Meningitis

Meningitis is a disease where the membranes surrounding your brain and spinal cord (called meninges) become infected and swollen. This swelling is called inflammation.

The inflammation from meningitis usually causes noticeable symptoms like a headache, a fever, and a stiff neck.

In the US, most cases of meningitis are caused by viruses. However, bacteria, parasites, and fungi can also cause it. Sometimes, the infection gets better on its own within a few weeks. But meningitis can also be very serious and even life-threatening. If it's caused by bacteria, it usually needs prompt treatment with antibiotics.

If you or someone you know has symptoms that might be meningitis, it's vital to seek immediate medical attention. Getting treatment quickly, especially for bacterial meningitis, can help prevent serious problems down the road.

Meningitis can be tricky because its early symptoms are often similar to the flu. These symptoms can develop gradually over a few hours or days.

Symptoms in children older than 2 years old:

• Sudden high fever: A fever that comes on quickly.
• Stiff neck: Difficulty bending the neck.
• Severe headache: A very bad headache.
• Nausea or vomiting: Feeling sick to your stomach and throwing up.
• Confusion or trouble focusing: Difficulty thinking clearly.
• Seizures: Uncontrollable shaking or spasms.
• Sleepiness or difficulty waking up: Feeling very tired and hard to rouse.
• Sensitivity to light: Discomfort or pain when exposed to light.
• Loss of appetite: Not wanting to eat or drink.
• Skin rash (sometimes): A rash, especially with meningococcal meningitis.

Symptoms in newborns and infants:

• High fever: A quickly developing fever.
• Constant crying: Excessive and persistent crying.
• Extreme sleepiness or irritability: Being unusually sleepy or easily upset.
• Difficulty waking: Having trouble being roused from sleep.
• Lack of activity: Being very still or sluggish.
• Poor feeding: Not eating or drinking well.
• Vomiting: Throwing up.
• Bulging fontanel (soft spot on head): A noticeable swelling or bulging in the soft spot on top of the baby's head.
• Stiffness in body and neck: Difficulty moving the body or neck.

When to seek immediate medical help:

If you or someone in your family has any of these symptoms, especially:

• Fever: High temperature.
• Severe headache that doesn't go away: A persistent and painful headache.
• Confusion: Difficulty thinking clearly.
• Vomiting: Repeated episodes of throwing up.
• Stiff neck: Difficulty bending the neck.

Meningitis, especially bacterial meningitis, can be very serious. Without quick antibiotic treatment, it can be deadly within a few days. Delaying treatment can also lead to lasting brain damage.

Contact your healthcare provider if:

You have been around someone with meningitis, whether a family member, housemate, or coworker. Your doctor might recommend preventive medications to reduce your risk of infection.

If you or a family member have signs of meningitis, get medical help immediately. Meningitis is a serious illness that needs quick treatment. Symptoms include:

• Fever: A high temperature.
• Severe headache: A headache that's very bad and doesn't ease up.
• Confusion: Difficulty thinking clearly or remembering things.
• Vomiting: Repeated episodes of throwing up.
• Stiff neck: Pain or difficulty moving your neck.

Bacterial meningitis can be deadly if not treated quickly with antibiotics. Waiting too long can also lead to lasting brain problems.

If you've been in close contact with someone who has meningitis—such as a family member, housemate, or coworker—talk to your doctor. Your doctor might recommend preventative medicine to lower your chances of getting the infection. It's crucial to seek medical attention promptly if you suspect meningitis.

Meningitis is an infection that causes swelling and irritation (inflammation) of the protective membranes surrounding the brain and spinal cord. These membranes are called the meninges. The tough outer layer is the dura mater, and the delicate inner layer is the pia mater. This inflammation can be caused by various things, but most often by viruses.

What Causes Meningitis?

Meningitis can be caused by viruses, bacteria, fungi, or parasites.

• Viral Meningitis: This is the most common type in the US. It's usually mild and gets better on its own. Enteroviruses are a common cause, often appearing in late summer and fall. Other viruses like herpes simplex, HIV, mumps, and West Nile virus can also trigger it.

• Bacterial Meningitis: This is more serious, as it can be life-threatening. Bacteria enter the bloodstream and travel to the brain and spinal cord, or sometimes directly enter the meninges, perhaps from a nearby infection like an ear or sinus infection, a skull fracture, or rarely, during surgery. Finding the exact bacteria is crucial for treatment. Several types of bacteria can cause bacterial meningitis:

  • Streptococcus pneumoniae: This is the most common cause in children and adults in the US. It often starts as pneumonia or an ear or sinus infection. A vaccine exists to help prevent it.
  • Neisseria meningitidis (meningococcal meningitis): This bacteria often causes an upper respiratory infection, but can cause meningitis by getting into the bloodstream. It's more common in teenagers and young adults and can cause outbreaks in close-living settings like colleges and military bases. A vaccine exists, and close contacts should take antibiotics to prevent infection.
  • Haemophilus influenzae type b (Hib): This used to be a common cause of meningitis in children, but vaccines have greatly reduced this type.
  • Listeria monocytogenes: Found in unpasteurized cheeses, hot dogs, and lunch meats. Pregnant women, newborns, older adults, and people with weakened immune systems are particularly vulnerable. Listeria can cross the placenta and cause severe illness or even death in the developing fetus.

