What is meningitis?
Meningitis is an inflammation of the meninges. The meninges are the three membranes that cover the brain and spinal cord. It can occur when fluid surrounding the meninges becomes infected.
The most common causes of meningitis are viral and bacterial infections. Other causes may include:
- chemical irritation
- drug allergies
Some viral and bacterial meningitis are contagious. They can be transmitted by coughing, sneezing, or close contact.
What are the symptoms of meningitis?
The symptoms of viral and bacterial meningitis can be similar in the beginning. However, bacterial meningitis symptoms are usually more severe. The symptoms also vary depending on your age.
Viral meningitis symptoms
Viral meningitis in infants may cause:
- decreased appetite
In adults, viral meningitis may cause:
- stiff neck
- sensitivity to bright light
- nausea and vomiting
- decreased appetite
Bacterial meningitis symptoms
Bacterial meningitis symptoms develop suddenly. They may include:
- altered mental status
- sensitivity to light
- stiff neck
- purple areas of skin that resemble bruises
Seek immediate medical attention if you experience these symptoms. Bacterial and viral meningitis can be deadly. There’s no way to know if you have bacterial or viral meningitis just by judging how you feel. Your doctor will need to perform tests to determine which type you have.
Fungal meningitis symptoms
Symptoms of fungal meningitis resemble the other types of this infection. These may include:
- sensitivity to light
- confusion or disorientation
Each type of meningitis has some distinguishing symptoms. Learn more about these so you can understand the differences between each type of meningitis.
One of the late signs that one bacterial cause of meningitis, Neisseria meningitidis, is in your bloodstream is a faint rash on your skin. The bacteria from a meningococcal meningitis infection reproduce in your blood and target cells around the capillariesTrusted Source. Damage to these cells leads to capillary damage and mild blood leaks. This shows up as a faint pink, red, or purple rash. The spots may resemble tiny pinpricks and are easily mistaken as a bruise.
As the infection worsens and spreads, the rash will become more obvious. The spots will grow darker and larger.
People with dark skin may have a hard time seeing the rash. Lighter areas of skin, such as the palms of hands and the inside of the mouth may show signs of a rash more easily.
Not every rash looks the same.
Types of meningitis
Viral and bacterial infections are the most common causes of meningitis. There are several other forms of it. Examples include cryptococcal, which is caused by a fungal infection, and carcinomatous, which is cancer-related. These types are less common.
Viral meningitis is the most common type of meningitis. Viruses in the Enterovirus category cause 85 percent of cases. These are more common during the summer and fall, and they include:
- coxsackievirus A
- coxsackievirus B
Viruses in the Enterovirus category cause about 10 to 15 million infections trusted Source per year, but only a small percentage of people who get infected will develop meningitis.
Other viruses can cause meningitis. These include:
- West Nile virus
- herpes viruses
- Coltivirus, which causes Colorado tick fever
Viral meningitis typically goes away without treatment. However, some causes do need to be treated.
Bacterial meningitis is contagious and caused by infection from certain bacteria. It’s fatal if left untreated. Between 5 to 40 percent trusted Source of children and 20 to 50 percent trusted Source of adults with this condition die. This is true even with proper treatment.
The most common types of bacteria that cause bacterial meningitis are:
- Streptococcus pneumoniae, which is typically found in the respiratory tract, sinuses, and nasal cavity and can cause what’s called “pneumococcal meningitis”
- Neisseria meningitidis, which is spread through saliva and other respiratory fluids and causes what’s called “meningococcal meningitis”
- Haemophilus influenza, which can cause not only meningitis but infection of the blood, inflammation of the windpipe, cellulitis, and infectious arthritis
- Listeria monocytogenes, which are foodborne bacteria
- Staphylococcus aureus, which is typically found on the skin and in the respiratory tract, and causes “staphylococcal meningitis”
Fungal meningitis is a rare type of meningitis. It’s caused by a fungus that infects your body and then spreads from your bloodstream to your brain or spinal cord.
People with a weakened immune system are more likely to develop fungal meningitis. This includes people with cancer or HIV.
The most common funguses related to fungal meningitis include:
- Cryptococcus, which is inhaled from dirt or soil that is contaminated with bird droppings
- Blastomyces, another type of fungus found in soil, particularly in the Midwestern United States
- Histoplasma, which is found in environments that are heavily contaminated with bat and bird droppings, especially in the Midwestern States near the Ohio and Mississippi Rivers
- Coccidioides, which is found in soil in specific areas of the U.S. Southwest and South and Central America
This type of meningitis is less common than viral or bacterial meningitis, and it’s caused by parasites that are found in dirt, feces, and on some animals and food, like snails, raw fish, poultry, or produce.
