Meningitis

Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.

Causes Symptoms Exams and Tests Treatment Outlook

The most common causes of meningitis are viral infections. These infections usually get better without treatment. Bacterial meningitis infections, however, are very serious. They may result in death or brain damage, even if treated. A lumbar puncture (or spinal tap) is required to determine the specific cause.

Meningitis may also be caused by:
Many types of viruses can cause meningitis:

Chemical irritation.
Medicine allergies.
Fungi.
Parasites.
Tumors.

Enteroviruses: These are viruses that also can cause intestinal illness.
Herpes viruses: These are the same viruses that can cause cold sores and genital herpes. However, people with cold sores or genital herpes do not have a higher chance of developing herpes meningitis.
Mumps virus: This virus causes a contagious disease that leads to painful swelling of the salivary glands. Meningitis is a complication of a mumps infection.

Fatigue is a common and bothersome symptom as MS progresses. It is often worse in the late afternoon.

Enteroviral meningitis occurs more often than bacterial meningitis and is milder. It usually occurs in the late summer and early fall. It most often affects children and adults under age 30.

Symptoms may include:
ymptoms usually come on quickly,
and may include:
Other symptoms that can occur
with this disease:
Numbness, tingling, or pain:
Other brain and nerve symptoms:
Sexual symptoms:
Speech and swallowing symptoms:

Headache.
Sensitivity to light (photophobia).
Slight fever.
Upset stomach and diarrhea.
Fatigue.

Fever and chills.
Mental status changes.
Nausea and vomiting.
Sensitivity to light.
Severe headache.
Stiff neck.

Agitation.
Bulging fontanelles in babies.
Decreased alertness.
Poor feeding or irritability in children.
Rapid breathing.
Unusual posture, with the head and neck arched backward (opisthotonos).

Facial pain
Painful muscle spasms
Tingling, crawling, or burning feeling in the arms and legs

Decreased attention span, poor judgment, and memory loss
Difficulty reasoning and solving problems
Depression or feelings of sadness
Dizziness and balance problems
Hearing loss

Problems with erections
Problems with vaginal lubrication

Slurred or difficult-to-understand speech
Trouble chewing and swallowing

You cannot tell if you have bacterial or viral meningitis by how you feel. Your health care provider must find out the cause. Go to a hospital emergency department right away if you think you have symptoms of meningitis.

Your provider will examine you. This may show:

Fast heart rate
Fever
Mental status changes
Stiff neck

If your provider thinks you have meningitis, a lumbar puncture (spinal tap) should be done to remove a sample of spinal fluid (cerebrospinal fluid, or CSF) for testing.

Other tests that may be done include:

Blood culture
Chest x-ray
CT scan of the head

Antibiotics are used to treat bacterial meningitis. Antibiotics do not treat viral meningitis. However, antiviral medicine may be given to those with herpes meningitis.

Other treatments will include:

Fluids through a vein (intravenous)
Medicines to treat symptoms, such as brain swelling, shock, and seizures

Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications.

Possible Complications When to Contact a
Medical Professional Prevention Alternative Names

Without prompt treatment, meningitis may result in the following:

Brain or neurologic damage
Buildup of fluid between the skull and brain (subdural effusion)
Hearing loss
Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus)
Seizures
Death

If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.

Certain vaccines can help prevent some types of bacterial meningitis:

Haemophilus vaccine (HiB vaccine) is given to children.
Pneumococcal vaccine is given to children and adults.
Meningococcal vaccine is given to children and adults; some communities hold vaccination campaigns after an outbreak of meningococcal meningitis.

Household members and others in close contact with people who have meningococcal meningitis should receive antibiotics to prevent becoming infected.

Meningitis – bacterial; Meningitis – viral; Meningitis – fungal; Meningitis – vaccine

References

Hasbun R, Van de Beek D, Brouwer MC, Tunkel AR. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.

Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 381.