Meningitis

Diagnosis
Early diagnosis and treatment are very important. Classic signs of meningitis include sudden onset of fever, headache and stiff neck. These signs are often accompanied by other symptoms, such as nausea, vomiting, sensitivity to light (photophobia), and altered mental status. Older children and adults may experience a skin rash. In young children, the signs may be more subtle and my include inactivity, irritability, vomiting, or poor feeding.

If meningitis is suspected, samples of blood or cerebrospinal fluid are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because the severity of illness and the treatment will differ depending on the cause. In the case of bacterial meningitis, for example, antibiotics can help prevent severe illness and reduce the spread of infection from person to person.
Bacterial Meningitis

If bacteria are present, they can be grown (cultured). Growing the bacteria in the laboratory is important for confirming the presence of bacteria and for identifying the specific type of bacteria that is causing the infection.
Viral Meningitis

The specific causes of meningitis may be determined by tests used to identify the virus in samples collected from the patient.
Fungal Meningitis

To confirm fungal meningitis, specific lab tests can be performed, depending on the type of fungus suspected.

Risk Factors of Meningitis

The most effective way to protect you and your child against certain types of meningitis is to complete the childhood vaccine schedule. The risk of meningitis increases by not following the recommended vaccine schedule. Other factors that can increase your risk of meningitis include:

* Age.
o Viral meningitis occurs mostly in children younger than age 5.
o Before the availability of effective vaccines, bacterial meningitis was most commonly diagnosed in young children. Now, as a result of the protection offered by current childhood vaccines, bacterial meningitis is more commonly diagnosed among pre-teens and young adults.
* Community setting.
o Infectious diseases tend to spread quickly wherever larger groups of people gather together. As a result, college students living in dormitories, military personnel and children in childcare facilities are at an increased risk.
* Pregnancy.
o Pregnant women are at an increased risk of catching listeriosis. The bacteria that cause listeriosis, listeria bacteria, can also cause meningitis. The unborn baby of a pregnant woman with listeriosis is also at risk.
* Working with animals.
o Dairy farmers, ranchers, and other people who work with domestic animals are at an increased risk of contracting listeriosis. The bacteria that cause listeriosis, listeria bacteria, can also cause meningitis.
* Weakened immune system.
o There are certain diseases, medications and surgical procedures that may weaken the immune system and increase risk of meningitis.

Signs & Symptoms

Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as

• Nausea
• Vomiting
• Photophobia (sensitivity to light)
• Altered mental status

Bacterial Meningitis

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure.

Infants younger than one month old are at a higher risk for severe infection. In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive, irritable, vomiting or feeding poorly. In young children, doctors may also look at the child’s reflexes, which can also be a sign of meningitis.

Although the early symptoms of viral meningitis and bacterial meningitis may be similar, later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). For this reason, if you think you or someone else may have meningitis, see a physician as soon as possible.

Viral Meningitis

Viral meningitis is an infection of the meninges (the covering of the brain and spinal cord) that is caused by a virus. Enteroviruses, the most common cause of viral meningitis, appear most often during the summer and fall in temperate climates.

Viral meningitis can affect babies, children, and adults. It is usually less severe than bacterial meningitis and normally clears up without specific treatment. The symptoms of viral meningitis are similar to those for bacterial meningitis, which can be fatal. Because of this, it is important to see a healthcare provider right away if you think you or your child might have meningitis.

Symptoms of viral meningitis in adults may differ from those in children:

Common symptoms in infants

• Fever
• Irritability
• Poor eating
• Hard to awaken

Common symptoms in adults

• High fever
• Severe headache
• Stiff neck
• Sensitivity to bright light
• Sleepiness or trouble waking up
• Nausea, vomiting
• Lack of appetite

The symptoms of viral meningitis usually last from 7 to 10 days, and people with normal immune systems usually recover completely.

Fungal Meningitis

Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis; however, they often appear more gradually. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience:

• Dislike of bright lights
• Changes in mental status, confusion
• Hallucinations
• Personality changes

Treatment

Bacterial Meningitis

Bacterial meningitis can be treated with a number of effective antibiotics. It is important that treatment be started early in the course of the disease. If bacterial meningitis is suspected, initial treatment with ceftriaxone and vancomycin is recommended. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.

Viral Meningitis

There is no specific treatment for viral meningitis. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Most patients completely recover on their own within 7 to 10 days. A hospital stay may be necessary in more severe cases or for people with weak immune systems.

Fungal Meningitis

Fungal meningitis is treated with long courses of high dose antifungal medications. This is usually given using an IV line and is done in the hospital. The length of treatment depends on the status of the immune system and the type of fungus that caused the infection. For people with immune systems that do not function well because of other conditions, like AIDS, diabetes, or cancer, there is often a need for longer treatment.