One type of parasitic meningitis is rarer than others. It’s called eosinophilic meningitis (EM). Three main parasites are responsible for EM. These include:
- Angiostrongylus cantonensis
- Baylisascaris procyonis
- Gnathostoma spinigerum
Parasitic meningitis is not passed from person to person. Instead, these parasites infect an animal or hide out on food that a human then eats. If the parasite or parasite eggs are infectious when they’re ingested, an infection may occur.
One very rare type of parasitic meningitis, amebic meningitis, is a life-threatening type of infection. This type is caused when one of several types of ameba enters the body through the nose while you swim in contaminated lakes, rivers, or ponds. The parasite can destroy brain tissue and may eventually cause hallucinations, seizures, and other serious symptoms. The most commonly recognized species is Naegleria fowleri.
Non-infectious meningitis is not an infection. Instead, it is a type of meningitis that’s caused by other medical conditions or treatments. These include:
- a head injury
- brain surgery
- certain medications
What are the causes of meningitis?
Each type of meningitis has a slightly different cause, but each ultimately acts in the same way: A bacterium, fungus, virus, or parasite spreads through the bloodstream until it reaches the brain or spinal cord. There, it sets up in the lining or fluids around these vital body parts and starts developing into a more advanced infection.
Non-infectious meningitis is the result of a physical injury or other condition; it doesn’t involve an infection.
Is there a vaccine for meningitis?
Yes, there is a vaccine for several types of bacterial meningitis. Meningococcal meningitis, caused by Neisseria meningitidis, is one version for which vaccines are available. While viral meningitis is more common, bacterial meningitis can be more dangerous if it’s not diagnosed and treated quickly.
For that reason, the two primary vaccines for meningitis are for bacterial causes. The first vaccine, the meningococcal conjugate vaccine, features a vaccine that targets four of the most common types of bacterial serotypes. It lasts longer and offers greater protection, especially if you maintain booster shots.
The second vaccine, MenB, targets one specific strain, and its protection window is much shorter. Only certain populations are recommended to get this vaccine.
Side effects of a meningitis vaccine include soreness, redness, and burning at the injection site. Some people may experience a low-grade fever for a day or two following the injection. Chills, headache, joint pain, and fatigue are also possible.
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
- people traveling to countries where meningococcal disease is common
- children ages 2 or older who don’t have a spleen or who have a compromised immune system
Teenagers should protect themselves by getting a meningitis vaccine.
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.
Parasitic meningitis may either involve treating just the symptoms or attempting to treat the infection directly. Depending on the cause, this type may get better without antibiotic treatment. If it worsens, however, your doctor may try to treat the infection itself.
Viral meningitis may resolve on its own, but some causes of viral meningitis will be treated with intravenous antiviral medications.
How contagious is meningitis?
Several types of meningitis are not contagious. Fungal, parasitic and non-infectious meningitis are not contagious.
Viral meningitis is contagious. It’s spread through direct contact with body fluids, including mucus, feces, and saliva. Droplets of infected fluid can be spread and shared with sneezing and coughing. You do not have to come into direct contact with an infected person to pick up this infection.
Bacterial meningitis, the most serious form of meningitis, can also be contagious, especially if it’s meningococcal meningitis. It’s spread through extended contact with an infected person. Schools, daycare centers, military barracks, hospitals, and college dormitories are prime locations for sharing this infection. Some types of meningitis are spread through person-to-person contact but not all.
Meningitis in infant
Babies who develop meningitis may show different signs and symptoms of infection than adults. These symptoms can include:
- body or neck stiffness
- high-pitched crying
- inconsolable behaviors
- sleepy and difficulty waking
- irritable and grumpy
- doesn’t feel well and has a weak suck during breastfeeding
Viral meningitis is common in infants. It develops as a result of colds, cold sores, flu, and diarrhea. The viruses that cause these common conditions also cause viral meningitis.
Bacterial meningitis, which is common but life-threatening, most likely spreads from a serious infection in a nearby area of the body. For example, the bacteria from a severe ear infection or sinus infection can enter the bloodstream and find their way to the brain or spinal cord and cause a bigger infection.
