Meningitis is inflammation of the membranes surrounding the brain and spinal cord, called the meninges. This inflammation is typically caused by infection of the fluid that surrounds the brain and spinal cord. Meningitis symptoms vary depending on the cause, but often include headache, fever and a stiff neck.

Viral meningitis is the most common cause of this inflammation, but it can also be caused by bacterial and fungal infections. Rare, non-infectious meningitis may also develop in people with certain injuries, cancers or autoimmune diseases. While the viruses causing viral meningitis are contagious through close contact, only a small number of people infected with those viruses will develop meningitis.

Bacterial meningitis is very contagious through close, personal contact and can be spread through coughing, sneezing, kissing and sharing glasses or utensils. It is the most dangerous type and without treatment it can quickly lead to death or brain damage.

Baptist Health is known for advanced, superior care in diagnosing and treating meningitis. Our 24/7 inpatient neurology neurosurgery and infectious disease specialty services, as well as our outpatient and Home Health physical, occupational, cognitive and speech therapy services are available to help treat people with meningitis. In addition, we have the region’s only advanced 3Tesla, MRI, MRI spectroscopy and functional MRI technology to accurately diagnose neurologic diseases including meningitis.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

 Symptoms of meningitis may initially mimic the flu and may develop quickly or over a few days. They can include:

• Confusion or difficulty concentrating
• Fatigue or difficulty waking
• Headache, often severe and/or accompanied by nausea or vomiting
• High fever, often sudden
• Lack of appetite or thirst
• Seizures
• Sensitivity to light
• Skin rash
• Stiff neck

If an infant develops meningitis, his or her symptoms may include:

• A bulge in the soft spot of his/her head
• Constant crying
• Excessive sleepiness or irritability
• High fever
• Inactivity
• Poor feeding
• Skin rash
• Stiffness in his/her body or neck

Diagnosis

To determine if someone has meningitis, we use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Blood cultures: Blood samples drawn from a patient’s arm are tested for microorganisms like bacteria or fungi. The sample may be placed on a slide, stained and studied under a microscope or placed in a special dish and monitored for bacterial or fungal growth.

Imaging: Computerized tomography (CT) or magnetic resonance (MR) scans of the head may be used to identify swelling or inflammation, and X-rays or CT scans of the chest or sinuses may also show the infection in other areas.

Spinal tap: Also known as a lumbar puncture, this test is performed by inserting a needle between two vertebrae in the lower back to remove a sample of cerebrospinal fluid (CSF). In meningitis, CSF often shows increased protein and white blood cells and a decreased glucose (sugar) level. A physician can also use special tests to check for bacteria, fungi or viral antibodies in the fluid.

Causes

Meningitis is nearly always caused by infection and not influenced by lifestyle factors or specific behaviors.

• Viral meningitis is more common than the bacterial form and typically less serious. It can be triggered by several different viruses, including some that can lead to diarrhea.
• Bacterial meningitis is a very serious illness that can be caused by several types of bacteria that enter the bloodstream from other areas of the body. The most common bacteria causing infection in the United States are meningococcus and pneumococcus.
• Fungal meningitis, and other forms of the illness, are very rare and generally occur in people with severely weakened immune systems.

Risk Factors

Risk factors that may contribute to meningitis include:

Age: Some age groups have a higher risk of developing meningitis than others. Viral meningitis is most common in children under the age of 5. Bacterial meningitis affects teenagers and young adults, ages 16 to 25, more often than other age groups. People over the age of 55 are at an increased risk of both types, as the immune system weakens with age.

Compromised immune system: People with HIV or AIDS, those undergoing chemotherapy or being treated with immunosuppressing drugs, or those with other conditions that affect the immune system – like diabetes – are more at risk for developing meningitis.

Living in a community setting: Bacterial meningitis is more common in dormitories, boarding schools, military bases and other areas in which people are living in close quarters.

Pregnancy: Infection with the listeria bacteria during pregnancy may cause meningitis in the mother and increases her risk of miscarriage, stillbirth and premature delivery.

