifungals are used to treat fungal meningitis. Antivirals can be used to treat some viral causes of meningitis. Non-infectious causes of meningitis are treated by addressing the underlying illness or injury.

There are no specific treatments for other infectious causes of meningitis. Medications might be used to reduce inflammation or relieve your symptoms.

What medications are used to treat meningitis?

Medications and other therapies that might be used to treat meningitis include:

• Antibiotics for bacterial meningitis.
• Antifungals for fungal meningitis.
• Antivirals for certain cases of viral meningitis, like herpesvirus and influenza.
• Corticosteroids, like dexamethasone or prednisone, to reduce inflammation.
• Pain relievers.
• IV fluids to keep you hydrated.

How soon after treatment for meningitis will I feel better?

You may start to feel better within a few days to a week after starting treatment for meningitis. Full recovery can take weeks to months.

How can I reduce my risk of meningitis?

The best way to reduce your risk of meningitis is to take simple precautions to protect yourself from the infectious diseases that most often cause it.

• Get vaccinated against the bacterial and viral infections that can cause meningitis. Ask your providers which ones might be recommended for you or your child. Take care to avoid fungal infections.
• Wash your hands frequently with soap and water.
• Avoid contact with others when sick with a contagious illness. Cover your mouth and nose when you cough or sneeze, and disinfect frequently touched surfaces.
• Don’t swim in or drink water that could be contaminated. Use distilled or treated water for nasal irrigation.
• Practice safe food prep. Don’t drink unpasteurized milk or eat food made from unpasteurized milk.
• Take precautions to avoid mosquito and tick bites.

Your healthcare provider might also prescribe prophylactic (“pro-fa-LAK-tik”) antibiotics to help prevent a bacterial infection if you’re at high risk. Talk to your provider about prophylactic antibiotics if someone close to you (like someone you live with or are around a lot) has:

• Meningitis caused by N. meningitides
• A serious Hib infection

What can I expect if I have meningitis?

The outlook for meningitis depends on what’s causing it, how severe it is and how soon you’re treated. If you’re treated quickly, you can usually make a full recovery, though it can take a long time to feel completely well again.

You might have to stay in the hospital for a few days and treatment may continue even after going home. Your healthcare provider will follow-up with you to check for lasting health concerns.

How long does meningitis last?

Viral meningitis can go away on its own within about a week. Symptoms of bacterial or fungal meningitis may last a few days to a week or more after treatment. It can take weeks to months to feel completely recovered, and some people have long-lasting or permanent health issues.

Long-term effects of meningitis

Research suggests that 10% to 20% of people who‘ve had meningitis will have long-term health issues. Bacterial meningitis is more likely to cause lasting health effects than other types of meningitis.

Long-term effects include:

• Vision or hearing loss.
• Trouble with memory and concentration.
• Epilepsy.
• Movement and balance issues.
• Behavioral issues or learning difficulties in kids.
• Arthritis.
• Organ damage.
• Loss of fingers, toes or limbs due to sepsis.

Complications of meningitis

Bacterial meningitis sometimes leads to sepsis, a condition where your body has a life-threatening response to an infection. Sepsis can cause tissue, blood vessel and organ damage. In extreme cases of sepsis, your organs might fail or you might have to have fingers, toes or limbs removed.

Flat red marks on your skin that look like a rash (petechiae) can be a sign of sepsis caused by bacterial meningitis.

Can you survive meningitis?

Yes, you can survive most forms of meningitis, though it is a very serious illness and requires immediate treatment. The survival rate for bacterial meningitis, the most deadly of the common forms of meningitis, is about 90%.

While Naegleria fowleri infections are extremely rare, few people survive amebic meningitis.

When should I see my healthcare provider?

You should see your healthcare provider right away if you:

• Think you have meningitis.
• Have had close contact with someone who has an meningitids or Hib infection.

When should I go to ER?

Bacterial meningitis is a medical emergency that can worsen quickly. Go to the nearest ER if you have symptoms of meningitis.

What questions should I ask my doctor?

• What type of meningitis do I have?
• What treatment will I need?
• How can I manage my symptoms?
• When should I follow-up?
• What signs and symptoms should prompt me to go to the ER?
• How can I avoid getting meningitis again?
• Will I have any long-term issues from meningitis?
• Am I contagious to others?

How can you test for meningitis at home?

There’s no way to test for meningitis at home. Only an exam and tests done by a healthcare provider can diagnose meningitis.

A note from Cleveland Clinic

Meningitis is an uncommon condition that can quickly become life-threatening. If you’re treated right away, you have a great chance of a full recovery. If you have symptoms of meningitis, it’s important to seek medical attention immediately.