Like most parts of our body, our central nervous system is also at risk of potential infections and inflammation due to external agents. Meningitis, like any other infections or inflammation, can lead to severe complications or even death in certain cases.
To avoid any unwanted consequences, it is important to understand how this disease is contracted and how to detect early signs. Early detection and treatment are key to minimising risks of serious complications from meningitis.
What is meningitis?
Meningitis is the inflammation of the meninges, which is the membrane surrounding the brain and spinal cord [1]. Most common cause of the inflammation is by infections of pathogens. Pathogens that can cause meningitis include viruses, bacteria, parasites, and fungi [1, 2]. The following are the more common types of meningitis:
The meninges are 3 layers that work together to cushion, protect and nourish the brain and spinal cord.
Viral meningitis — Viral infections of the meninges by enteroviruses, HSV, mumps virus, arbovirus, respiratory virus, etc.
Bacterial meningitis — Bacterial infection of Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, etc.
Fungal meningitis — Rare infection of the meninges caused by fungi such as Blastomyces, Candida, Coccidioides, Cryptococcus, etc.
Anyone can be affected by meningitis, but it is most common in babies and young children. Meningitis can be life-threatening if not treated.
What are the signs and symptoms of meningitis?
Common symptoms of meningitis include:
High fever
Stiffness of and round the neck
Bad headache
Nausea and vomiting
Mental confusion
Trouble sleeping
Sensitivity to light
Seizures
Skin rash can develop in some cases (meningococcal meningitis)
Meningitis is an infection of the meninges, and will present symptoms such as fever, headache, sensitivity to light, nausea and vomiting, and seizures.
Symptoms in babies or newborns require special attention, as they are the most vulnerable to complications and long-term disabilities if not diagnosed early [3]. Among the common symptoms in babies and newborns with meningitis include:
High fever
Constantly crying
Being fussy, irritable, or sleepy
Poor feeding, or not eating properly
Low energy or lethargic responses
Vomiting
Seizures
Bulging fontanel (soft spot on a baby’s skull)
Tremors [3]
Constant crying and irritability in babies and newborns are some of the symptoms of meningitis.
If you suspect potential meningitis in your baby, an immediate visit to the doctor is important. Infants and newborns are the most vulnerable to infections including sepsis and meningitis. Delayed medical attention may result in severe complications, long-term disabilities, or even death [3].
How is meningitis caused?
The following are common routes of infection of meningitis-causing pathogens:
Spread through droplets (coughing, sneezing)
Spread through saliva (sharing utensils)
Faecal-oral route (not washing hands after using the toilet, diaper change)
Spread from mother to baby through the birth canal
Spread via contact with blister fluids (Varicella zoster/chicken pox virus)
Environmental exposure to fungal spores or animal faeces
Raw or uncooked meats or fish
Who is most at risk of meningitis?
Anyone can be at risk of exposure to meningitis-causing pathogens. However, the risks are increased with these factors:
Age – Babies and young children are more vulnerable to infections because their immune systems are not fully developed. Often meningitis in newborns and babies develop from other infections such as bacteraemia or sepsis, which may spread to the central nervous system [2].
Existing conditions – Conditions that can weaken the immune system, such as HIV infections or cancer, also puts someone at a higher risk of meningitis.
Not getting vaccinated – Vaccinations can offer protection from common meningitis-causing pathogens such as mumps virus, influenza virus.
Living conditions – Living in crowded conditions or in close contact, such as dorms or bunks, can also increase the risk of meningitis.
Diagnosis of meningitis
Clinical diagnosis of meningitis often relies on laboratory tests.
Blood tests – Blood cultures are taken to identify the presence of bacteria.
Spinal tap (lumbar puncture) – Your neurologist will perform a lumbar puncture to collect cerebrospinal fluid (CSF) samples for analysis. The CSF samples will be used to measure white blood cell count, differentiate white blood cell types, and detect the presence of pathogens [4].
