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Things to Know About Meningitis

By Edited Nov 11, 2015 0 2

What is meningitis? Meningitis is an inflammation of the membrane, called meninges, surrounding the spinal cord and brain. The disease can be mild or it can be life-threatening.  Because of the possibility of death, it is always, at least initially, considered a medical emergency.

Causes of Meningitis

Meningitis is usually caused by:[4]

  • a viral infection
  • a bacterial infection that started off in some other part of the body
  • a fungal infection
  •  non-infectious causes

Bacterial meningitis. The bacterial type of the infection is the one to cause the most concern, for it is this one that can be deadly.  This infection needs immediate medical attention because death can occur within hours.[3]  Acute bacterial meningitis most often occurs when the bacterium gets in the bloodstream and travels to the brain.[4]  The illness can be spread when infected people cough or sneeze.  There are several strains of bacteria which cause the illness:[4]

  • Streptococcus pneumoniae (pneumococcus) is the most common bacterium in the United States.  It usually causes pneumonia or ear or sinus infections.
  • Neisseria meningitidis (meningococcus) is another common type. This one usually
    Brain infected with Meningitis; Photo courtesy of the U.S. CDC, Source: Wikimedia Commons
    occurs when bacteria from an upper respiratory infection enters the bloodstream. It is highly contagious and affects mostly teenagers and young adults.
  • Haemophilus influenzae (haemophilus) is one that used to be the most common in children; however, a vaccine routinely given as part of childhood immunizations in the United States has greatly reduced the number of instances.
  • Listeria monocytogenes (listeria) bacteria is found in soft cheeses, luncheon meat, and hot dogs.  Most healthy people exposed to this type of bacteria don’t become ill; however pregnant women, older adults and those with weakened immune systems are more susceptible to it with the latter being the most vulnerable. An infection from this bacterium in the late stages of a pregnancy can cause the baby to be stillborn or succumb to death shortly after birth.

Viral meningitis. This type of the illness causes more cases than does the bacteria type. It is usually mild and clears on its own. Enteroviruses are responsible for most cases of this type in the United States and tend to spread in late summer and early fall.  Other viruses causing meningitis include mumps, West Nile, HIV, and herpes simplex.

Chronic meningitis.  This type occurs when the membranes and fluid of the brain are invaded by slow-growing organisms.  It develops over two or more weeks and the symptoms are similar to acute meningitis.

Fungal meningitis. This one is relatively rare and causes chronic meningitis.  Sometimes it mimics the acute bacterial form, but it isn’t contagious.  If not treated with an antifungal medication, this type is deadly. 

 

Infection Causing Fungi; Photo courtesy of the U.S. CDC, Source: Wikimedia Commons

Non-infectious causes. Sometimes meningitis can be caused by chemical reactions, some types of cancer, allergies, inflammatory diseases such as sarcoidosis, and some medications.

Symptoms of Meningitis

Because the early signs of meningitis are so good at mimicking the flu, it is important to pay close attention to the progress of the symptoms and seek medical attention when symptoms become worse.  The symptoms for bacterial meningitis can develop quickly over several hours and death can occur in a matter of days or even hours.  [4]  Anyone over the age of two may experience the following symptoms:[4]

  •  Sudden high fever
  • Severe headache that isn't easily confused with other types of headache
  • Stiff neck
  • Vomiting or nausea with headache
  • Confusion or difficulty concentrating
  • Seizures
  • Sleepiness or difficulty waking up
  • Sensitivity to light
  • Lack of interest in drinking and eating
  • Skin rash in some cases, such as in meningococcal meningitis

Young Boy with Epidemic Meninigitis; Photographer unknown, Source: Wikimedia Commons

Newborns and infants may exhibit the following symptoms:[4]

  • High fever
  • Constant crying
  • Excessive sleepiness or irritability
  • Inactivity or sluggishness
  • Poor feeding
  • A bulge in the soft spot on top of a baby's head (fontanel)
  • Stiffness in a baby's body and neck

In addition, infants may be difficult to comfort and cry harder when picked up if they have contracted meningitis.[4]

Sarah's Story - Meningococcal meningitis

 

Diagnosing Meningitis

While viral meningitis can clear on its own, there is no way to determine which type of the illness a person has unless tests are conducted.  A nurse will first make note if the following symptoms appear:[2]

  • Fast heart rate
  • Fever
  • Mental status changes
  • Stiff neck

The doctor may examine for infections around the ears and throat, head and the skin along the spine. If meningitis is suspected further tests may be conducted.  These may include a blood sample, x-rays and CT scans, and a spinal tap.

Lumbar Puncture; Photographer unknown, Source: Wikimedia Commons
The spinal tap, also called a lumbar puncture,  is the definitive test for meningitis.[4] Cerebrospinal fluid (CSF) is collected and analyzed.  Those with the illness usually show low a glucose level and an increase in protein and white blood cell count.  The analysis also helps the doctor determine which bacterium is causing the illness.  If a virus is suspected, the doctor may conduct a DNA-based test called a polymerase chain reaction (PCR) amplification.[4]  Other tests can be ordered to check for specific viruses. 

Treatment for Meningitis

Treatment for the meningitis depends upon which type a person has.[2]  Acute infection requires quick treatment of antibiotics given intravenously.[4]  In recent years, cortisone medications have been administered with good results.[4]  The particular antibiotics depend upon which bacteria are causing the infection.  In addition, if the sinuses or mastoids are infected, the doctor may drain them.

Treatment for viral meningitis differs because antibiotics don’t cure the illness.  For mild cases of the viral infection, doctors prescribe:[4]

  • Bed rest
  • Plenty of fluids
  • Over-the-counter pain medication

Most viral infections will cure themselves over the course of a couple of weeks.  Fungal meningitis is treated with anti-fungal medications and chronic meningitis is treated based on the underlying cause.[4]  Non-infectious types of the illness is treated with cortisone medication when the cause is related to allergies or an autoimmune disease.  Treatment for cancer related causes of the illness focus on the particular cancer.[4]

If the meningitis goes untreated, besides possible death, other complications include:[2]

  • Hearing loss
  • Seizures
  • Brain damage
  • Fluid build-up between the skull and the brain
  •  Hydrocephalus ( "water on the brain;’ fluid build-up inside the skull causes the brain to swell)

Infected Brain; Photo courtesy of the U.S. CDC, Source: Wikimedia Commons

Scientists continue to research vaccines and medicines for treating meningitis.  In 2002 there was some evidence steroids could improve the prognosis of bacterial meningitis.[1]  Also, vaccines targeting some of the bacteria causing the illness are effective in the long-term and reduce the occurrence of the illness significantly.[1]

 

The copyright of the article Things to Know About Meningitis” is owned by Cheryl Weldon and permission to republish in print or online must be granted by the author in writing.

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Comments

Apr 13, 2013 4:26am
butterflysolomon
Great article, when visiting my mom in the hospital I saw a teenage girl in a coma because meningitus attacked her brain. It is very serious, thanks for the great article.
Apr 13, 2013 10:03am
weianow
Thank you for the kind words. Yes, this is a nasty illness. I learned a lot researching it.
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Bibliography

  1. "Meningitis." Wikipedia. 02/04/2013 <Web >
  2. "Meningitis." PubMed Health. 02/04/2013 <Web >
  3. "Understanding Meningitis-The Basics." WebMD. 02/04/2013 <Web >
  4. Mayo Clinic Staff "Meningitis." Mayo Clinic. 02/04/2013 <Web >

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