One of the physically demonstrable symptoms of meningitis is Kernig’s sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000680.htm
Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord. This inflammation causes changes in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.
- Aseptic meningitisAseptic meningitis
- Meningitis – gram-negativeMeningitis – gram-negative
- Meningitis – H. influenzaeMeningitis – H. influenzae
- Meningitis – meningococcalMeningitis – meningococcal
- Meningitis – pneumococcalMeningitis – pneumococcal
- Meningitis – staphylococcalMeningitis – staphylococcal
- Meningitis – tuberculousMeningitis – tuberculous
Causes
Causes
The most common causes of meningitis are viral infections that usually get better without treatment. However, bacterial meningitis infections are extremely serious, and may result in death or brain damage even if treated.
Meningitis is also caused by:
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- Chemical irritation
- Drug allergies
- Fungi
- Tumors
Types include:
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- Aseptic meningitisAseptic meningitis
- Cryptococcal meningitisCryptococcal meningitis
- Gram negative meningitisGram negative meningitis
- H. influenza meningitisH. influenza meningitis
- Meningitis due to cancer (carcinomatous meningitis)
- Meningococcal meningitisMeningococcal meningitis
- Pneumococcal meningitisPneumococcal meningitis
- Staphylococcal meningitisStaphylococcal meningitis
- Syphilitic aseptic meningitisSyphilitic aseptic meningitis
- Tuberculous meningitisTuberculous meningitis
A rare type of meningitis was diagnosed in Arkansas yesterday that has only been reported rarely worldwide. Naegleria meningitis (N. fowleri) can cause a rapidly progressive, almost always fatal, primary amebic meningoencephalitis. Early symptoms include fever, headache, vomiting, and sometimes, disturbances of smell and taste. The illness progresses rapidly to signs of meningoencephalitis, including nuchal rigidity, lethargy, confusion, and altered level of consciousness. Seizures are common. Death occurs within a week of onset of symptoms. No distinct clinical features differentiate this disease from fulminant bacterial meningitis. N fowleri is found in warm fresh water and moist soil. Most infections with N fowleri have been associated with swimming in warm, natural bodies of water, such as hot springs, but other sources have included tap water, contaminated and poorly chlorinated swimming pools, and baths. Small outbreaks associated with swimming in a warm lake or swimming pool have been reported. Disease has been reported worldwide but is uncommon. In the United States, infection occurs primarily in the summer and usually affects children and young adults. The trophozoites of the parasite invade the brain directly from the nose along the olfactory nerves via the cribriform plate. In infections with N fowleri, trophozoites but not cysts can be visualized in sections of brain. The incubation period for N fowleri infection is 1 to 2 weeks.
AcuteAcute bacterial meningitis is a true medical emergency, and requires immediate treatment in a hospital.
Viral meningitis is milder and occurs more often than bacterial meningitis. It usually develops in the late summer and early fall, and often affects children and adults under age 30. Most infections occur in children under the age of 5. Most viral meningitis is due to enteroviruses, which are viruses that also cause intestinal illness.
Many other types of viruses can cause meningitis. For example, viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpesgenital herpes (although people with cold sores or genital herpes are not at a greater risk of developing herpes meningitis).
Recently, West Nile virusWest Nile virus, spread by mosquito bites, has become a cause of viral meningitis in most of the United States.
Symptoms
- Symptoms
- Fever and chills
- Mental status changesMental status changes
- Nausea and vomiting
- Sensitivity to light (photophobiaphotophobia)
- Severe headache
- Stiff neck (meningismus)
Other symptoms that can occur with this disease:
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- AgitationAgitation
- Bulging fontanellesBulging fontanelles
- Decreased consciousnessDecreased consciousness
- OpisthotonosOpisthotonos
- Poor feeding or irritability in children
- Rapid breathing
Meningitis is an important cause of fever in newborn children.
Exams and Tests
- Exams and Tests
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- Blood cultureBlood culture
- Chest x-rayChest x-ray
- Head CT scanHead CT scan
- Gram-stain and culture of CSF (cerebral spinal fluid)Gram-stain and culture of CSF (cerebral spinal fluid)
- Lumbar punctureLumbar puncture (“spinal tap”) with CSF glucose measurementCSF glucose measurement and CSF cell countCSF cell count
Treatment
Treatment
Doctors prescribe antibiotics for bacterial meningitis. The type will vary depending on the bacteria causing the infection. Antibiotics are not effective in viral meningitis.
Other medications and intravenousintravenous fluids will be used to treat symptoms such as brain swelling, shockshock, and seizuresseizures. Some people may need to stay in the hospital, depending on the severity of the illness and the treatment needed.
Outlook (Prognosis)
Outlook (Prognosis)
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
- Possible Complications
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- Brain damage
- Hearing lossHearing loss or deafness
- HydrocephalusHydrocephalus
- Loss of visionLoss of vision
When to Contact a Medical Professional
When to Contact a Medical Professional
If you feel that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.
Prevention
- Prevention
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- Haemophilus vaccine (HiB vaccineHiB vaccine) in children will help prevent one type of meningitis.
- The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis.
- Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics to avoid becoming infected themselves.
The meningococcal vaccination is recommended for:
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- Adolescents ages 11 – 12 and adolescents entering high school (about age 15) who have not already received the vaccination.
- All college freshmen who have not been vaccinated and are living in dorms.
- Children age 2 and older who do not have their spleen or who have other problems with their immune system.
- Those traveling to countries where diseases caused by meningococcus are very common (ask your doctor).
Some communities conduct vaccination campaigns after an outbreak of meningococcal meningitis.
References
References
Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437
