Meningitis: What Do You Want to Know About?

Meningitis is an inflammation of the fluid and membranes (meninges) surrounding your brain and spinal cord.

The swelling from meningitis typically trigger signs and symptoms such as headache, fever and a stiff neck.

Meningitis is an inflammation of the meninges. The meninges are the three membranes that cover the brain and spinal cord. It can occur when fluid surrounding the meninges becomes infected.

The most common causes of meningitis are viral and bacterial infections. Other causes may include:

cancer
chemical irritation
fungi
drug allergies

Some viral and bacterial meningitis are contagious. They can be transmitted by coughing, sneezing, or close contact.

Most cases of meningitis are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Some cases may improve without treatment in a few weeks. Others can be life-threatening and require emergency antibiotic treatment.

Seek immediate medical care if you suspect that someone has meningitis. Early treatment can prevent serious complications.

Symptoms of Meningitis

Early symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.

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

Sudden high fever
Stiff neck
Severe headache that seems different from normal
Headache with nausea or vomiting
Confusion or difficulty concentrating
Seizures
Sleepiness or difficulty waking
Sensitivity to light
No appetite or thirst
Skin rash (sometimes, such as in meningococcal meningitis)

Signs in newborns

Newborns and infants may show these signs:

High fever
Constant crying
Excessive sleepiness or irritability
Difficulty waking from sleep
Inactivity or sluggishness
Not waking to eat
Poor feeding
Vomiting
A bulge in the soft spot on top of a baby’s head (fontanel)
Stiffness in the body and neck

Infants with meningitis may be difficult to comfort, and may even cry harder when held.

When to see a doctor

Seek immediate medical care if you or someone in your family has signs or symptoms, such as:

Fever
Severe, unrelenting headache
Confusion
Vomiting
Stiff neck

Bacterial meningitis is serious and can be fatal within days without prompt antibiotic treatment. Delayed treatment increases the risk of permanent brain damage or death.

It’s also important to talk to your doctor if a family member or someone you live or work with has meningitis. You may need to take medications to prevent getting the infection.

What are the causes?

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 bloodstream 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.

However, non-infectious meningitis is the result of a physical injury or other condition; it doesn't involve an infection.

Types of meningitis

Viral and bacterial infections are the most common causes of meningitis. There are several other forms of meningitis. Examples include cryptococcal, which is caused by a fungal infection, and carcinomatous, which is cancer- related. And these types are less common.

Viral meningitis

Viral meningitis is the most common type of meningitis. Viruses in the Enterovirus categories cause 85 percent of cases. These are more common during the summer and fall, and they include:

coxsackievirus A
coxsackievirus B
echoviruses

Viruses in the Enterovirus categories cause about 10 to 15 million infections per year, but only a small percentage of people who get infected will develop meningitis.

Other viruses can cause meningitis. These include:

West Nile virus
influenza
mumps
HIV
measles
herpes viruses
Coltivirus , which causes Colorado tick fever

Viral meningitis typically goes away without treatment. But treatment are needed in some cases.

Bacterial meningitis

Bacterial meningitis is contagious and caused by infection from certain bacteria. It's fatal if left untreated. Between 5 to 40 percent of children and 20 to 50 percent of adults with this condition die. This is true even with proper treatment.

The most common types of bacteria that cause bacterial meningitis are:

Streptococcus pneumoniae , which is typically found in the respiratory tract, sinuses, and nasal cavity and can cause what's called pneumococcal meningitis
Neisseria meningitidis , which is spread through saliva and other respiratory fluids and causes what's called meningococcal meningitis
Haemophilus influenza , which can cause not only meningitis but infection of the blood, inflammation of the windpipe, cellulitis, and infectious arthritis
Listeria monocytogenes, which are foodborne bacteria
_Staphylococcus aureus, which is typically found on the skin and in the respiratory tract, and causes staphylococcal meningitis

Fungal meningitis

Fungal meningitis is a rare type of meningitis. It's caused by a fungus that infects your body and then spreads from your bloodstream to your brain or spinal cord.

People with a weakened immune system are more likely to develop fungal meningitis. This includes people with cancer or HIV.

The most common funguses related to fungal meningitis include:

Cryptococcus – which is inhaled from dirt or soil that is contaminated with bird droppings
Blastomyces – another type of fungus found in soil.
Histoplasma – which is found in environments that are heavily contaminated with bat and bird droppings.
Coccidioides – which is also found in soil.

Parasitic meningitis

This type of meningitis is less common than viral or bacterial meningitis, and it's caused by parasites that are found in dirt, feces, and on some animals and food, like snails, raw fish, poultry, or produce.

One type of parasitic meningitis is rarer than others. It's called eosinophilic meningitis (EM). Three main parasites are responsible for EM. These include:

Angiostrongylus cantonensis
Baylisascaris procyonis
Gnathostoma spinigerum

Parasitic meningitis is not passed from person to person. Instead, these parasites infect an animal or hide out on food that a human then eats. If the parasite or parasite eggs are infectious when they're ingested, an infection may occur.

