Meningitis

Choose the content to read

• What is meningitis?
• How many types of meningitis?
• What causes meningitis?
• What are the symptoms of meningitis?
• What are the complications of meningitis?
• What are the risk factors for a meningitis?
• How is meningitis diagnosed?
• How is meningitis treated?
• What is the prevention of meningitis?
• FAQ

Meningitis

Meningitis is an inflammation of the meninges, the protective membranes surrounding your brain and spinal cord. Bacterial, viral, fungal, and parasitic infections and non-infectious causes can cause meningitis. Symptoms of meningitis include fever, severe headache, stiff neck, nausea, vomiting, and light sensitivity. If you suspect that you have meningitis, it is advisable to seek immediate medical attention.

What is meningitis?

Meningitis is an inflammation of the membranes surrounding your brain and spinal cord, called meninges. Meninges protect your brain and spinal cord from injury, providing support and structure. They contain nerves, blood vessels, and cerebrospinal fluid (CSF). 

Meningitis can be caused by:

• Infectious diseases from viruses and bacteria which can spread from one to another. 
• Non-infectious conditions such as cancer or head injuries

In addition, the disease can cause severe and painful symptoms, therefore, it is advisable not to wait until these symptoms worsen before seeking medical attention.

Types of meningitis

The naming system of meningitis depends on the cause and duration of symptoms. They are as follows:

• Viral meningitis. This type of meningitis is usually mild and can resolve on its own.
• Bacterial meningitis.
• Fungal meningitis.
• Parasitic meningitis. 
• Primary amebic meningoencephalitis (PAM): This rare meningitis is due to brain-eating amoeba or Naegleria fowleri.
• Drug-induced aseptic meningitis (DIAM): Certain medications can cause this type of meningitis; NSAIDs and antibiotics are the most common causes.
• Chronic meningitis. The condition becomes chronic meningitis when it has lasted a month or more.
• Acute meningitis. This type of meningitis comes with severe and sudden symptoms.

What causes meningitis?

The cause of meningitis can be both infectious diseases and non-infectious conditions. Infectious causes usually are due to bacteria, viruses, fungi, parasites, and the ameba Naegleria fowleri. Non-infectious causes include inflammatory diseases, certain medications, some types of cancer, and chemical reactions. In addition, distinct meningitis types have different causes, which can be categorized as follows.

Causes of bacterial meningitis

• E. coli.
• Group B Streptococcus.
• Mycobacterium tuberculosis.
• Streptococcus pneumonia.
• Listeria monocytogenes.
• Haemophilus influenzae.
• Neisseria meningitides.

Causes of viral meningitis

• Mumps.
• Lymphocytic choriomeningitis virus.
• Non-polio enteroviruses.
• Herpesviruses.
• Measles.
• Arboviruses, such as West Nile virus.
• Influenza.

Causes of fungal meningitis

• Coccidioides.

Causes of parasitic meningitis

• Angiostrongylus Cantonensis.
• Baylisascaris Procyonis.
• Gnathostoma Spinigerum.

Causes of amebic meningitis

• Naegleria fowleri

Causes of non-infectious meningitis

• Systemic lupus erythematosus (lupus).
• NSAIDs and antibiotics.
• Head injuries.
• Brain surgery.
• Certain types of cancer.
• Chemical reactions.

What are the symptoms of meningitis?

Early symptoms of meningitis can be flu-like. Symptoms may develop over several hours or over a few days and worsen rapidly. In addition, symptoms in infants differ from those in children and adults.

Signs and Symptoms of meningitis in infants include:

• Bulging fontanelle of the head.
• Being sluggish due to low energy.
• Being sleepy or having difficulty waking up.
• Refusal to feed.
• Constant crying.
• Vomiting.

Symptoms in children and adults include:

• A sudden high fever.
• Neck stiffness.
• Severe headache.
• Nausea or vomiting.
• Seizures. 
• Confusion or trouble concentrating.
• Sleepiness or trouble waking up.
• Sensitivity to light.
• Lack of appetite or thirst.
• Skin rash in some types, such as meningococcal meningitis.

What are the complications of meningitis?

Complications of meningitis can arise if the condition has been left untreated. The longer the condition is untreated, the higher the risk of developing the following complications:

• Low blood pressure.
• Trouble walking.
• Learning disabilities.
• Hearing loss.
• Memory problems.
• Seizures.
• Kidney failure.
• Brain damage.
• Death.

Risk factors

Factors that can lead to an increased risk of meningitis include:

• Age: Bacterial meningitis is common in people under 20; almost 70% of bacterial meningitis cases occur in children under 5.
• Living in a crowded setting: Bacterial causes of meningitis can be spread easily in crowded areas.
• Under vaccination: People who have not completed childhood or adult vaccination schedule may have an increased risk of meningitis. 
• Pregnancy: Pregnancy increases the risk of infection that can give rise to
• Weakened immunity: Disorders such as AIDS, diabetes, alcoholism, and immunosuppressants can diminish your immune system, increasing the risk of meningitis.

How is meningitis diagnosed?

Medical history, a physical exam, and tests are involved in diagnosing meningitis. During the test, your doctor may check for signs of infection around the ears, head, throat, and skin along the spine.

