Meningitis

Overview

The meninges are thin layers that cover the brain and spinal cord. Infection makes them swell, which can damage the brain and nerves.

Viruses cause most meningitis and people usually get better on their own. Bacteria cause the most dangerous kind, which can kill within hours or cause hearing loss and brain damage. Fungi and parasites are rare causes.

Symptoms

Symptoms can come on over hours to a day or two.

• Fever
• Bad headache
• Stiff neck or neck pain
• Sensitivity to light

Less common

• Nausea or vomiting
• Confusion or not acting like themselves
• Very sleepy or hard to wake
• A rash of small red or purple spots that don't fade when pressed
• Seizures

How it usually goes

• Babies: Fever, crying that won't stop, poor feeding, a bulging soft spot, or being very sleepy or floppy. Babies may not have a stiff neck.

When to get medical care

Causes

Common causes are viruses (like enteroviruses) and bacteria (like pneumococcus, meningococcus, Hib, and group B strep in newborns). Some bacteria spread through coughing, kissing, or living closely together.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: eating raw, undercooked snails, slugs, produce they crawled on, or usually your own gut bacteria.
• Washing hands often and staying home when sick help protect others.

Who is more likely to get it

• Babies and young children
• Teens and young adults, especially in dorms
• Missed vaccines
• Weak immune system or no spleen
• Travel to parts of Africa

Possible complications

• Hearing loss
• Sepsis: Blood infection
• Brain damage or seizures

Diagnosis

Doctors test quickly and often start antibiotics before results come back.

Questions you may be asked

• When symptoms started
• Vaccines you've had
• Contact with someone who had meningitis

The exam

They'll check for a stiff neck, rash, alertness, and nerve problems.

Tests

Common tests:

• Spinal tap (lumbar puncture): A needle takes a small amount of spinal fluid to look for germs.
• Blood tests: Look for infection in the blood.
• CT scan: Sometimes done first to check for brain swelling.

Treatment

Bacterial meningitis is treated in the hospital with IV antibiotics right away.

Self-care

• Call 911 or go to the ER for fever with a stiff neck, confusion, or a rash
• For viral meningitis, rest, fluids, and pain relievers help most people recover in 7 to 10 days

Medicines

Treatment depends on the cause.

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Steroids may be given to lower swelling. Close contacts of someone with some kinds of bacterial meningitis may need antibiotics to prevent it.

Prevention

Vaccines prevent most bacterial meningitis:

• Pneumococcal, Hib, and meningococcal vaccines
• MMR and chickenpox vaccines
• Wash hands and don't share drinks or utensils
• Testing for group B strep in pregnancy

Which doctor treats this

• Emergency doctors treat it first, in the ER.
• They may send you to a neurologist (brain and nerve doctor).

Back to school, work, or sports

• Stay home until you've had no fever for 24 hours without fever medicine and you're feeling better.
• For the next 5 days, wash hands often and wear a mask around others.

Children, pregnancy, and older adults

• Babies: Signs can be subtle. Any fever in a baby under 3 months needs care right away.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Learn CPR. Many hospitals and the Red Cross offer classes.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Most people with viral meningitis recover fully. Bacterial meningitis can be deadly, but fast treatment saves most people. Some have lasting problems like hearing loss.

Getting ready for your visit

Bring your vaccine records.

What to bring

• Vaccine records
• Names of close contacts if you've been diagnosed

Questions to ask

• Is it bacterial or viral?
• Do my family members need medicine?
• Will I need a hearing test?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Meningitis