Meningitis in children
Meningitis becomes more common in children as they grow older and reach high school and college ages. Symptoms of viral and bacterial meningitis in children are very similar to symptoms in adults. These include:
- sudden fever
- body and neck aches
- confusion or disorientation
- tiredness or fatigue
You may be curious if your child is at risk for developing this condition.
Meningitis in adults
The risk for several forms of meningitis decreases after young adulthood. That’s in large part due to changing circumstances. Schools and college dormitories are common sites where some forms of meningitis can be easily shared. Once a young adult ages out of these settings, the likelihood of infection begins to fall.
However, after age 60, the risk starts to rise again. That’s because of underlying diseases or health conditions that weaken the immune systems in older individuals.
Adults with a compromised immune system are at a greater risk of developing meningitis. Likewise, adults in environments where individuals are in close contact with one another may be at greater risk for an infection. This includes teachers, healthcare providers, daycare staffers.
How is meningitis diagnosed?
Diagnosing meningitis starts with a health history and physical exam. Age, dorm residence, and daycare center attendance can be important clues. During the physical exam, your doctor will look for:
- a fever
- an increased heart rate
- neck stiffness
- reduced consciousness
Your doctor will also order a lumbar puncture. This test is also called a spinal tap. It allows your doctor to look for increased pressure in the central nervous system. It can also find inflammation or bacteria in the spinal fluid. This test can also determine the best antibiotic for treatment.
Other tests may also be ordered to diagnose meningitis. Common tests include the following:
- Blood cultures identify bacteria in the blood. Bacteria can travel from the blood to the brain. N. meningitidis and S. pneumonia, among others, can cause both sepsis and meningitis.
- A complete blood count with differential is a general index of health. It checks the number of red and white blood cells in your blood. White blood cells fight infection. The count is usually elevated in meningitis.
- Chest X-rays can reveal the presence of pneumonia, tuberculosis, or fungal infections. Meningitis can occur after pneumonia.
- A CT scan of the head may show problems like a brain abscess or sinusitis. Bacteria can spread from the sinuses to the meninges.
Your doctor may also conduct a glass test. For this test, your doctor will roll a glass over the meningitis rash. If the rash doesn’t fade under the pressure, it’s likely meningitis rash. If it does fade, the unusual spots on the skin may be the result of another condition.
How is meningitis prevented?
Maintaining a healthy lifestyle, especially if you’re at increased risk, is important. This includes:
- getting adequate amounts of rest
- not smoking
- avoiding contact with sick people
If you’ve been in close contact with one or more people who have a bacterial meningococcal infection, your doctor can give you preventive antibiotics. This will decrease your chances of developing the disease.
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
- meningococcal vaccine
Practicing good personal hygiene may also help you prevent meningitis. Some types of meningitis are spread through close contact with an infected person’s body fluid, such as saliva and nasal secretions. Avoid sharing drinks, utensils, and personal items that may carry saliva or other fluids. Take these steps to prevent getting meningitis.
What are the complications from meningitis?
These complications are typically associated with meningitis:
- hearing loss
- vision loss
- memory problems
- migraine headaches
- brain damage
- a subdural empyema, or a buildup of fluid between the brain and the skull
A meningitis infection may produce bacteria in the bloodstream. These bacteria multiply and some release toxins. That can cause blood vessel damage and leaking of blood into the skin and organs.
A serious form of this blood infection can be life-threatening. Gangrene may damage skin and tissue. In rare cases, amputation may be necessary. Several other serious complications may occur in people with meningitis. Read more about them and the long-term effects of an infection.
Meningitis and pneumonia
Pneumococcal meningitis is a rare but serious and life-threatening form of bacterial meningitis. Even with treatment, 20 percent of people with this type of infection die.
About 40 percent of people carry bacteria called Streptococcus pneumoniae in their throat and the back of the nose. These bacteria are responsible for common illnesses like pneumonia, sinus infections, and ear infections.
From time to time, however, those bacteria manage to cross the blood-brain barrier and cause inflammation and infection in the brain, spinal cord, or fluids immediately surrounding them.
Symptoms of this serious form of meningitis include:
- high fever
- chest pain
Fortunately, two vaccines are available to prevent pneumococcal meningitis. Learn more about them and other ways to prevent this deadly form of infection.
What are the risk factors for meningitis?
