Meningitis: Symptoms, Diagnosis, & Treatment

What Is Meningitis?

Meningitis occurs when the membranes surrounding the brain and spinal cord, known as the meninges, become inflamed. Most commonly, meningitis occurs due to a viral infection; however, meningitis can occur due to a bacterial or fungal infection.

The trademark symptoms of meningitis, which occur due to swelling in the brain and spinal cord membranes, include a severe headache, high fever, and a stiff neck. Meningitis can occur in a person of any age, but since it spreads quickly among people who live in close contact, it’s more common in children, teenagers, and college students.

There are several types of meningitis, and symptoms and causes can vary among them. Some cases, especially bacterial meningitis, are extremely important to treat quickly. Viral meningitis usually clears on its own in about ten days. Bacterial meningitis is more serious and severe, but tends to improve with medical treatment.

Viral meningitis

Most commonly, meningitis is caused by a viral infection. Usually, viral meningitis is milder than other forms, and it often resolves on its own without treatment.

Bacterial meningitis

When bacteria enters the bloodstream and ends up in the brain or spinal cord, a person may get acute bacterial meningitis. This can also happen when bacteria enter the meninges through an ear or sinus infection or a skull fracture. More rarely, bacteria can invade the meninges after a surgery.

Bacterial meningitis is usually more serious than viral meningitis—if it’s not treated promptly, it can result in sepsis, a condition in which the body's response to infection causes injury to tissues and organs throughout the body—so it requires prompt treatment.

Fungal meningitis

Fungal meningitis is far more uncommon than viral and bacterial meningitis. Symptoms are similar to bacterial meningitis, but fungal meningitis won’t respond to antibiotics like bacterial forms. Fungal meningitis isn’t contagious. People who developed fungal meningitis often have weakened immune symptoms from some other cause.

Meningitis Symptoms

In its early stages, meningitis may seem like influenza. Symptoms of meningitis in people older than age two develop over the course of hours or a few days. Common symptoms are listed below:

• Sudden high fever
• Stiff neck
• Severe, unrelenting headache
• Nausea or vomiting
• Lack of energy
• Sensitivity to light
• Loss of appetite or thirst
• Confusion or difficulty concentrating
• Seizures
• Skin rash (in meningococcal meningitis)

Babies, including newborns and infants younger than two years of age, may exhibit the following signs of meningitis:

• High fever
• Inconsolable crying
• Extreme sleepiness
• Irritability
• Sluggishness or inactivity
• Poor feeding
• Stiffness in the body or neck
• A bulge in the fontanel, or the soft spot on top of a baby’s head

Causes of Meningitis

It’s most common for people to get meningitis as a result of a viral infection. The next most common cause is a bacterial infection, followed by fungal infections, which are far rarer.

Causes of viral meningitis

Most cases of viral meningitis, the mildest version of the illness, are caused by enteroviruses, which tend to spread in the late summer and early fall months in the United States. Other viruses can also cause viral meningitis, such as:

• Enteroviruses
• Herpes
• HIV
• Mumps
• West Nile virus

Causes of bacterial meningitis

There are many kinds of bacteria that can cause acute bacterial meningitis, including:

• Streptococcus pneumoniae (pneumococcus): which can also cause pneumonia, ear, or sinus infections.

• Neisseria meningitidis (meningococcus): which can also cause an upper respiratory infection.

• Haemophilus influenzae (haemophilus): which can also cause ear infections or pneumonia.

• Listeria monocytogenes (listeria): which can be found in unpasteurized cheeses, hot dogs, and deli meats.

Causes of fungal meningitis

Fungal meningitis can develop after a fungus spreads from somewhere else in the body to the brain or spinal cord. People contract fungal meningitis when they breathe in fungal spores which spread to their brain or spine. Some of the most common causes of fungal meningitis include:

• Cryptococcus: which lives in soil, on decaying wood, or in bird droppings.

• Histoplasma: which lives in environments that contain a high amount of bird or bat droppings.

• Blastomyces: which lives in moist soil, decaying wood, and leaves.

• Coccidioides: which lives in soil.

Other meningitis causes

Infections aren’t always the cause of Inflammation in the brain or spinal cord. Meningitis can also be caused by:

• Head injuries
• Drug allergies
• Systemic lupus erythematosus (lupus)
• Some types of cancer
• Inflammatory diseases like sarcoidosis, which causes tiny collections of inflammatory cells to grow in different parts of the body

Diagnosing Meningitis

Since cases of meningitis can have adverse health consequences, it’s important to seek medical care.

Your doctor will do an intake of your medical history, ask about your symptoms and do a physical exam of your head, ears, throat, and spine. He or she will be looking for any rashes, lumps, or unusual markings.

