What is meningitis?

Meningitis is a swelling of the tissues that cover the brain and spinal cord. The swelling sometimes affects the brain itself. Meningitis can be hard to recognize in the early stages. Symptoms can be similar to those of the common flu and can develop quickly over hours. The most common symptoms among teens and young adults are

Children, older adults, and people with other medical problems may have different symptoms.

• Babies may be cranky and refuse to eat.
• They may have a rash.
• They may cry when held or appear listless.
• Young children may act like they have the flu. They may cough or have trouble breathing.
• Older adults and people with other medical problems may have only a slight headache and fever.

It is important to see a doctor right away if these symptoms appear. Only a doctor can order the specific tests that indicate whether the symptoms are caused by viral or bacterial meningitis. When meningitis is suspected, there are multiple tests a doctor can conduct to confirm a diagnosis.

• Blood cultures: Blood tests can indicate an infection. Blood samples are studied to see if microorganisms, such as bacteria, are growing.
• Imaging: Computed tomography (CT) or magnetic resonance imaging (MRI) scans of the head can show swelling or inflammation associated with meningitis. CT scans of the chest or sinuses can also show infections in other associated areas.
• Spinal tap: To get a definitive diagnosis of meningitis, a spinal tap or lumbar puncture is needed. This procedure collects cerebrospinal fluid that can show glucose and protein levels, as well as a white blood cell count.

How is meningitis treated?

Treatment of meningitis depends on the cause.

Bacterial meningitis

• It is treated immediately with intravenous antibiotics.
• This helps ensure the recovery of the patient and reduces the risk of complications, such as brain swelling and seizures.

Viral meningitis

• It is usually mild and often clears on its own.
• Treatment may include supportive care, such as resting, keeping warm and comfortable, and drinking plenty of fluids.
• Viral meningitis cannot be treated with antibiotics.

Noninfective meningitis

• This may be treated with corticosteroids.
• In some cases, no treatment may be required because the condition can get better on its own.
• Cancer-related meningitis requires therapy to manage cancer.

Vaccination

• Immunization against the meningococcus bacterium may be recommended when an outbreak (defined as three cases of the same type within three months) of meningococcal disease has occurred in a community.
• It is important to note that the meningococcal vaccine should not be used in place of treatment for those exposed to an infected person. The protection from immunization is quite slowly developed in this situation.
• Immunization against the bacterium Neisseria meningitides may be recommended for persons older than two years of age if they are members of a population that is experiencing an outbreak of meningococcal disease. For example, students at a university where an outbreak has occurred.
• Untreated bacterial meningitis has an extremely high death rate. Even with appropriate treatment, the death rate from bacterial meningitis is about 15 to 20 percent with a higher death rate associated with increasing age. The type of bacteria makes a difference. Pneumococcal and Listeria meningitis is associated with higher death rates than meningococcal meningitis. Patients who survive may be left with long-term disabilities, such as deafness, blindness, seizures, paralysis, impaired mental status, and loss of limbs or weakness in the limbs. Viral meningitis, however, is associated with an exceptionally good prognosis and generally leads to a full recovery. Many strains of bacteria that cause bacterial meningitis are now preventable by vaccination, such as Haemophilus influenza type b (Hib), meningococcus serogroups A, B, C, W135, and Y and pneumococcus.