Meningitis

Overview

Meningitis is an inflammation of the fluid and membranes (meninges) surrounding your brain and spinal cord. The swelling from meningitis typically triggers signs and symptoms such as headache, fever and a stiff neck.

Symptoms

Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.

 

Possible symptoms in anyone older than the age of 2

  • Sudden high fever

  • Stiff neck 

  • Severe headache that seems different from normal

  • Headache with nausea or vomiting

  • Confusion or difficulty concentrating

  • Seizures

  • Sleepiness or difficulty waking

  • Sensitivity to light

  • No appetite or thirst

  • Skin rash (sometimes, such as in meningococcal meningitis)

 

Newborns and infants may show these signs

  • High fever

  • Constant crying

  • Excessive sleepiness or irritability

  • Difficulty waking from sleep

  • Inactivity or sluggishness

  • Not waking to eat

  • Poor feeding

  • Vomiting

  • A bulge in the soft spot on top of a baby's head (fontanel)

  • Stiffness in the body and neck

Infants with meningitis may be difficult to comfort, and may even cry harder when held.

 

Causes (Types)

  • Bacterial(caused by the meningococcal bacteria)

  • Viral

  • Fungal

  • Parasitic

  • Amebic

  • Non-infectious 

 

The infection can pass through the brain's natural barrier and infect the meninges, causing them to swell as they attempt to stop the infection from spreading. Meningitis can also infect the cerebrospinal fluid (CSF), leading to a rise in intracranial pressure. Inflammation and increased pressure around the brain can cause serious injury if left untreated.

 

Diagnosis

  • lumbar puncture: the bacteria can sometimes be seen in microscopic examinations of the spinal fluid

  • blood tests 

  • a CT scan or a chest X-ray

 

 

Risk Factors

  • Skipping vaccinations

  • Age. Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis is common in those under age 20.

  • Living in a community setting. College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at greater risk of meningococcal meningitis. 

  • Pregnancy. Pregnancy increases the risk of listeriosis — an infection caused by listeria bacteria, which may also cause meningitis. Listeriosis increases the risk of miscarriage, stillbirth and premature delivery.

  • Compromised immune system. AIDS, alcoholism, diabetes, use of immunosuppressant drugs and other factors that affect your immune system also make you more susceptible to meningitis. 

 

Prevention

  • Wash your hands

  • Practice good hygiene. Don't share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. 

  • Stay healthy. Maintain your immune system by getting enough rest, exercising regularly, and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.

  • Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and nose.

  • If you're pregnant, take care with food. Reduce your risk of listeriosis by cooking meat, including hot dogs and deli meat, to 165 F (74 C). Avoid cheeses made from unpasteurized milk. Choose cheeses that are clearly labeled as being made with pasteurized milk.

 

Treatment

Bacterial meningitis

  • intravenous antibiotics 

  • sometimes corticosteroids (ensure recovery and reduce the risk of complications)

 

Viral meningitis

most cases improve on their own in several weeks. 

 

Treatment of mild cases of viral meningitis usually includes:

  • Bed rest

  • Plenty of fluids

  • Over-the-counter pain medications to help reduce fever and relieve body aches

  • corticosteroids (to reduce swelling in the brain) 

  • anticonvulsant medication (to control seizures)

  • antiviral medication 

 

Other types of meningitis

  • Antifungal medications treat fungal meningitis, and a combination of specific antibiotics can treat tuberculous meningitis. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal.

  • Noninfectious meningitis due to allergic reaction or autoimmune disease may be treated with corticosteroids. In some cases, no treatment may be required because the condition can resolve on its own. 

  • Cancer-related meningitis requires therapy for the specific cancer.

 

Effects of Meningitis

  • Most people with meningitis will make a full recovery

  • In some cases, it can cause long term effects such as hearing loss, vision loss, seizures, memory problems, balance and coordination problems. 

  • In some rare cases, loss of limbs/amputation of affected limb.

 

Helpful links

 

Reference

“Meningitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Oct. 2020, www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508. 

MEDIAmaker. “Meningitis.” Headway, www.headway.org.uk/about-brain-injury/individuals/types-of-brain-injury/meningitis/. 

“Meningitis.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Jan. 2020, www.cdc.gov/meningitis/index.html. 

Resources by Jenny Tao