Common tests used to diagnose meningitis include:

• Blood tests and blood cultures: A blood test helps detect infection. For bacterial blood cultures, a blood sample will be obtained and incubated in a culture media in a petri dish to see if it grows bacteria. Microscopic examination of blood samples to detect bacteria may be helpful.
• Medical imaging. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans to look for swelling or inflammation in the head can aid diagnosis. In addition, the scans of the chest or sinuses may show an infection that can be related to meningitis.
• Lumbar puncture or spinal tap. This technique involves inserting a needle into the lower back into the spinal canal. A sample of cerebrospinal fluid surrounding the brain and spinal cord is removed and tested for infection or bacterium.

If suspecting viral meningitis, a DNA-based test known as a polymerase chain reaction (PCR) may be required. Another option is a test to check antibodies against certain viruses, allowing a physician to determine the specific cause and proper treatment.

How is meningitis treated?

Due to the diverse nature of meningitis causes, each type requires a tailored treatment approach. Early intervention, regardless of the severity, is crucial for optimal recovery.

Bacterial meningitis

Intravenous antibiotics are the treatment for bacterial meningitis. In addition to IV antibiotics, corticosteroids such as dexamethasone may be prescribed in some bacterial meningitis cases to attenuate inflammatory response to the bacterial invaders. Patients with acute bacterial meningitis must receive intravenous antibiotics or corticosteroids immediately. This prompt treatment hastens recovery and reduces the risk of developing complications.

Viral meningitis

Most viral meningitis cases improve on their own within weeks. Treatment of mild cases of viral meningitis may include:

• Get plenty of rest.
• Staying hydrated.
• Pain medications to help alleviate fever and body aches.

Keep in mind that antibiotics cannot cure meningitis caused by viral infections. However, your doctor may prescribe corticosteroids to reduce swelling in the brain and a medicine to help manage seizures. For meningitis caused by herpes virus or influenza, antiviral agents are available for treatment.

Other types of meningitis

For chronic meningitis, the treatment modality depends on its underlying cause. Antifungal medications can help treat fungal meningitis. In some cases, no treatment is required, given that the condition can resolve itself. To treat cancer-related meningitis, therapy for specific cancers is indicated. Noninfectious meningitis caused by allergic reactions or autoimmune diseases is treatable with corticosteroid medicines or immunosuppressants.

What is the prevention of meningitis?

Preventive steps to protect yourself from infectious causes of meningitis include:

• Wash your hands. Handwashing can prevent the spread of pathogens that may lead to meningitis.
• Practice good hygiene. Do not share drinks, foods, or personal belongings such as eating utensils, toothbrushes, or lip balm with anyone else.
• Staying healthy. Getting enough sleep, exercising regularly, and eating a healthy balanced diet with plenty of fresh fruits, vegetables, and whole grains can help you maintain your immunity.
• Cover your mouth. Make sure to cover your mouth and nose when coughing or sneezing to reduce the spread of germs.
• Follow a doctor’s instructions on what food to avoid, especially during pregnancy. Cook or freeze food to safe temperatures. Avoid unpasteurized milk or cheeses made from unpasteurized milk.

Vaccinations

Apart from the abovementioned steps, vaccinations can help prevent specific bacterial meningitis. Examples of vaccinations that can help prevent bacterial infections leading to meningitis include:

• Haemophilus influenza type b vaccine (Hib): The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recommend this type of vaccine for children aged 2 and older, adults with sickle cell anemia and AIDS, and those who have no spleen.
• Pneumococcal conjugate vaccine (PCV13 and PCV15): These vaccines are CDC’s recommended vaccination schedule for children under 2 years old. In addition, children between 2-5 years old who are at risk of developing pneumococcal disease and adults with chronic heart and lung disease should receive additional doses. Moreover, adults over 60 years old should receive the vaccination.
• Pneumococcal polysaccharide vaccine (PPSV23) is suitable for adults and older children who need prevention against pneumococcal bacteria. CDC recommends this vaccine for older adults over 60, teenagers, and children aged 2 and over with weakened immunity or chronic diseases like heart disease, diabetes, or sickle cell disease, and those with no spleen.
• Meningococcal conjugate vaccine (MenACWY): The CDC recommends children between 11-12 receive 1 dose of this vaccine and booster shots when they turn 16. Administration of the first dose of the vaccine at 13-15 years of age necessitates a subsequent booster dose at 16-18 years old. Conversely, no booster dose is required if receiving the initial dose at 16. In addition, adults who are at risk, such as AIDS patients and those who live in crowded or military housings, should also get the vaccine.
• Serogroup B meningococcal vaccine (MenB): The CDC recommends that adults and children aged 10 and over with an elevated risk of contracting meningococcal disease receive this vaccine, including adults and children with sickle cell anemia and no spleen.

Preparing for your appointment

With potential severe complications, it is crucial to seek medical attention if you suspect that you have meningitis of any type. If you are not sure whether you have meningitis, follow these steps to prepare yourself before consulting a doctor.

• Ask what you should or should not do before and after the appointment. 
• Write down symptoms you experience.
• Write down key personal information, including your recent vacations, activities, or interactions with animals. 
• Write down the medicines you are taking. 
• Bring a family member or friend with you. They can help note necessary information you may receive and stay with you if needed.
• Write down questions to ask a doctor.

FAQ

• Can a test for meningitis be performed at home?
  Currently, there is no home testing for meningitis. If you have doubts regarding meningitis, you should see a specialist for a prompt and accurate diagnosis.

A note from MedPark's doctor

Although meningitis is an uncommon disease, its severity can escalate in a brief period. Prompt treatment can ensure a high chance of a full recovery. In addition, it is highly advisable to seek immediate medical attention if symptoms of meningitis develop.