An overview of Meningitis

Meningitis is an inflammation of the area surrounding your brain and spinal cord (meninges). It’s sometimes called spinal meningitis.

Your meninges protect your brain and spinal cord from injury and provide support and structure. They contain nerves, blood vessels and protective fluid (cerebrospinal fluid).

Infectious diseases, like viruses and bacteria, and non-infectious conditions, like cancer or head injuries, can cause meningitis.

The difference between meningitis and encephalitis is the location of the inflammation. Meningitis is an inflammation of the protective lining of the brain and spinal cord and encephalitis is an inflammation of the brain itself.

Bacterial meningitis : Bacteria that enter the bloodstream and travel to the brain and spinal cord cause bacterial meningitis. But bacterial meningitis also can occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or — rarely — some surgeries.

Viral meningitis : Viral meningitis is usually mild and often clears on its own. Most cases in the United States are caused by a group of viruses known as enteroviruses. They're most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps virus, West Nile virus and others also can cause viral meningitis.

Chronic meningitis : When meningitis has lasted a month or more, it’s called chronic meningitis. It can be caused by slow-growing organisms such as fungi and Mycobacterium tuberculosis. They invade the membranes and fluid surrounding the brain.

Fungal meningitis : Meningitis caused by fungi is rare, but people can get it by inhaling fungal spores from the environment. People with certain medical conditions, like diabetes, cancer, or HIV, are at higher risk of fungal meningitis.

Parasitic meningitis : Meningitis caused by certain parasites is called eosinophilic meningitis or eosinophilic meningoencephalitis (EM). Various parasites can cause meningitis or can affect the brain or nervous system in other ways.

Amebic Meningitis : Primary amebic meningoencephalitis (PAM) is a rare and devastating infection of the brain caused by Naegleria fowleri. Naegleria fowleri is a free-living microscopic ameba that lives in warm water and soil.

Non-Infectious Meningitis : Sometimes cancers, systemic lupus erythematosus (lupus), certain drugs, head injury, and brain surgery can cause meningitis.

Each type of meningitis has a slightly different cause, but each ultimately acts in the same way: A bacterium, fungus, virus, or parasite spreads through the body (via the bloodstream, nerve endings, or even a dormant reactivation in the nervous system) until it reaches the brain, or spinal cord. There, it sets up in the lining or fluids around these vital body parts and starts developing into a more advanced infection.

Non-infectious meningitis is the result of a physical injury or other condition; it doesn’t involve an infection.

Symptoms of meningitis can be different in babies than in children and adults.

Possible symptoms in anyone older than the age of 2 years include:

1. Confusion or trouble concentrating.

2. Seizures.

3. Sudden high fever.

4. Stiff neck.

5. Severe headache.

6. Nausea or vomiting.

7. Sleepiness or trouble waking.

8. Sleepiness or trouble waking.

9. Skin rash in some cases, such as in meningococcal meningitis.

10. No appetite or thirst.

Signs in newborns

1. Vomiting.

2. Poor feeding.

3. Being very sleepy or irritable.

4. High fever.

5. Constant crying.

6. Trouble waking from sleep.

7. Being inactive or sluggish.

8. Not waking to eat.

9. Stiffness in the body and neck.

10. A bulge in the soft spot on top of the baby's head.

Your healthcare provider will diagnose meningitis by doing a physical exam, asking you about your symptoms and testing your cerebrospinal fluid (CSF). They may also ask you if you’ve been around anyone with certain illnesses or traveled recently, get a blood or poop (stool) sample, swab your nose or throat or get imaging of your brain.

Your treatment is determined by the cause of your meningitis.

Bacterial meningitis requires immediate hospitalization. Early diagnosis and treatment will prevent brain damage and death. Bacterial meningitis is treated with intravenous antibiotics and steroids. There’s no specific antibiotic for bacterial meningitis. It depends on the bacteria involved.

Fungal meningitis is treated with antifungal agents.

Parasitic meningitis may either involve treating just the symptoms or attempting to treat the infection directly. Depending on the cause, this type may get better without antibiotic treatment. If it worsens, however, your doctor may try to treat the infection itself.

Viral meningitis may resolve on its own, but some causes of viral meningitis will be treated with intravenous antiviral medications.

Chronic meningitis is treated by treating the underlying cause first, such as a fungal infection or an autoimmune issue such as rheumatoid arthritis.

1. Skipping vaccinations : Risk rises for anyone who hasn't completed the recommended childhood or adult vaccination schedule.

2. Age : Most cases of viral meningitis occur in children younger than age 5 years. Bacterial meningitis is common in those under age 20.

3. Living in a community setting : College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at greater risk of meningococcal meningitis. This is probably because the bacterium is spread through the respiratory route, and spreads quickly through large groups.

4. Pregnancy : Pregnancy increases the risk of an infection caused by listeria bacteria, which also may cause meningitis. The infection increases the risk of miscarriage, stillbirth and premature delivery.

5. Weakened immune system : AIDS, alcohol use disorder, diabetes, use of immunosuppressant drugs and other factors that affect your immune system increase the risk of meningitis. Having a spleen removed also increases risk. People without a spleen should get vaccinated to lower the risk.

Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette.

These steps can help prevent meningitis:

1. Wash your hands : Careful hand-washing helps prevent the spread of germs. Teach children to wash their hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. Show them how to thoroughly wash and rinse their hands.

2. Practice good hygiene : Don't share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Teach children and teens to avoid sharing these items too.

3. Stay healthy : Maintain your immune system by getting enough rest, exercising regularly, and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.

4. Cover your mouth : When you need to cough or sneeze, be sure to cover your mouth and nose.

5. If you're pregnant, take care with food : Reduce your risk of a listeria infection by cooking meat, including hot dogs and deli meat, to 165 degrees Fahrenheit (74 degrees Celsius). Avoid cheeses made from unpasteurized milk. Choose cheeses that are clearly labeled as being made with pasteurized milk.