The following are some of the risk factors for meningitis:
People with an immune deficiency are more vulnerable to infections. This includes the infections that cause meningitis. Certain disorders and treatments can weaken your immune system. These include:
- autoimmune disorders
- organ or bone marrow transplants
Cryptococcal meningitis, which is caused by a fungus, is the most common form of meningitis in people with HIV.
Meningitis is easily spread when people live in close quarters. Being in small spaces increase the chance of exposure. Examples of these locations include:
- college dormitories
- boarding schools
- day care centers
Pregnant women have an increased risk of listeriosis, which is an infection caused by the Listeria bacteria. Infection can spread to the unborn child.
All ages are at risk for meningitis. However, certain age groups have a higher risk. Children under the age of 5 are at increased risk of viral meningitis. Infants are at higher risk of bacterial meningitis.
Working with animals
Farmworkers and others who work with animals have an increased risk of infection with Listeria.
Frequently Asked Questions about Meningitis
What is meningitis?
Meningitis is inflammation of the protective layers that surround the brain and spinal cord. These layers are called the meninges.
What is MenA, B, C, W and Y?
Meningococcal bacteria, the most common cause of bacterial meningitis in the UK, can be divided into several groups. The groups that most commonly cause the disease are A, B, C, W and Y.
What causes meningitis?
Meningitis can be divided into two main types; viral and bacterial meningitis.
- Viral meningitis is more common than bacterial meningitis but rarely fatal
- Bacterial types are comparatively rare, but extremely dangerous and can be fatal
- The most common bacterial cause in the UK is meningococcus. This can cause both meningitis and septicemia (meningococcal disease)
- Other types of bacterial meningitis include pneumococcal, Hib, neonatal (usually caused by group B streptococcus and E. coli) and TB
How do you get meningitis; Can anyone get meningitis?
Everybody is at risk, but certain age groups are more susceptible.
- The under-fives are most at risk, particularly the under-ones
- Teenagers and young adults are the second most at-risk group
- Those over 65 are also at increased risk
Can you get meningitis more than once?
It is very unusual for anyone to have meningitis more than once, but it is possible. Most people develop immunity to the organism that has caused their disease. However, there are several different causes of meningitis and therefore it is possible, but rare, to have the disease more than once.
Although extremely rare, some viruses can cause recurring meningitis. This is known as Mollaret’s meningitis.
Is meningitis seasonal?
Although meningitis can occur at any time of the year, in the UK the number of bacterial meningitis cases rise during the winter months and the number of viral meningitis cases increases during the summer months.
What is meningococcal disease?
- Meningococcal bacteria can affect the body in different ways
- Meningitis is caused when the bacteria enter the bloodstream and travel to the meninges where they multiply and cause inflammation
- Septicemia is blood poisoning; bacteria in the bloodstream multiply rapidly and release toxins (poisons) as they die. These toxins damage blood vessels throughout the body; this can lead to organ damage
- It is common for meningococcal bacteria to cause both meningitis and septicemia; this is known as meningococcal disease
What is septicemia?
Septicaemia is blood poisoning and can be caused by some types of bacteria that also cause meningitis. The bacteria enter the bloodstream and multiply uncontrollably. As the bacteria die and breakdown, they release toxins (poisons) into the blood. These toxins damage the blood vessels throughout the body, causing organ damage. The rash associated with meningitis is actually caused by septicaemia.
What is the difference between meningitis and meningococcal septicaemia?
The meningococcal bacteria can affect the body in several ways:
- Meningitis is caused when bacteria enter the bloodstream and travel to the meninges, where they multiply and cause inflammation
- Septicemia is caused when bacteria enter the bloodstream and multiply rapidly. They release toxins that poison the blood. If the bacteria do not reach the meninges, meningitis does not occur
- Commonly, the bacteria will multiply in both the meninges and the bloodstream, causing meningococcal meningitis and septicemia to occur. This is referred to as meningococcal disease.
What are the main symptoms?
The common signs and symptoms associated with meningitis and septicemia can appear in any order, and some may not appear at all.
In adults and children:
Fever with cold hands and feet – Vomiting – Drowsy, difficult to wake – Confusion and irritability – Severe muscle pain – Pale blotchy skin, spots or a rash that does not fade under pressure – Severe headache – Stiff neck – Dislike of bright lights – Convulsions/seizures
In babies and toddlers:
Fever with cold hands and feet – Refusing food or vomiting – Fretful, dislike of being handled – Drowsy, floppy, unresponsive – Rapid breathing or grunting – Pale blotchy skin, spots or a rash that does not fade under pressure – Unusual cry, moaning – Tense, bulging fontanelle – Neck stiffness – Dislike of bright lights – Convulsions/seizures
What is the rash?