One very rare type of parasitic meningitis, amebic meningitis, is a life- threatening type of infection. This type is caused when one of several types of ameba enters the body through the nose while you swim in contaminated lakes, rivers, or ponds. The parasite can destroy brain tissue and may eventually cause hallucinations, seizures, and other serious symptoms. The most commonly recognized species is Naegleria fowleri.

Non-infectious meningitis

Non-infectious meningitis is not an infection. Instead, it is a type of meningitis that's caused by other medical conditions or treatments. These include:

lupus
a head injury
brain surgery
cancer
certain medications

How is meningitis treated?

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. 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. And it’s also 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.

Antiviral medication can treat viral meningitis. Although it sometimes may resolve on its own.

How contagious is meningitis?

Several types of meningitis are not contagious. Fungal, parasitic and non- infectious meningitis are not contagious.

Viral meningitis is contagious. Through droplets of fluid such as saliva, or with feces the infection can spread. Sneezing and coughing can spread the virus. You do not have to come into direct contact n infected person to pick up this infection.

Bacterial meningitis, the most serious form of meningitis, can also be contagious, especially if it's meningococcal meningitis. It's spread through extended contact with an infected person. Schools, daycare centers, military barracks, hospitals, and college dormitories are prime locations for sharing this infection. But not all can spread through person-to-person contact.

Diagnosed

Diagnosing usually starts with a health history and physical exam. Age, dorm residence, and day care center attendance can be important clues. During the physical exam, your doctor will look for:

a fever
an increased heart rate
neck stiffness
reduced consciousness

Your doctor will also order a lumbar puncture which also called a spinal tap. It allows your doctor to look for increased pressure in the central nervous system. It can also find inflammation or bacteria in the spinal fluid. This test can also determine the best antibiotic for treatment.

additional testing:

Blood cultures identify bacteria in the blood. Bacteria can travel from the blood to the brain. N. meningitidis and S. pneumonia, among others, can cause both sepsis and meningitis.
A complete blood count with differential is a general index of health. It checks the number of red and white blood cells in your blood. Also white blood cells fight infection.
Chest X-rays can reveal the presence of pneumonia, tuberculosis, or fungal infections. Meningitis can occur after pneumonia.
A CT scan of the head may show problems like a brain abscess or sinusitis. Bacteria can spread from the sinuses to the meninges.

Your doctor may also conduct a glass test. For this test, your doctor will roll a glass over the meningitis rash. If the rash doesn't fade under the pressure, it's likely meningitis rash. If it does fade, the unusual spots on the skin may be the result of another condition.

Risk factors

Risk factors for meningitis include:

First skipping vaccinations.
- The risk rises for anyone who hasn’t completed the recommended childhood or adult vaccination schedule.
Second Age.
- Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis is common in those under age 20.
Those 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.
Pregnancy
- Pregnancy increases the risk of Listeriosis an infection caused by Listeria bacteria, which may also cause meningitis. Listeriosis increases the risk of miscarriage, stillbirth and premature delivery.
Compromised immune system
- AIDS, alcoholism, diabetes, use of immunosuppressant drugs and other factors that affect your immune system also make you more susceptible to meningitis.

Complications

Meningitis complications can be severe. The longer you or your child has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including:

Hearing loss
Memory difficulty
Learning disabilities
Brain damage
Gait problems
Seizures
Kidney failure
Shock
Death

With prompt treatment, even people with severe meningitis can have a good recovery.

Prevention

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

These steps can help prevent meningitis:

Wash your hands.
- Careful handwashing helps prevent the spread of germs, wash hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. wash hand thoroughly and rinse it properly
Practice good hygiene
- Never share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else.
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.
Cover your mouth
- When you need to cough or sneeze, be sure to cover your mouth and nose.
If you’re pregnant, take care with food.
- Reduce your risk of listeriosis by cooking meat, including hot dogs and deli meat, to 165 F (74 C). And especially avoid cheeses made from unpasteurized milk.

Vaccinations

Some forms of bacterial meningitis are preventable with the following vaccinations:

Haemophilus influenzae type b (Hib) vaccine – recommended vaccine for children starting at about 2 months of age. Also, recommended for some adults, most especially patient who have sickle cell disease or AIDS and those who don’t have a spleen.
Pneumococcal conjugate vaccine (PCV13) – recommended for routine vaccination for children younger than 2 year old. Especially children with chronic heart or lung disease. Additional doses between the ages of 2 and 5 because they have the highest risk of contracting risk of pneumococcal disease.
Pneumococcal polysaccharide vaccine (PPSV23) – Older children and adults who need protection from pneumococcal bacteria may receive this vaccine. Older people, younger adults and children age 2 and older who have weak immune systems or chronic illnesses such as heart disease, diabetes or sickle cell anemia; and for anyone who doesn’t have a spleen.
Meningococcal conjugate vaccine – children ages 11 to 12 should be give a single dose , with a booster shot given at age 16. But, no booster necessary if the the first shot is given at age 16 or older.