Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The meninges are the three membranes that cover the brain and spinal cord. Meningitis can occur when fluid surrounding the meninges becomes infected.
The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck.
The most common causes of meningitis are viral and bacterial infections. Other causes may include:
Viral and bacterial meningitis are contagious. They can be transmitted by coughing, sneezing, or close contact.
Bacterial meningitis is serious, and can be fatal within days without prompt antibiotic treatment. Delayed treatment increases the risk of permanent brain damage or death.
Causes of Meningitis
Viral infections are the most common cause of meningitis, followed by bacterial infections and, rarely, fungal infections. Because bacterial infections can be life-threatening, identifying the cause is essential.
Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or rarely, after some surgeries.
Several strains of bacteria can cause acute bacterial meningitis, most commonly:
Streptococcus pneumoniae (pneumococcus). This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the United States. It more commonly causes pneumonia or ear or sinus infections. A vaccine can help prevent this infection.
Neisseria meningitidis (meningococcus). This bacterium is another leading cause of bacterial meningitis. These bacteria commonly cause an upper respiratory infection but can cause meningococcal meningitis when they enter the bloodstream. This is a highly contagious infection that affects mainly teenagers and young adults. It may cause local epidemics in college dormitories, boarding schools and military bases. A vaccine can help prevent infection.
Haemophilus influenzae (haemophilus). Haemophilus influenzae type b (Hib) bacterium was once the leading cause of bacterial meningitis in children. But new Hib vaccines have greatly reduced the number of cases of this type of meningitis.
Listeria monocytogenes (listeria). These bacteria can be found in unpasteurized cheeses, hot dogs and luncheon meats. Pregnant women, newborns, older adults and people with weakened immune systems are most susceptible. Listeria can cross the placental barrier, and infections in late pregnancy may be fatal to the baby.
Viral meningitis (also called aseptic meningitis) is usually mild and often clears on its own. Most cases are caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps, West Nile virus and others also can cause viral meningitis.
Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) that invade the membranes and fluid surrounding your brain cause chronic meningitis. Chronic meningitis develops over two weeks or more. The symptoms of chronic meningitis — headaches, fever, vomiting and mental cloudiness — are similar to those of acute meningitis.
Fungal meningitis is relatively uncommon and causes chronic meningitis. It may mimic acute bacterial meningitis. Fungal meningitis isn't contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS. It's life-threatening if not treated with an antifungal medication.
Other meningitis causes
Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies, some types of cancer and inflammatory diseases such as sarcoidosis.
Symptoms of Meningitis
Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.
Possible signs and symptoms in anyone older than the age of 2 include:
Sudden high fever
Severe headache that seems different than normal
Headache with nausea or vomiting
Confusion or difficulty concentrating
Sleepiness or difficulty waking
Sensitivity to light
No appetite or thirst
Skin rash (sometimes, such as in meningococcal meningitis)
Signs in newborns
Newborns and infants may show these signs:
Excessive sleepiness or irritability
Inactivity or sluggishness
A bulge in the soft spot on top of a baby's head (fontanel)
Stiffness in a baby's body and neck
Infants with meningitis may be difficult to comfort, and may even cry harder when held.
The Glass Test
1. Press the side of a drinking glass firmly against the rash.
2. If the rash fades and loses colour under pressure it is not a meningitis rash.
3. If it does not change colour you should contact a doctor immediately.
What are the Complications from Meningitis?
These complications are typically associated with meningitis:
a subdural effusion, or a buildup of fluid between the brain and the skull
Risk factors for meningitis include:
Skipping vaccinations. Risk rises for anyone who hasn't completed the recommended childhood or adult vaccination schedule.
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. This is probably because the bacterium is spread by the respiratory route, and spreads quickly through large groups.
Pregnancy. Pregnancy increases the risk of listeriosis — an infection caused by listeria bacteria, which also may 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. Having your spleen removed also increases your risk, and patients without a spleen should get vaccinated to minimize that risk.
Working with Animals. Farm workers and others who work with animals have an increased risk of infection with Listeria.
How Is Meningitis Diagnosed?
Your family doctor or pediatrician can diagnose meningitis based on a medical history, a physical exam and certain diagnostic tests. During the exam, your doctor may check for signs of infection around the head, ears, throat and the skin along the spine.
You or your child may undergo the following diagnostic tests:
Blood cultures. Blood samples are placed in a special dish to see if it grows microorganisms, particularly bacteria. A sample may also be placed on a slide and stained (Gram's stain), then studied under a microscope for bacteria.
Imaging. Computerized tomography (CT) or magnetic resonance (MR) scans of the head may show swelling or inflammation. X-rays or CT scans of the chest or sinuses may also show infection in other areas that may be associated with meningitis.
Spinal tap (lumbar puncture). For a definitive diagnosis of meningitis, you'll need a spinal tap to collect cerebrospinal fluid (CSF). In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.
CSF analysis may also help your doctor identify which bacterium caused the meningitis. If your doctor suspects viral meningitis, he or she may order a DNA-based test known as a polymerase chain reaction (PCR) amplification or a test to check for antibodies against certain viruses to determine the specific cause and determine proper treatment.
How Is Meningitis Treated?
Your treatment is determined by the cause of your meningitis.
Bacterial meningitis requires immediate hospitalization. Early diagnosis and treatment will prevent brain damage and death. Bacterial meningitis is treated with intravenous antibiotics. There’s no specific antibiotic for bacterial meningitis. It depends on the bacteria involved.
Fungal meningitis is treated with antifungal agents.
Viral meningitis isn’t treated. It usually resolves on its own. Symptoms should go away within two weeks. There are no serious long-term problems associated with viral meningitis.
Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette.
These steps can help prevent meningitis:
Wash your hands. Careful hand-washing helps prevent germs. Teach children to wash their hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. Show them how to vigorously and thoroughly wash and rinse their hands.
Practice good hygiene. Don't share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Teach children and teens to avoid sharing these items too.
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.
Vaccinations can also protect against certain types of meningitis. Vaccines that can prevent meningitis include the following:
Haemophilus influenzae type B (Hib) vaccine
pneumococcal conjugate vaccine
Who Should be Vaccinated against Meningococcal Meningitis?
These five groups are considered at risk and should get a meningitis vaccine:
college freshmen who live in dorms and haven’t been vaccinated
adolescents who are 11 to 12 years old
new high school students who haven’t been vaccinated
people travelling to countries where meningococcal disease is common
children who are ages 2 or older and who don’t have a spleen or have a compromised immune system
When to see a doctor
Seek immediate medical care if you or someone in your family has meningitis symptoms, such as:
Severe, unrelenting headache
It's also important to talk to your doctor if a family member or someone you work with has meningitis. You may need to take medications to prevent getting the infection.
....making effort to "STAY WELL"