When meningococcal bacteria multiply in the blood stream, they release toxins (poisons) that damage the blood vessels. The rash is caused by blood leaking from the damaged blood vessels into the tissues underneath the skin.
What does it look like?The rash can start anywhere on the body. It begins as tiny red pin pricks, but may quickly develop to look like fresh bruising. The Glass Test can be used to see if the rash might be septicaemia. If you press the side of a clear drinking glass firmly onto the spots or bruises, they will not fade. A rash will not always appear with meningitis and can be one of the last symptoms to be displayed. Never wait for a rash if you suspect meningitis.
Are signs and symptoms different for septicaemia?If someone has septicaemia alone, the common signs of meningitis, such as a severe headache or neck stiffness, may not be present. The early signs and symptoms of septicaemia include:
- Fever with cold hands and feet
- Severe muscle pain
- Pale blotchy skin
- Stomach cramps and diarrhoea
Septicaemia can progress very quickly, resulting in severe shock and, in some cases, death within hours. If septicaemia is suspected, urgent medical help is needed.
What should you do if someone has signs and symptoms?If you have identified signs and symptoms and someone’s general health is deteriorating, you need to act quickly.
- Seek medical help immediately
- Describe the symptoms as accurately as possible
- Say that you think it could be meningitis or septicaemia
- If you have had advice and are still worried, get medical help again
The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. The following links are relevant to the diagnosis and treatment of meningitis and septicaemia:
Bacterial meningitis and septicaemia
Fever in the under 5s
How is meningitis treated?
- Bacterial meningitis and septicaemia need urgent hospital admission so appropriate care and treatment can be given as quickly as possible
- Bacterial meningitis can be treated with antibiotics, but depending on the condition of the patient many other procedures and interventions can be needed
- The progression of the disease varies, with some people needing only a few days in hospital and others needing a longer stay with treatment in an intensive care unit
- There is no specific treatment for viral meningitis, however some people will need hospital care, ensuring the patient has plenty of fluids, pain relief and rest
Why are antibiotics given to some people after a case of bacterial meningitis?When there is a case of meningococcal disease there is a slightly increased risk of the disease spreading to the household and kissing contacts of a primary case.
Antibiotics are given to kill any meningococcal bacteria which may be carried at the back of the throat of the contact and prevent any further transmission. These antibiotics are not a form of prevention. If someone is already incubating the disease, the antibiotics will not stop them developing meningitis and/or septicaemia.
It is still important to look out for signs and symptoms.
What vaccines are available?
Vaccines are available to prevent some types of meningitis and most of these are available as part of the UK routine immunisation schedule. However, not all types of meningitis can be prevented by these vaccines.
- A combined vaccine that protects against Hib, diptheria, tetanus, polio, pertussis and hepatitis B is offered to babies at 2, 3 and 4 months
- A Men B vaccine is offered to babies at 2, 4 and 12 months
- A pneumococcal conjugate vaccine (PCV) protects against 13 strains that commonly cause disease. It is offered to babies at 2, 4 and 12-13 months
- A different combined vaccine (Hib and MenC) is offered at 12-13 months
- A Men C vaccine – combined with Hib – is offered to infants at 12-13 months
- The MMR vaccine protects against measles, mumps and rubella and is offered at 12-13 months and again at around 4 years
- The MenACWY vaccine is offered around 14 years of age. It is also offered to new university entrants up to the age of 25 years, who have not previously been vaccinated
- A pneumococcal polysaccharide vaccine (PPV) is offered to anyone aged 65 years and over
- The MenACWY vaccine is available to people travelling to areas of the world with a high incidence of MenA, C, W or Y disease e.g. sub-Saharan Africa or Saudi Arabia during Hajj and Umrah pilgrimages
Read our Men B FAQs and Men ACWY FAQs for more information.
What are the after-effects?
The majority of people will make a full recovery, but some people may be left with after-effects from both bacterial meningitis and viral meningitis.
Brain injury – Deafness – Learning difficulties – Epilepsy – Mood swings – Disruptive behaviour – Sight problems – Headaches – Tiredness – Memory loss – Concentration problems
The toxins that are released during septicaemia cause damage to blood vessels. This can prevent the vital flow of blood and oxygen to major organs and can result in after-effects such as:
- Skin and tissue damage
- Organ failure
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