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Meningitis is inflammation of the lining around the brain and spinal cord. It is usually caused by an infection.
The infection occurs most often in children, teens, and young adults. Also at risk are older adults and people who have long-term health problems, such as a weakened immune system.
There are two main kinds of meningitis:
Viral meningitis is caused by viruses. Bacterial meningitis is caused by bacteria.
Meningitis can also be caused by other organisms and some medicines, but this is rare.
Meningitis is contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact.
The most common symptoms among teens and young adults are:
Children, older adults, and people with other medical problems may have different symptoms:
It is very important to see a doctor right away if you or your child has these symptoms. Only a doctor can tell whether they are caused by viral or bacterial meningitis. And bacterial meningitis can be deadly if not treated right away.
Your doctor will ask questions about your health, do an exam, and use one or more tests.
Lumbar puncture is the most important lab test for meningitis. It is also called a spinal tap. A sample of fluid is removed from around the spine and tested to see if it contains organisms that cause the illness.
Your doctor may also order other tests, such as blood tests, a CT scan, or an MRI.
Bacterial meningitis is treated with antibiotics in a hospital. You may also get dexamethasone, a type of steroid medicine. And you will be watched carefully to prevent serious problems such as hearing loss, seizures, and brain damage.
But viral meningitis is more common, and most people with this form of the illness get better in about 2 weeks. With mild cases, you may only need home treatment. Home treatment includes taking medicine for fever and pain and drinking enough fluids to stay hydrated.
The best way to protect your child from meningitis is to make sure he or she gets all the standard immunizations for children. These include shots for measles, chickenpox, Haemophilus influenzae type B (Hib) disease, and pneumococcal infection.
Talk to your doctor about whether you or your child also needs the meningococcal vaccine, which is a shot to prevent bacterial meningitis. Two doses are recommended for all adolescents. And at least one dose is recommended for anyone 6 weeks of age and older who has immune system problems or a damaged or missing spleen. The vaccine is also needed for travel to countries known to have meningitis outbreaks, such as the countries in Africa south of the Sahara Desert.
Learning about meningitis:
Most meningitis is caused by bacteria and viruses that often live in our bodies. Usually these germs stay in the intestines or in the nose and throat, where they may or may not make us sick. But if they spread to the tissues (meninges) that surround the brain and spinal cord, they cause inflammation. This inflammation is called meningitis.
The germs that can lead to meningitis are contagious, which means they can be passed from one person to another.
Viral meningitis is the most common and the least dangerous. It's caused by viruses, most often enteroviruses that live in the intestines. These viruses can be spread through food, water, or contaminated objects. Meningitis caused by enteroviruses occurs most often in babies and young children.
Bacterial meningitis is caused by bacteria. It is a very serious illness. These germs are usually passed from one person to another through infected saliva or mucus. Most people who get bacterial meningitis get it from one of two types of bacteria:footnote 1
In the United States, bacterial meningitis mainly affects adults.footnote 2
Other types of bacteria that sometimes cause meningitis are:
The Centers for Disease Control and Prevention (CDC) recommends screening for group B streptococci in all pregnant women at 35 to 37 weeks. Women who have the bacteria are given antibiotics during labor in order to prevent infection in their newborns.footnote 3
In rare cases, other kinds of bacteria cause meningitis, usually in people with long-term medical conditions. Meningitis also can be caused by other organisms, such as a fungus, and by conditions such as cancer or lupus. Meningitis also can be a complication of an injury (particularly to the skull or face), or brain surgery.
Germs that cause meningitis can be spread:
Symptoms of bacterial meningitis usually appear suddenly.
Symptoms of viral meningitis may appear suddenly or develop gradually over a period of days. For example, the symptoms of viral meningitis after mumps may take several days or weeks to develop.
The most common symptoms of either form of meningitis include:
Less common symptoms include:
Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.
Other conditions with symptoms similar to meningitis include viral hepatitis and flu.
The course of meningitis often depends on your age, general health, and the organism causing the infection. The illness can range from mild to severe.
Viral meningitis is more common in the late summer and early fall. It usually doesn't cause serious illness. A visit to the doctor followed by home treatment may be all you need.
You may get better within 2 weeks. But some people may feel lightheaded and tired for several months after the illness.
Bacterial meningitis occurs most often from late winter to early spring. It usually causes serious illness and can be life-threatening. The symptoms usually develop suddenly and last for 2 to 3 weeks. A person with bacterial meningitis is treated with antibiotics in a hospital.