• Fungal Meningitis: Less common in the US, fungal meningitis can mimic bacterial meningitis but often develops more gradually. Breathing in fungal spores from soil, decaying wood, or bird droppings can cause this. Cryptococcal meningitis is a common type, often affecting people with weakened immune systems, like those with AIDS. It's serious and can be fatal if not treated with antifungal medication. It may recur even with treatment. Tuberculosis (TB) can also cause a rare form of fungal meningitis.

• Parasitic Meningitis: Rare, this type of meningitis is caused by parasites that usually infect animals. People can get it from eating contaminated food. Also rare is amoebic meningitis, which can be life-threatening, sometimes stemming from swimming in freshwater.

Other Causes:

Besides infections, meningitis can also result from chemical reactions, certain medications, allergies, some cancers, and diseases like sarcoidosis.

Chronic Meningitis: Meningitis with symptoms that last at least four weeks is considered chronic. Many causes exist, and symptoms can be similar to new-onset meningitis but develop more slowly and last longer. Examples of symptoms include headaches, fever, vomiting, and mental fogginess.

Understanding the different types of meningitis and their potential causes is important to ensure prompt and appropriate treatment. Early diagnosis and treatment are key to improving outcomes.

Meningitis, a serious infection of the membranes surrounding the brain and spinal cord, can have several risk factors. Understanding these factors can help people take steps to protect themselves and others.

Vaccination: Not getting vaccinated against meningitis is a significant risk factor. This includes all recommended childhood and adult vaccinations. Getting these shots helps protect you from the harmful germs that can cause the infection.

Age: Meningitis affects people of all ages, but certain age groups are more vulnerable. Viral meningitis is more common in young children under 5 years old. Bacterial meningitis, a more severe form, is more frequently seen in people younger than 20.

Crowded Living Environments: People living in close quarters, such as college students in dorms, military personnel, and children in boarding schools or daycare centers, are at higher risk for meningitis. This is likely because germs can spread quickly in these close-knit settings.

Pregnancy: Pregnancy itself can increase the risk of a specific type of meningitis caused by a bacteria called listeria. A listeria infection during pregnancy can raise the risk of miscarriage, stillbirth, and premature birth. It's important for pregnant women to be aware of this risk and take steps to avoid infections, such as thoroughly washing foods.

Weakened Immune System: A weakened immune system, due to conditions like AIDS, alcohol use disorder, diabetes, or certain medications, can increase the risk of meningitis. Having a spleen removed also significantly raises the risk. People who have had their spleen removed can reduce their risk with specific vaccines. This is because the spleen plays a key role in fighting infections.

Meningitis, a serious infection, can lead to severe complications if not treated promptly. The longer someone has meningitis without getting medical help, the higher the chance of developing problems with their nervous system.

These complications can include:

• Hearing problems: Difficulty hearing or even complete hearing loss.
• Vision issues: Trouble seeing clearly or even blindness.
• Memory problems: Difficulty remembering things, or forgetting things easily.
• Learning difficulties: Challenges with learning and academic performance.
• Brain damage: This can cause various problems, affecting thinking, movement, and other functions.
• Walking problems: Difficulty walking or loss of mobility.
• Seizures: Sudden, uncontrolled bursts of electrical activity in the brain.
• Kidney failure: The kidneys may stop working properly.
• Shock: A life-threatening condition where the body's blood pressure drops dangerously low.
• Death: In severe cases, meningitis can be fatal.

It's crucial to seek medical attention immediately if you suspect meningitis. Early treatment significantly reduces the risk of these serious complications.

Preventing Meningitis: Simple Steps and Vaccines

Meningitis is a serious infection of the lining around the brain and spinal cord. Harmful germs can spread meningitis through everyday actions like coughing, sneezing, kissing, or sharing items like eating utensils, toothbrushes, or even cigarettes. Here's how to protect yourself and others:

Preventing the Spread of Germs:

• Wash Your Hands Frequently: Regular handwashing is crucial in stopping the spread of germs. Teach children the importance of washing their hands before meals, after using the restroom, after being in public places, after playing with pets, and after any activity where germs might be present. Make sure they know how to thoroughly wash and rinse their hands.

• Practice Good Hygiene: Avoid sharing drinks, food, straws, eating utensils, lip balm, and toothbrushes with others. Emphasize this with children and teenagers.

• Boost Your Immunity: A strong immune system helps fight off infections. Get enough sleep, exercise regularly, and eat a healthy diet rich in fruits, vegetables, and whole grains to keep your immune system strong.

• Cover Your Mouth: When coughing or sneezing, cover your mouth and nose with a tissue or your elbow to prevent the spread of germs. Coughing or sneezing into your elbow is better than into your hands because it reduces the risk of spreading germs to surfaces and other people.