Imaging – Imaging tests such as magnetic resonance imaging (MRI) scans or computed tomography (CT) scans can identify structural changes in the brain (e.g. swelling), swelling of the optic disc (papilloedema), or in cases of seizures [4].
A spinal tap is performed to detect the presence of meningitis-causing pathogens in the CSF.
Treatment of meningitis
Viral meningitis is often less severe than bacterial meningitis, in most cases it can resolve on its own. Doctors may prescribe antimicrobial treatments such as acyclovir, which is usually prescribed for infections of HSV or varicella zoster virus (chicken pox virus).
Bacterial meningitis is treated with antibiotics. In some cases, your doctor may prescribe dexamethasone to reduce inflammation before antibiotic administration [1]. The type of antibiotics selected for treatment may also vary depending on the type of bacteria found in the CSF sample. Your doctor may switch to a specific antibiotic from a broad-spectrum antibiotic for this reason.
Ask your doctor about antibiotic use in case you may have allergies to certain types of antibiotics.
Complications from meningitis
Most cases of meningitis are fully treatable and rarely cause long-term complications. However, if treatment is delayed, patients can be left with serious long-term complications including:
Hearing loss
Vision loss
Problems with memory or concentration
Learning disabilities
Problems with coordination
Loss of limb due to necessary amputations
Bone and/or joint problems
Kidney problems
Shock
Death
What can I do to prevent meningitis?
Common preventive measures can be taken to reduce the risk of meningitis.
Hygiene – In practice, good hygiene is always recommended to limit the spread of diseases. Washing hands and regular cleaning of living spaces are such examples.
Vaccination – Stay protected by vaccinating you or your child and keep updated with news from your local health ministry.
Avoiding close contact – Limit exposure to pathogens by limiting contact with people who are sick. If you or your child is sick, it is recommended to stay at home instead of going to work or school.
Staying healthy – A healthy lifestyle is important to keep your immune system strong to fight off infections. Keeping a good diet with fresh produce and whole grains, and exercising regularly can be beneficial in your general well-being.
Vaccinations can protect your child from infections that can cause meningitis.
Frequently Asked Questions
Can meningitis go away on its own?
Mild viral meningitis can resolve on its own, bacterial meningitis requires medical treatment.
How serious is bacterial meningitis compared to viral meningitis?
Bacterial meningitis poses a greater risk compared to viral meningitis and should be treated as soon as possible.
How long does recovery take?
People with mild viral meningitis usually feel better after 7 to 10 days, bacterial meningitis may take weeks to months for a full recovery. This may also vary according to severity of the infection and patient’s condition [5].
Are there any long term effects even after treatment?
Long term complications can occur if medical attention is delayed. The most common complication in meningitis patients is hearing loss, patients treated for meningitis are usually required to come back after a few weeks to check for potential hearing loss.
2. Kumar R. Aseptic meningitis: diagnosis and management. Indian J Pediatr. 2005 Jan;72(1):57-63. doi: 10.1007/BF02760582. PMID: 15684450.
3. Bedetti L, Marrozzini L, Baraldi A, Spezia E, Iughetti L, Lucaccioni L, Berardi A. Pitfalls in the diagnosis of meningitis in neonates and young infants: the role of lumbar puncture. J Matern Fetal Neonatal Med. 2019 Dec;32(23):4029-4035. doi: 10.1080/14767058.2018.1481031. Epub 2018 Jun 13. PMID: 29792059.
4. Griffiths MJ, McGill F, Solomon T. Management of acute meningitis. Clin Med (Lond). 2018 Mar;18(2):164-169. doi: 10.7861/clinmedicine.18-2-164. PMID: 29626023; PMCID: PMC6303447.5. Adawe DH, Mengistie DT. Determine the factors affecting the time to recovery of children with bacterial meningitis at Jigjiga university referral hospital in the Somali Regional State of Ethiopia: using the parametric shared frailty and AFT models. BMC Res Notes. 2024 Mar 19;17(1):85. doi: 10.1186/s13104-024-06740-9. PMID: 38504305; PMCID: PMC10953244.
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