Meningitis

Overview

What is meningitis?

Meningitis is an infection of the meninges. The meninges are a protective lining around your brain and spinal cord. There are three main types of meningitis. All types can cause fever, a headache and a stiff neck. Meningitis can be very serious or even fatal. See your healthcare provider immediately if you develop signs of meningitis.

What are the different types of meningitis?

The different types of meningitis include:

  • Bacterial meningitis, caused by bacteria.
  • Fungal meningitis, caused by fungus.
  • Viral (or aseptic) meningitis, caused by a virus.
  • Parasitic meningitis, caused by a parasite (an organism that attaches to you and causes harm).
  • Amebic meningitis, a rare but severe brain infection caused by a tiny organism called an ameba.
  • Noninfectious meningitis, which can be caused by cancers, lupus, certain medications, brain surgery or a head injury.

Healthcare providers also categorize meningitis by how quickly the symptoms develop:

  • Acute meningitis: Symptoms develop quickly.
  • Chronic meningitis: Symptoms develop over a few weeks or months.

What is bacterial meningitis?

Acute bacterial meningitis can be life-threatening. Approximately 80% of all meningitis cases are bacterial, making it the most common type. With bacterial meningitis, tissues swell around the brain. The swelling can reduce blood flow to the brain, resulting in paralysis or stroke.

Is bacterial meningitis contagious?

Most people don’t catch meningitis from casual contact. But if you have meningitis, let close friends and family members know. Anyone you’ve had close contact with should seek preventive treatment.

Who is at risk for developing bacterial meningitis?

Children younger than 2 months old have the highest incidence of bacterial meningitis. About 70% of all bacterial meningitis cases occur in children under age 5.

Adults may develop this condition, too, especially if they have risk factors, such as certain illnesses, injuries and surgeries:

Other risk factors include:

  • Alcohol use disorder.
  • Group living, such as in a dorm.
  • Travel to certain parts of the world.
  • Work with meningitis-causing bacteria.

What is viral meningitis?

Viral, or aseptic, meningitis results when a virus causes a meningitis infection. People of all ages can get viral meningitis. The risk increases for those who:

What is chronic meningitis?

Chronic meningitis develops over weeks or months. Chronic meningitis typically affects people with weakened immune systems, such as those who have:

  • AIDS.
  • Cancer.
  • Had cancer treatment using medication, such as chemotherapy.
  • Used prednisone (a steroid) long term.

Is meningitis the same as encephalitis?

The two diseases aren’t the same, but they have similar causes. When an infection affects the membranes around the brain, it’s meningitis. When it affects the brain itself, it’s encephalitis.

How common is meningitis?

Approximately 600 to 1,000 people develop meningitis in the United States every year. The number of cases is decreasing, likely due to more people getting the meningitis vaccine.

Symptoms and Causes

What causes bacterial meningitis?

Bacteria enter your bloodstream and travel to the meninges, causing an infection. Meningitis can also happen after a head injury or an infection that weakened your immune system. Often, healthcare providers can’t identify the cause of bacterial meningitis.

What are bacterial meningitis symptoms?

Signs of bacterial meningitis include:

  • Fever.
  • Headaches.
  • Inability to lower chin to chest because of neck stiffness.

Symptoms in young children:

  • Vomiting.
  • Refusal to eat.
  • Irritability and crying.
  • Seizures.
  • Swelling in the head due to fluid buildup around the brain.

Older children and adults may also experience:

  • Confusion.
  • Irritability.
  • Drowsiness.
  • Seizures and stroke.

What causes viral meningitis?

A certain group of viruses called the non-polio enteroviruses are the most common cause of viral meningitis in the U.S. Other viruses that can cause meningitis include:

What are symptoms of viral meningitis?

Symptoms of viral meningitis are similar to symptoms of bacterial meningitis:

  • Fever.
  • Headache.
  • Irritability.
  • Lack of appetite.
  • Sensitivity to light.
  • Sleepiness or a hard time waking up.
  • Stiff neck.
  • Vomiting and nausea.
  • Weakness.

What causes chronic meningitis?

Chronic meningitis typically affects people with weakened immune systems, such as those who have:

  • AIDS.
  • Cancer.
  • Had cancer treatment using medication, such as chemotherapy.
  • Used prednisone (a steroid) long term.

What are symptoms of chronic meningitis?

Symptoms of chronic meningitis are similar to symptoms of bacterial meningitis. The difference is that signs develop slowly, over weeks or months, and are less severe. Symptoms include:

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

Diagnosis and Tests

What tests might I have to diagnose meningitis?

Your healthcare provider will decide if the cause of meningitis is bacterial, viral or fungal. The right treatment depends on identifying what type of meningitis it is.

You may need a spinal tap to analyze your spinal fluid. You may also need tests to analyze your:

  • Blood.
  • Urine.
  • Mucus from nose and throat.

How is bacterial meningitis diagnosed?

If you or a loved one has signs of bacterial meningitis, get medical help as soon as possible. The healthcare provider will perform a physical exam, looking for:

  • Purple or red skin rash.
  • Neck stiffness.
  • Hip and knee flexion (bending ability). The hip and knee may automatically flex when the provider flexes the neck.

How is viral meningitis diagnosed?

Your healthcare provider will want to rule out other causes of your symptoms. You may need a:

  • Nose and throat swab.
  • Spinal tap to look for an increase in white blood cells and any bacteria.
  • MRI scan.
  • CT scan.
  • Blood test.
  • Stool sample.

How is chronic meningitis diagnosed?

