Meningitis By Healthgrades Editorial Staff

Introduction

What is meningitis?
Meningitis is a serious disease that is marked by inflammation of the membranes (meninges) and
cerebrospinal fluid (CSF), which encase and protect the brain and spinal cord. Meningitis is also
called spinal meningitis.

Types of meningitis include:

• Acute bacterial meningitis occurs suddenly due to a bacterial infection and is generally
the most serious type of meningitis.

• Aseptic meningitis is similar to other forms of meningitis, but the cause is not a bacterial
infection of the meninges or CSF. Aseptic meningitis can be caused by viruses, some drug
reactions, and certain conditions, such as tuberculosis, brain surgery, head injury, cancer,
or Lyme disease.

• Chronic meningitis is a long-term disease and develops over weeks or months.

• Viral meningitis can occur suddenly (acute) or develop slowly over a two-week period or
longer (chronic).

The viruses and bacteria that can cause many forms of meningitis are carried by humans in the
nose and throat and are spread into the air by coughing and sneezing. Once pathogens are
airborne, they can be picked up by anyone who breathes them into their respiratory tract. The
pathogens then spread from the respiratory tract to the bloodstream where they are carried to
the nervous system. In the nervous system they multiply and cause infection and inflammation of
the meninges and cerebrospinal fluid.

Typical symptoms of meningitis include a high fever and stiff neck. Treatment of meningitis varies
depending on the type of meningitis. Almost all people with viral meningitis will recover, but acute
bacterial meningitis is often life threatening if it is not quickly diagnosed and treated.

Meningitis is a serious disease that can be life threatening because of serious complications, such
as shock and coma. Seek prompt medical care if you have been exposed to someone who has
meningitis.

Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of
meningitis such as high fever, stiff neck, change in consciousness, seizure, and a rash of tiny purple
or red spots.

Symptoms
What are the symptoms of meningitis?
Symptoms of meningitis vary depending on the type of meningitis and individual factors. Some
symptoms can resemble symptoms of other diseases, such as the flu.

Symptoms of acute bacterial meningitis are generally the most severe. Milder forms of meningitis,
such as chronic meningitis and viral meningitis, resemble the symptoms of acute bacterial
meningitis. However, symptoms of chronic meningitis develop more slowly, over a period of
weeks, and the fever may not be as high. Symptoms of viral meningitis may not be as severe as
symptoms of acute bacterial meningitis.

Only a health care professional can determine if you have viral or bacterial meningitis, so you
should seek prompt medical care for any of the symptoms listed below.

General symptoms of all forms of meningitis

The following symptoms can occur in all forms of meningitis:

• Bulging of the soft spot on the top of the head of an infant

• Fever
• Fussiness or reduced feeding in an infant or toddler
• Headache
• Irritability
• Nausea
• Vomiting

Serious symptoms that indicate a life-threatening condition

Symptoms of acute bacterial meningitis, the most serious form of meningitis, progress rapidly and
dramatically, within minutes to hours, and can lead to death within days. Seek immediate medical
care (call 911) if you or your child, or someone you are with, have any of these symptoms:

• Abnormal pupil size or nonreactivity to light

• Change in mental status or sudden behavior change, such as confusion, delirium,
lethargy, hallucinations and delusions
• High fever (higher than 101 degrees Fahrenheit)
• Lethargy
• Loss of consciousness and coma
• Rash of tiny purple or red spots
• Seizure
• Sensitivity to light
• Severe headache
• Severe neck stiffness

Causes
What causes meningitis?
The most common cause of meningitis is a virus, specifically enteroviruses, which are very
common viruses that spread by hand-to-mouth contact, coughing, and contact with fecal matter
of an infected person (such as changing the diaper of a baby infected with the virus). In most
cases, enteroviruses cause a cold-like illness, but in some individuals the virus spreads to the
membranes (meninges) that cover the brain and spinal cord and causes meningitis.

