Bacterial Meningitis

Overview

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.

What is 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 the tissues around the brain to swell. This in turn interferes with blood flow and can result in paralysis or even stroke.

Who gets bacterial meningitis?

Children between the ages of 1 month and 2 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, sustain a head injury or get pneumococcal pneumonia.

You are also at higher risk if you have a weakened immune system, have had your spleen removed, are on corticosteroids because of kidney failure or have a sickle cell disease.

Additionally, if you have had brain or spinal surgery or have had a widespread blood infection you are also a higher risk for bacterial meningitis.

Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks.

Symptoms and Causes

What causes bacterial meningitis?

The bacteria most often responsible for bacterial meningitis are common in the environment and can also be found in your nose and respiratory system without causing any harm.

Sometimes meningitis occurs for no known reason. Other times it occurs after a head injury or after you have had an infection and your immune system is weakened.

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, increasing drowsiness. Seizures and stroke may occur.

In young children, the fever may cause vomiting and they may refuse to eat. Young children may become very irritable and cry. There may be seizures. Also, because the fluid around the skull may become blocked their heads may swell.

The onset of symptoms is fast, within 24 hours. If allowed to progress, you can die from bacterial meningitis.

Diagnosis and Tests

How is bacterial meningitis diagnosed?

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

Your doctor will conduct a physical exam. Your doctor will look for a purple or red rash on the skin. Your doctor will check your neck for stiffness and will exam 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 so a spinal tap will be ordered.

Your blood and urine may also be analyzed as well as the mucous from your nose and throat.

Management and Treatment

How is bacterial meningitis treated?

Bacterial meningitis is treated with antibiotics. A general intravenous antibiotic with a corticosteroid to bring down the inflammation may be prescribed even before all the test results are in. When the specific bacteria are identified, your doctor may decide to change antibiotics. In addition to antibiotics, it will be important to replenish fluids lost from loss of appetite, sweating, vomiting and diarrhea.

Prevention

Is bacterial meningitis contagious?

You should encourage anyone who you have come into close contact with to seek preventative treatment. Anyone who you have had casual contact with should not be affected.

Is there a vaccine for bacterial meningitis?

Yes, there are two kind of vaccines available for meningitis in the United States. One type is called a meningococcal conjugate (MenACWY); brand names are Mentactra® and Menveo®. The other type is a Serogroup B meningococcal (MenB) vaccine; brand names are Bexsero® and Trumenba®. The Centers for Disease Control and Prevention (CDC) agency has specific guidelines regarding who should receive the vaccine.

The CDC recommends MenACWY vaccine for:

  • All children aged 11-12 years old, with a booster dose at 16 years old.
  • Children and adults who are at higher risk of disease due to:
    • Complement component deficiency
    • Compromised spleen function
    • HIV

The CDC recommends the MenB vaccine be given to people who are 10 years old or older who have risk factors for meningococcal disease.

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.
  • Anyone who has a severe (life threatening) allergy to any vaccine component. 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 their shot 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.

Outlook / Prognosis

Can bacterial meningitis be cured?

There is a 10 percent death rate from bacterial meningitis, but if diagnosed and treated early enough, most people recover.

Are there ever complications from meningitis?

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

Resources

Where can I learn more about meningitis?

CDC Hotline: 800.232.4636

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy