Meningitis

Meningitis is inflammation of the three tissues that surround your brain and spinal cord, the meninges. Another name for it is spinal meningitis. This condition can be life-threatening.

Your meninges normally protect your brain and spinal cord from injury. They contain nerves, blood vessels and cerebrospinal fluid (CSF). When your meninges become inflamed, they swell too much and put pressure on your brain and/or spinal cord.

Infectious diseases, like viruses and bacteria, can cause meningitis. Noninfectious conditions, like cancer and head injuries, can cause it, too.

Meningitis needs medical treatment right away.

Types of meningitis

Infectious types include:

• Bacterial meningitis (most common)
• Viral meningitis
• Fungal meningitis
• Parasitic meningitis (eosinophilic meningitis)

Noninfectious types include:

• Autoimmune meningitis
• Carcinomatous (cancer) meningitis
• Drug-induced aseptic meningitis (DIAM)
• Post-traumatic meningitis

Your healthcare provider may also describe meningitis as:

• Acute: The symptoms come on suddenly. Bacterial meningitis is often acute.
• Chronic: The symptoms develop slowly and last a month or more.
• Aseptic: If your CSF tests negative for bacteria, providers call it aseptic meningitis. This means either the bacterium causing it is difficult to grow or your case isn’t caused by bacteria. The most common cause of aseptic meningitis is a viral infection.

Symptoms of meningitis

Symptoms of meningitis can vary depending on age.

Symptoms of meningitis in children and adults can include:

• Fever
• Stiff neck
• Sensitivity to light (photophobia)
• Headache
• Nausea or vomiting
• Confusion or altered mental status
• Lack of energy, extreme sleepiness or trouble waking up
• Lack of appetite

Signs of meningitis in babies can include:

• Bulging soft spot (fontanelle) on your baby’s head
• Poor feeding
• Irritability
• Sleepiness or trouble waking up from sleep
• Low energy or slower responses (lethargy)

If you have symptoms of meningitis, see a healthcare provider right away. A provider can diagnose it, find the cause and offer the best treatment.

What does a meningitis headache feel like?

Meningitis can cause severe headaches that can be quite painful. The pain may spread down your back or to other parts of your body. It may be almost impossible to move your neck in certain ways.

Some people have mild pain. Don’t wait for severe pain to see your healthcare provider if you have other symptoms of meningitis.

Meningitis causes

Infectious diseases (caused by something harmful from outside your body) and noninfectious conditions cause meningitis. Specific causes of each type include:

• Bacterial meningitis: Common bacteria include Streptococcus pneumoniae, group B Streptococcus and Neisseria meningitidis.
• Viral meningitis: Viruses include non-polio enteroviruses, like group B coxsackievirus and echovirus.
• Fungal meningitis: Some fungi that can cause meningitis include Cryptococcus neoformans, Coccidioides immitis and Candida.
• Parasitic meningitis (also called eosinophilic meningitis): Parasites that can cause this include rat lungworm and Baylisascaris procyonis (a roundworm).
• Drug-induced aseptic meningitis (DIAM): NSAIDs and antibiotics are the most common causes of DIAM. But overall, it’s rare.
• Carcinomatous meningitis: Cancer cells get into your meninges and cause inflammation. It can occur in the advanced stage of any cancer.
• Post-traumatic meningitis: This can result from brain or head injury.
• Autoimmune meningitis: Autoimmune conditions like lupus and rheumatoid arthritis are causes.

How does someone get it?

You can get meningitis in many ways, depending on whether the cause is infectious. You could get it:

• From a contagious bacterial or viral illness passed person-to-person
• From food contaminated with something infectious
• From fungi in the environment that you breathe in
• As a complication of noninfectious conditions, like cancer or lupus
• From a head injury or as a complication of brain surgery
• As a side effect of a medication

Meningitis itself — swelling of the meninges — isn’t contagious. But some of its causes are. Most bacterial and viral causes of meningitis can spread from person to person.

Risk factors

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

You’re at a higher risk for it if you:

• Are under 5 years old or over 65 years old
• Have a weakened immune system
• Have a CSF leak
• Don’t have a spleen
• Have chronic nose and ear infections
• Have pneumococcal pneumonia
• Have alcohol use disorder
• Have a brain or spinal cord injury or surgery
• Have sickle cell disease
• Live in or travel to places where infectious diseases that cause meningitis are common
• Live in a group setting, like in a college dorm

Complications of this condition

Complications of meningitis can include:

• Hearing or vision loss
• Behavioral and thinking issues
• Movement issues
• Seizures
• Increased intracranial pressure
• Buildup of fluid in your brain
• Damage to the blood vessels in your brain
• Sepsis

How doctors diagnose this condition

Your healthcare provider will do a physical exam and ask about your symptoms. They’ll ask several questions about your medical history and recent activities, like whether you’ve traveled. This can help narrow down the cause of meningitis.

You’ll need tests to confirm the diagnosis and find the cause.

Tests that are used

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 tests your sample for signs of infection.
• Brain CT scan or MRI: These imaging tests look for inflammation around your brain.
• Blood tests: These can also look for signs of infection.
• Lumbar puncture/spinal tap: Your 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.

How is it treated?

Meningitis treatment depends on the cause. Medications treat most infectious cases. Treatment for noninfectious cases involves addressing the underlying condition or injury.

Medications and other therapies that may be a part of your treatment plan include:

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

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. Chronic meningitis may last for months to years.

Some people have long-lasting or permanent health issues from meningitis.

When should I see my healthcare provider?

You’ll need follow-up appointments with your healthcare provider to make sure your treatment is working. It may be helpful to ask your provider these questions:

• 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?

What can I expect if I have meningitis?

The outlook for meningitis depends on the cause, how severe it is and how soon you get treatment. With quick treatment, you can usually make a full recovery. But it can take a long time to feel completely well again.

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

Can you recover from meningitis?

Yes, you can recover from most forms of meningitis. But it’s a very serious illness and requires immediate treatment.

Bacterial meningitis is the deadliest of the common forms of meningitis. According to the World Health Organization, about 1 in 6 people who get this type die. Around 1 in 5 has severe complications.

Can I prevent meningitis?

Meningitis isn’t always preventable. But there are steps you can take to reduce your risk of getting the infectious diseases that typically cause it. They include:

• Get vaccinated against the bacterial and viral infections that can cause meningitis. Ask your providers which ones they recommend for you or your child.
• 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. Disinfect frequently touched surfaces.
• Avoid swimming in or drinking 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 antibiotics to help prevent a bacterial infection if you’re at high risk. Talk to your provider about prophylactic antibiotics if someone you live with or are around a lot has:

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