The second most common cause of meningitis is a bacterial infection, most frequently Neisseria
meningitidis and Streptococcus pneumoniae. These bacteria are spread from person to person
through coughing, sneezing and kissing. However, the bacteria are not spread as easily as other
pathogens, such as the viruses that cause the common cold and influenza.

Once in the body, the bacteria can spread from the respiratory tract to the bloodstream where
they are carried to the nervous system. In the nervous system they multiply and cause infection
and inflammation of the meninges and cerebrospinal fluid (CSF).

Meningitis can also be caused by fungi and reactions to certain drugs and vaccines.

The different types of meningitis are named according to the cause, the length of time for the
disease to develop, and the duration. Types of meningitis include:

Acute bacterial meningitis is caused by bacteria, often Neisseria meningitidis.

Aseptic meningitis is often caused by a viral infection, but can also be caused by a bacterial
infection, certain drugs, reaction to a vaccine, or certain conditions, such as tuberculosis, brain
surgery, head injury, Lyme disease, and syphilis.

Chronic meningitis can be the result of side effects of certain drugs, such as chemotherapy, or can
be caused by a viral, fungal, or bacterial infection.

Viral meningitis is caused by a virus such as echovirus, coxsackie virus, or other type of
enterovirus.
What are the risk factors for catching meningitis?
Meningitis can occur in any age group or population. A number of factors increase the risk of
catching meningitis, although not all people with risk factors will catch meningitis. Risk factors for
catching meningitis include:

• Crowded conditions, such living or working in military barracks, prisons, refugee camps,
day care centers, or college dormitories
• Exposure to a person with meningitis
• Poor hygiene, such as not washing your hands frequently and thoroughly, or sharing
unwashed drinking glasses, water bottles, dishware, or personal items, such as lip balm
and toothbrushes
•
Reducing your risk of meningitis
You can lower your risk of catching or spreading meningitis by:

Avoiding contact with a person who has meningitis

Avoiding touching the eyes, nose and mouth, which can transmit meningitis bacteria from the
hands into the body

Covering the mouth and nose with the elbow (not the hand) or a tissue when sneezing or coughing

Getting a bacterial meningitis vaccination as recommended by your health care provider

Not sharing unwashed drinking glasses, water bottles, dishware, or personal items, such as lip
balm and toothbrushes

Using appropriate antibacterial cleaners to clean hands and surfaces

Washing hands with soap and water for at least 15 seconds several times throughout the day and
after contact with a person who has meningitis

How is meningitis treated?

Treatment of meningitis varies depending on the type of meningitis, your age, and other factors.
General treatment of all forms of meningitis includes:

• Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) and other medications for pain and
fever
• Close monitoring and possibly treatment of people who have had close contact with a
person with meningitis, even if there are no symptoms
• Fluid administration by mouth or intravenously
• Rest
Treatment of acute bacterial meningitis

Acute bacterial meningitis is a medical emergency, because it can rapidly result in permanent,
serious complications and death within days. Treatment includes:

Hospitalization, generally in an intensive care setting

Immediate administration of intravenous antibiotics

Intensive monitoring for and treatment of potential complications, such as brain swelling, seizures,
and coma. Life support measures may also be necessary.

Treatment of viral meningitis

Some types of viral meningitis are treated with antiviral drugs. Antibiotics are generally not given
because they are not effective in treating viral meningitis. However, in some cases, antibiotics may
be administered as a precaution if the type of meningitis cannot be determined quickly or if it is
suspected that the meningitis is due to a bacterial infection.

What are the possible complications of meningitis?

Meningitis, especially acute bacterial meningitis, can lead to serious and life-threatening
complications. In some cases death can occur in a matter of days. You can help minimize your risk
of complications by following the treatment plan you and your health care professional design
specifically for you. Complications of meningitis include:

• Coma
• Disseminated intravascular coagulation (DIC), a blood-clotting disorder
• Encephalitis
• Kidney failure
• Permanent neurological damage, such as blindness, hearing loss, brain damage, or
paralysis
• Seizures

Medical Reviewers: William C. Lloyd III Last Review Date: 2019 Jan 5 © 2019
Healthgrades Operating Company, Inc.
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