Complications, short-term and long-term, are more common with bacterial than with viral meningitis. People with bacterial meningitis can die if not treated right away. People who are more likely to have these problems include:
The risk of dying from bacterial meningitis is also higher for adults who:footnote 1
Most survivors recover completely.footnote 4
A risk factor is anything that makes you more likely to get a certain disease. Risk factors for meningitis include:
Medical problems that can increase your risk include:
Call 911 or other emergency services right away if:
Call your doctor right away if:
Call a doctor soon if you think you may have been exposed to meningitis. You can be treated with antibiotics, which may keep you from getting the illness.
Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment.
Watchful waiting isn't appropriate if you think that you or your child has meningitis, because you can't tell what type of meningitis it may be. Call your doctor as soon as symptoms appear.
The following health professionals can diagnose and treat meningitis:
Specialists may be needed to treat meningitis, especially if complications develop:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Diagnosis of meningitis is based on a medical history, a physical exam, and tests.
Your doctor will almost always do a lumbar puncture. This is done by inserting a long, thin needle into the spinal canal. The doctor uses the needle to collect samples of spinal fluid to check for bacteria and viruses.
Other tests that may be done include:
Most people with viral meningitis usually start getting better within 3 days of feeling sick, and they recover within 2 weeks. With mild cases of viral meningitis, you may only need home treatment, including drinking extra fluids and taking medicine for pain and fever.
Bacterial or severe viral meningitis may require treatment in a hospital, including:
Most healthy adults who have recovered from meningitis don't need follow-up care.
But adults who have other medical problems that make them more likely to have long-term complications or get meningitis again should see their doctors after recovery.
Babies and children always need follow-up care after recovery. They need to be checked for long-term complications such as hearing loss.
Childhood vaccinations are the best way to prevent meningitis. These shots prevent germs from causing some of the diseases that can lead to meningitis. They include shots for:
For more information about immunizations, see the topic Immunizations.
A link has been found between meningitis and cochlear implants for severe hearing loss. To help protect against meningitis, experts recommend that people with cochlear implants get a pneumococcal shot. Also, some people with implants have ear infections before they get meningitis, so it's important to treat ear infections right away with antibiotics.
Take steps to lower your risk of getting or spreading meningitis:
Home treatment usually is all that is needed for most people who have viral meningitis. It includes:
When you or your child is recovering at home, watch for signs of long-term complications of meningitis, such as hearing loss.
The decision about what medicine to use depends on the organism causing the infection, the extent of the infection, and the person's age and general health.
Medicines used for treating meningitis include:
People who are very sick may need to be treated in the intensive care unit of a hospital. They may need one or both of these additional treatments:
Roos KL, Tyler KL (2015). Meningitis, encephalitis, brain abscess, and empyema. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 19th ed., vol. 2, pp. 883–906. New York: McGraw-Hill Education.
Tunkel AR, et al. (2010). Acute meningitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., pp. 1189–1229. Philadelphia: Churchill Livingstone Elsevier.
Verani JR, et al. (2010). Prevention of perinatal group B streptococcal disease: Revised guidelines from CDC, 2010. MMWR, 59(RR-10): 1–36. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w.
Hirschmann JV (2006). Bacterial infections of the central nervous system. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 36. New York: WebMD.
Reefhuis J, et al. (2003). Risk of bacterial meningitis in children with cochlear implants. New England Journal of Medicine, 349(5): 435–445.
Biernath KR, et al. (2006). Bacterial meningitis among children with cochlear implants beyond 24 months after implementation. Pediatrics, 117(2): 284–289.
Other Works Consulted
American Academy of Pediatrics (2009). Meningococcal infections. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed, pp. 455–466. Elk Grove Village, IL: American Academy of Pediatrics.
American Academy of Pediatrics (2015). Meningococcal infections. In DW Kimberlin et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed., pp. 547–558. Elk Grove Village, IL: American Academy of Pediatrics.
Biernath KR, et al. (2006). Bacterial meningitis among children with cochlear implants beyond 24 months after implantation. Pediatrics, 117(2): 284–289.
Centers for Disease Control and Prevention (2013). Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 62(RR-02): 1–22. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm?s_cid=rr6202a1_x.
Feigin RD, Cutrer WB (2009). Bacterial meningitis beyond the neonatal period. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 1, pp. 439–471. Philadelphia: Saunders.
Gilden DH (2008). Acute viral central nervous system diseases. In DC Dale, DD Federman, eds., ACP Medicine, section 11, chap. 16. Hamilton, ON: BC Decker.
Swartz MN (2012). Meningitis: Bacterial, viral, and other. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 2355–2371. Philadelphia: Elsevier Saunders.
Tunkel AR, et al. (2004). Practice guidelines for the management of bacterial meningitis. Clinical Infectious Diseases, 39(9): 1267–1284.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerW. David Colby IV, MSc, MD, FRCPC - Infectious Disease
Current as ofMay 24, 2016
Current as of:
May 24, 2016
E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
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