Overview

Meningitis is swelling or inflammation of the fluid and membrane (meninges) surrounding the brain and spinal cord. Swelling due to meningitis usually causes signs and symptoms such as headache, fever, and stiff shoulders.

Viral infections cause most cases of meningitis in the United States, but a bacterial, parasite and fungal infections are other causes. Some cases of meningitis get better within a few weeks without treatment. Others can be life-threatening and require urgent treatment with antibiotics. If you suspect that someone has meningitis, see a doctor right away. Early treatment of bacterial meningitis can stop serious risks.

 Diagnosis

Your doctor or pediatrician can diagnose meningitis based on your medical history, physical examination, and specific diagnostic tests. The doctor may look for infections around the head, ears, throat, and skin along the spine during the trial. You or your child may take the following diagnostic tests:

 Blood culture

Place a blood sample in a special dish to see if microorganisms, mainly bacteria, are growing in it. You can also place the piece on a slide and stain it (Gram stain) and then look into a microscope for the presence of bacteria.

 Imaging

Computer tomography (CT) or magnetic resonance imaging (MRI) of the head might show swelling or inflammation. X-rays or CT scans of the chest might also indicate an infection associated with meningitis.

Spinal puncture (lumbar puncture)

A definitive diagnosis of meningitis requires a lumbar puncture to collect cerebrospinal fluid (CSF). CSF in people with meningitis often has low levels of sugar (glucose), showing an increase in white blood cell count and protein. CSF analysis also helps doctors determine which bacteria caused meningitis. When a doctor suspects viral meningitis, you may order a DNA-based test called polymerase chain reaction (PCR) amplification or a test that looks for antibodies to a particular virus to identify the specific cause and the correct one to determine treatment.

Treatment

Treatment of various types of meningitis:

Bacterial meningitis

Acute bacterial meningitis requires intravenous administration of antibiotics and, in some cases, immediate treatment with corticosteroids. This ensures recovery and reduces the risk of complications such as cerebral edema and seizures. The antibiotic or mixture of antibiotics depends on the bacteria that cause the infection.

Doctors may recommend broad-spectrum antibiotics until the exact cause of meningitis can be identified. Your doctor may drain the infected sinuses or mastoid process (the bone behind the outer ear that leads to the middle ear).

Viral meningitis

Antibiotics cannot cure viral meningitis and, in most cases, improve spontaneously in a few weeks. Doctors may prescribe corticosteroids to reduce swelling in the brain and anticonvulsants to control seizures. If the herpes virus causes meningitis, antiviral drugs are available.

Other types of meningitis

If the cause of meningitis is unknown, the doctor may start treatment with antivirals and antibiotics while the cause is identified. Treatment of chronic meningitis depends on the underlying cause. Antifungal drugs can treat fungal meningitis, and certain antibiotic combinations can treat tuberculous meningitis.

However, these drugs could cause serious side effects, delaying treatment until the lab confirms that the cause is a fungus. Non-infectious meningitis can be treated with corticosteroids due to allergic reactions or autoimmune diseases. In some cases, the symptoms resolve spontaneously, and no treatment is needed. Cancer-related meningitis is a cure for certain cancers.

Preparing for the treatment

Depending on the cause, meningitis can be life-threatening. If you have symptoms of bacterial meningitis, go to the emergency room and tell your health care staff that you may have meningitis. If you don’t know what you have to do, ask your doctor to make an appointment, and prepare for your visit with the doctor in the following ways:

 What you can do

•  Please observe the restrictions before and after booking. Ask in advance if you need to do anything.
• Restrict your diet. Also, ask if you need to stay in the clinic for post-test observations.
• Write down any symptoms, such as changes in mood, thoughts, or behavior.
• Keep in mind when each sign appears and if you have any symptoms like a cold or flu.
• Mention crucial personal information such as recent trips, vacations, and animal interactions.
•  If you’re a college student, your doctor will likely ask questions about similar signs or symptoms in your roommates.
• Your doctor might also want to know your history of vaccinations.
• Make a list of all medicines, vitamins, or supplements you’re taking.
• Take a family member or friend along. Meningitis can be a medical emergency. Take with you someone who can help you remember all the information from your doctor and can be with you if necessary.

For meningitis, some initial questions to ask your doctor include:

• What kinds of tests do I need?
• What treatment do you recommend?
• Am I at risk of long-term complications?
• What can I do if my condition is not treatable with antibiotics to help my body recover?
• What is the chance for my family? Should they take preventive medication?

What to expect from your doctor

Your doctor would likely ask you some questions, such as:

•  When did you start experiencing symptoms?

• How severe are your symptoms?
•  Do they seem to be getting worse?
•  Does anything seem to improve your symptoms?
• Have you ever been in contact with someone with meningitis?

•  Does anyone in your family have similar symptoms?
•  What is your vaccination history?
•  Do you have any other health problems, including allergies to certain medications?

Prevention tips:

Common bacteria or viruses that can cause meningitis can be spread by coughing, sneezing, kissing, or sharing kitchen utensils, toothbrushes, or cigarettes. The following steps can help prevent meningitis:

Handwashing: Hand washing helps prevent the spread of germs. Teach children to wash their hands often, especially before eating and after using the washroom, in crowded public places, or petting animals. Teach them how to clean and wash their hands vigorously and thoroughly.

Practice good hygiene: Do not share drinks, food, straws, cooking utensils, lip balm, or toothbrushes. Instruct children and adolescents to avoid sharing these items.

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

Cover your mouth: Cover your mouth and nose when you need to cough or sneeze. If you are pregnant, pay attention to your diet.

Avoid cheeses made from unpasteurized milk.

Choose cheeses that are clearly labeled as made with pasteurized milk.

Vaccination

Some forms of bacterial meningitis can be prevented with the following vaccines:

 Haemophilus influenza type b (Hib) vaccine

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend this vaccine for babies from about two months of age. This vaccine is also recommended for confident adults with sickle cell disease or AIDS and people who do not have a spleen.

Pneumococcal conjugate vaccine (PCV13)

This vaccine is also part of the routine immunization schedule recommended by WHO and CDC for children under two years of age. Additional doses are recommended for children 2 to 5 years of age who are at high risk for pneumococcal disease, including children with chronic heart, lung disease, or cancer.

Children and adults who need protection against pneumococcal bacteria can receive this vaccine. CDC recommends PPSV23 vaccination for all adults 65 years of age; for young adults and children two years of age and older with weakened immune systems or chronic conditions such as heart disease, diabetes, or sickle cell disease; and for anyone without a spleen.

Meningococcal conjugate vaccine.

The CDC recommends that children 11 to 12 get a single dose, with a booster shot at age 16. If the vaccine is given for the first time between 13 and 15, a booster shot at age 16 is recommended— for ages 16 to 18. No champion is needed if the first hit is 16 or older.