In some cases, your doctor may do any of the following tests to help with a diagnosis:

• Spinal tap: A spinal tap is the only test available to diagnose meningitis. A needle is placed in the lower back and spinal fluid is removed for testing. People with meningitis usually have a low glucose (sugar) level in their cerebrospinal fluid (CSF). They may also have an increased white blood cell count (indicating an infection) and an increased amount of protein. A spinal tap allows your doctor to collect and test CSF around your spine which can confirm the diagnosis and inform the best course of treatment.

• Imaging tests: Imaging tests such as a CT scan or MRI may be done of the head prior to spinal tap to confirm that there isn’t some other cause of the symptoms such as a mass or an abscess. However, a CT scan or MRI cannot diagnose meningitis.

• Blood tests: Your doctor will oftentimes order other blood tests which can support the diagnosis of meningitis. The doctor may order a CBC, which is a panel of tests which are used to check for infections. In addition, blood cultures may be ordered, which can yield the type of bacteria causing the infection if they show growth.

How to Treat Meningitis

Treatment of meningitis depends on the cause. The majority of viral meningitis cases resolve on their own within ten days. Some people may need hospital treatment for viral meningitis. For example, if someone is dehydrated, they may stay in the hospital to receive IV fluids. In milder cases, a doctor may encourage someone with viral meningitis to manage symptoms at home.

More serious cases of meningitis are more likely to require medical intervention and are curable with antibiotics. If a doctor diagnoses or suspects bacterial meningitis, he or she will likely start antibiotics as soon as possible. A provider may also give intravenous fluids to treat dehydration due to fever, sweating, vomiting, or loss of appetite.

If you were exposed to someone with bacterial meningitis, make sure you talk to your doctor, who might prescribe a dose of antibiotics as a preventative measure.

How to Prevent Meningitis

Vaccinations and common sense hygiene are the best ways to prevent contracting meningitis. Since meningitis can stem from other bacterial infections, some kinds of bacterial meningitis can be prevented with the following vaccines.

• Haemophilus influenzae type b (Hib) vaccine): As per the recommended schedule of vaccines, children in the U.S. receive this vaccine starting at around two months of age.

• Pneumococcal conjugate vaccine (PCV13): The PCV13 vaccine is also recommended for children younger than two years of age. Children at a higher risk for pneumococcal disease, an infection caused by a type of bacteria called Streptococcus pneumoniae, may receive additional doses between ages two and five.

• Pneumococcal polysaccharide vaccine (PPSV23): The Centers for Disease Control and Prevention (CDC) recommends the PPSV23 vaccine for all adults older than age 65, for younger adults and children age two and older who have weak immune systems or chronic illnesses such as heart disease, diabetes or sickle cell anemia, and for anyone who doesn't have a spleen.

• Meningococcal conjugate vaccine: The CDC recommends children ages 11-12 receive a meningococcal conjugate immunization, followed by a booster shot at around age 16. This vaccine may also be recommended to children between the ages of two months and ten years of age if they are at high risk of bacterial meningitis or have been exposed to someone with the disease.

Basic hygiene can also prevent the spread of meningitis, since it can be spread through coughing, sneezing, kissing, or sharing a toothbrush, cup, or eating utensils. To prevent meningitis, always:

• Wash your hands: Do this frequently and thoroughly, especially before eating or touching your face.

• Strengthen your immune system: Get ample rest, drink enough water, and eat a nutritious diet.

• Avoid certain foods if pregnant: Avoid eating unpasteurized cheese, all deli meat, and hot dogs unless the hot dogs are cooked to 165° F (74° C).

Meningitis Risk Factors and Complications

Typically, if meningitis is diagnosed and treated, it doesn’t cause long-term adverse effects. But some populations may need to be more careful. Certain people may be more susceptible to meningitis, including those who:

• Skip vaccinations
• Are younger than five years old (for viral meningitis) and under 20 (for bacterial meningitis)
• Live in a community setting, like a college, boarding school, or military base
• Are pregnant, since that increases the risk of listeriosis, a bacterial infection that can cause meningitis
• Have an immuno-compromising condition such as AIDS or diabetes
• Have had their spleen removed

If you suspect you or your child may have meningitis, prompt medical care is crucial. In some cases, meningitis can cause neurological (conditions related to the brain or spinal cord) effects, leading to complications such as:

• Hearing loss
• Learning disabilities
• Memory problems
• Seizures
• Brain damage
• Kidney failure
• Gait problems
• Shock
• Death

When to See a Doctor

Keep in mind that if it’s not treated, bacterial meningitis can be serious, even fatal. Talk to your physician or a doctor through K Health right away if you or your child have meningitis symptoms, including:

• Fever
• Severe headache
• Confusion
• Nausea and vomiting
• Stiff neck

You should also seek medical care if someone close to you, like a roommate, family member, or co-worker, has meningitis. Your doctor may recommend you take a preventative round of antibiotics.

How K Health Can Help

If you think you have meningitis, you should speak to a doctor. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.