• Food Safety (Especially During Pregnancy): If you're pregnant, take extra care with food safety. Cook meats like hot dogs and lunch meats to a safe internal temperature of 165°F (74°C). Choose cheeses made from pasteurized milk to minimize the risk of listeria infections. Always check food labels to ensure pasteurization.

Vaccines to Prevent Meningitis:

Several vaccines can help prevent different types of bacterial meningitis. The Centers for Disease Control and Prevention (CDC) recommends these vaccines:

• Haemophilus influenzae type b (Hib) vaccine: This vaccine is recommended for children starting around 2 months old. It's also recommended for some adults, including those with sickle cell disease, AIDS, or those who have had their spleen removed.

• Pneumococcal conjugate vaccines (PCV15 or PCV20): These vaccines are important for children under 2 years old. They are also recommended for older children (2-18) who are at higher risk of pneumococcal disease.

• Pneumococcal polysaccharide vaccine (PPSV23): This vaccine is for older children and adults to protect against pneumococcal germs. The CDC recommends this vaccine for all adults over 65. It's also beneficial for younger adults and children (2 and older) with weakened immune systems, chronic illnesses (like heart disease or diabetes), or who lack a spleen.

• Meningococcal conjugate vaccine (MenACWY): This vaccine is given in a single dose to children aged 11-12, with a booster shot at age 16. Children who get the first dose between 13 and 15 can get the booster between 16 and 18. Those getting the first dose at 16 or older don't need a booster. The vaccine is also for children between 2 months and 10 years who are at high risk of meningitis, or those who have been exposed to the disease. It's also for people who haven't been vaccinated and have been exposed to meningitis but are not yet sick.

• Serogroup B meningococcal vaccine (MenB): This vaccine is recommended for adults and children 10 years and older at higher risk of meningococcal disease, including those with sickle cell disease, a damaged spleen, or those who have had their spleen removed. People with certain immune disorders (complement component deficiency) or who take certain medications might also benefit from this vaccine. It's also recommended if there's a serogroup B meningococcal outbreak.

By understanding how meningitis spreads and getting recommended vaccinations, you can significantly reduce your risk of contracting this potentially serious illness. Always consult with a healthcare professional for personalized advice.

Doctors diagnose meningitis using a combination of information from your medical history, a physical exam, and various tests.

Here are some common tests:

• Blood Cultures: A blood sample is sent to a lab. In the lab, the sample is placed in a special environment to see if bacteria or other germs grow. Sometimes, a lab technician will look at a stained sample under a microscope to check for germs.

• Imaging Tests: A CT scan or MRI scan of your head can reveal if there's swelling or irritation in your brain. X-rays or CT scans of your chest or sinuses might show an infection that could be connected to meningitis. These images can help doctors look for signs of infection elsewhere in your body that may be related to meningitis.

• Spinal Tap (Lumbar Puncture): A spinal tap is a procedure where a small amount of fluid is taken from around your spinal cord. If you have meningitis, this fluid often shows specific changes. The fluid might have a lower-than-normal sugar level, a higher-than-normal number of white blood cells, and more protein than usual.

• Analyzing the Spinal Fluid: Examining the spinal fluid can help doctors figure out what kind of germ (if any) caused the meningitis. For viral meningitis, a special test called a polymerase chain reaction (PCR) test can be done on the fluid to look for the specific virus. Other tests might also be needed to get a complete picture.

Meningitis treatment varies depending on the cause.

Bacterial Meningitis: If you have a new case of bacterial meningitis, you need quick treatment with antibiotics given directly into a vein (intravenously). Sometimes, corticosteroids are also used. These help your body recover and lower the risk of problems like brain swelling and seizures. The best antibiotic, or combination of antibiotics, depends on the specific bacteria causing the infection. Before the exact cause is known, doctors often start with a broad-spectrum antibiotic that works against many types of bacteria. Corticosteroids can reduce brain swelling, and medicines to control seizures might be prescribed. If a herpes virus is the cause, antiviral medicine is used.

Viral Meningitis: Antibiotics don't work for viral meningitis. This type of meningitis usually gets better within a few weeks. Treatment for mild viral meningitis focuses on:

• Rest: Staying in bed helps your body heal.
• Plenty of fluids: Drinking enough water and other fluids is important.
• Pain relief: Over-the-counter pain relievers can help reduce fever and muscle aches.

Other Types of Meningitis: If the cause of meningitis isn't immediately clear, doctors may wait to start antibiotic treatment until they identify the cause. Treatment for ongoing (chronic) meningitis depends on the specific cause.

• Fungal meningitis: Antifungal medicines are used.
• Tuberculous meningitis: A combination of antibiotics treats this type. However, these medicines can have serious side effects, so treatment might be delayed until lab tests confirm the cause.
• Meningitis from an allergic reaction or autoimmune disease: Corticosteroids might be used. In some cases, the condition may improve without any treatment.
• Cancer-related meningitis: Treatment focuses on managing the underlying cancer.

Important Note: If you or someone you know is experiencing symptoms of meningitis, it's crucial to seek medical attention right away. Prompt diagnosis and treatment are essential for a positive outcome.