Skipping vaccinations: Four vaccinations are available in the United States to prevent bacterial meningitis. These are often given during adolescence and/or early adulthood. The Haemophilus influenza type B (Hib) vaccine is given to infants to prevent a type of infection that used to cause meningitis in children. Pneumococcal vaccines are given to children under age 2 and recommended for adults over age 65. Meningococcus vaccine is given to adolescents ages 12 to 16. The measles-mumps-rubella and varicella (chickenpox) vaccines also offer protection against certain viruses that can lead to viral meningitis. Skipping any of these can raise the risk of meningitis.

Prevention

Though not all types of meningitis can be prevented, you can greatly reduce your – and your child’s – risk by:

Stay current on vaccinations: Follow the recommended vaccine schedule.

Get treatment: Get antibiotic treatment from your physician if household members, or others you’ve had close contact with, develop bacterial meningitis.

Practice good hygiene: Limit contact with a person who has been diagnosed with meningitis and wash hands frequently.

Prognosis

Prognosis depends on the severity and cause of a meningitis infection. People with viral meningitis typically recover fully within a week or two. Bacterial meningitis is far more serious and requires immediate antibiotic and supportive treatment. In severe or fast-onset cases of bacterial meningitis, the risk of death or long-term disability is quite high, even with proper treatment. These long-term disabilities may include blindness, deafness, paralysis and seizures.

Treatment and Recovery

Proper management and treatment of meningitis often requires the collaboration of several medical specialists. Neurologists manage diagnosis and treatment of complications of infection affecting the brain and spinal cord. Infectious disease specialists guide antibiotic treatment. Radiologists interpret brain imaging and perform spinal taps. Treatment focuses on reversing the infection (in the case of bacterial meningitis), reducing symptoms, preventing complications and providing support.

Treatment, which in most cases requires hospitalization and possibly admission to the intensive care unit, may include:

Antibiotics

Intravenous (IV) antibiotics are the first line of treatment for bacterial meningitis – necessary to ensure survival and reduce complications. The antibiotic or combination of antibiotics given depends on the bacteria causing the infection.

Anticonvulsants

These medications may be prescribed to control seizures during an active infection or as a result of meningitis complications.

Antifungal Medications

Rarely, meningitis can be caused by a fungal infection, rather than by bacteria or a virus. In this case, antifungals will be administered intravenously or by mouth.

Bed Rest

In the case of viral meningitis, most cases improve on their own after a couple of weeks. Bed rest is recommended as a patient recovers. Bed rest is also necessary after treatment for bacterial meningitis until a patient regains his/her strength.

Corticosteroids

These medications help reduce swelling in the brain and around the spinal cord. They may be administered in the case of bacterial, viral, fungal and other types of meningitis.

Fluid Replacement

Preventing dehydration is very important in treating meningitis. In the case of bacterial meningitis, patients may receive IV fluids. For viral meningitis, patients can take fluids by mouth.

Over-the-Counter Pain Medications

These medications can help reduce fever and muscle aches associated with meningitis. They may be the only medications a patient with mild-to-moderate viral meningitis needs to take.

Complications

Meningitis, especially bacterial meningitis, can lead to the following complications without rapid treatment:

Brain damage: Acquired brain injuries caused by meningitis can cause problems with movement, speech, memory, posture and coordination, cognitive difficulties and more.

Death: Approximately 10 to 15 percent of patients with bacterial meningitis die, even with appropriate treatment.

Gait problems: The loss of coordination, balance or other movement skills can be a result of brain damage caused by meningitis.

Hearing loss: Hearing loss may be partial or total. People who have had meningitis should undergo hearing testing.

Learning disabilities: Brain damage from meningitis can lead to learning difficulties.

Memory problems: Brain damage from meningitis can lead to memory problems.

Kidney failure: Meningococcal meningitis may be associated with kidney failure.

Seizures: Patients may experience seizures as they fight the meningitis infection or as a result of brain damage caused by the infection.

Shock: Patients with meningitis may go into shock, characterized by a fast heartbeat and/or low blood pressure, breathing problems, confusion and other symptoms.

Related Conditions

Encephalitis