Often, your healthcare provider needs to rule out other illnesses to confirm a diagnosis of chronic meningitis. You will likely need a:

  • Spinal tap.
  • MRI scan.
  • CT scan.

Management and Treatment

How is bacterial meningitis treated?

You'll need antibiotics to treat bacterial meningitis. Your healthcare provider may start treatment even before all the test results are in. The provider may prescribe an intravenous antibiotic (delivered through an IV needle) with a corticosteroid to reduce inflammation.

Once the results come in, identifying the specific bacteria, your provider may change antibiotics to most effectively target the disease. You’ll also need to replenish fluids you may have lost from sweating, vomiting, diarrhea and loss of appetite. You may have IV fluids to help.

How is viral meningitis treated?

If you have severe symptoms, your provider may prescribe antiviral medications. If symptoms are not severe, your provider may choose not to treat the disease and let it run its course. Most people who have a mild illness get better within a week to 10 days.

How is chronic meningitis treated?

Chronic meningitis treatment depends on whether you have an infectious type or a noninfectious type.

  • Noninfectious meningitis: Your provider may prescribe prednisone.
  • Fungal meningitis: You may need antifungal medications.
  • Viral meningitis: Symptoms often clear up without treatment.

Prevention

Is there a bacterial meningitis vaccine?

Yes, a vaccine is available for bacterial meningitis. The Centers for Disease Control and Prevention (CDC) has guidelines regarding who should get the vaccine:

  • All preteens at 11-12 years old.
  • All teenagers at 16 years of age.

Additionally, an extra meningitis vaccine is recommended for:

  • First-year college students living in dorms.
  • Military recruits.
  • Scientists working with the meningococcal bacteria.
  • People traveling to or living in areas where the disease is common, such as Africa.
  • Those with a damaged spleen or who have had their spleen removed.
  • People with terminal complement component deficiency (an immune system disorder).

Who shouldn't get the bacterial meningitis vaccine?

The CDC doesn't recommend the vaccine for people who had:

  • Severe, life-threatening allergic reaction to a previous dose of the meningococcal vaccine.
  • Severe reaction to any part of the vaccine.

Wait before receiving the vaccine or talk further with your provider if you:

  • Are moderately or severely ill at the time of your scheduled vaccination appointment. Wait until you recover to receive the vaccine.
  • Had Guillain-Barré syndrome.
  • Are pregnant. Typically, pregnant people should only get the vaccine if there is a clear need.
  • Have any severe allergies.

Is there a viral meningitis vaccine?

There is no vaccine for viral meningitis. The best way to stay healthy is:

  • Wash hands often.
  • Avoid close contact with people who are sick.
  • Stay home if you’re sick, and keep children who are sick out of school.
  • Get vaccinated on schedule to protect against diseases that can lead to viral meningitis.

Outlook / Prognosis

What is the outlook for people with bacterial meningitis?

Bacterial meningitis requires prompt treatment. People who receive treatment quickly can make a full recovery. Your healthcare provider will monitor you to help manage any long-term health issues, including problems with:

In rare cases, meningitis leads to a blood infection. Because of the infection, the body reduces blood supply to the extremities — fingers, toes, hands and feet — causing those body parts to die. Providers may need to amputate the damaged extremities.

Can bacterial meningitis be cured?

Most people recover fully from bacterial meningitis if they get prompt diagnosis and treatment. The disease has a high death rate (10%) if untreated.

Is bacterial meningitis fatal?

Typically, symptoms develop quickly, over 24 hours. If the symptoms continue without treatment, bacterial meningitis may be fatal.

Are there complications of bacterial meningitis?

Bacterial meningitis requires prompt medical care. Without it, there’s a risk of permanent damage. It can cause life-threatening blood poisoning called septicemia. Lifelong complications from untreated meningitis include:

  • Seizures.
  • Mental impairment.
  • Paralysis.

What is the outlook for people with viral meningitis?

People with viral meningitis typically recover without any treatment. And viral meningitis usually does not cause long-term complications.

Living With

What should I ask my healthcare provider?

Ask your healthcare provider:

  • What type of meningitis do I have?
  • What treatment will I need?
  • How can I avoid getting meningitis again?
  • Will I have any long-term problems from meningitis?
  • How can I avoid spreading it to my friends and family?

A note from Cleveland Clinic

If you or a loved one has meningitis symptoms, such as fever and neck stiffness, seek immediate medical care. People who get quick treatment can make a full recovery from meningitis. It’s important to stick to the vaccine schedule for you and your children. The meningitis vaccine (along with other vaccines) reduces your risk of developing this disease. Talk to your healthcare provider about signs of meningitis and how to stay safe.

Last reviewed by a Cleveland Clinic medical professional on 02/23/2021.

References

  • Centers for Disease Control and Prevention (CDC). Meningitis. (https://www.cdc.gov/meningitis/index.html) Accessed 2/23/2021.
  • Health Direct. Meningitis. (https://www.healthdirect.gov.au/meningitis) Accessed 2/23/2021.
  • Meningitis Research Foundation. What Are Meningitis and Septicemia? (https://www.meningitis.org/meningitis/what-is-meningitis) Accessed 2/23/2021.
  • National Meningitis Association. Statistics and Disease Facts. (https://www.nmaus.org/nma-disease-prevention-information/statistics-and-disease-facts/) Accessed 2/23/2021.
  • National Organization for Rare Disorders. Meningitis, Bacterial. (https://rarediseases.org/rare-diseases/meningitis-bacterial/) Accessed 2/23/2021.

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