The brain and spinal cord are encased by layers of tissue. These layers are called the meninges. Certain bacteria can cause an infection in these layers. This is called bacterial meningitis.
It is a serious infection that can cause death within hours. A quick diagnosis and treatment is vital.
The bacteria first cause an upper respiratory tract infection]]> . Then it travels through the blood stream to the brain.
Worldwide, three types of bacteria cause the majority of cases of acute bacterial meningitis:
- Streptococcus pneumoniae (the bacteria that causes ]]>pneumonia]]> )
- Neisseria meningitidis
- Haemophilus influenzae b
- In the US, widespread immunization has almost eliminated meningitis due to Hib
Other forms of bacterial meningitis include:
- Listeria monocytogenes meningitis
- Escherichia coli meningitis
- Mycobacterium tuberculosis meningitis
Newborn babies and the elderly are more prone to get sick.
Some forms are spread by direct contact with fluid from the mouth or throat of an infected person. This can happen during a kiss or by sharing eating utensils. In general, meningitis is not spread by casual contact.
If you have any of these risk factors for meningitis, tell your doctor:
- Age: infancy and early childhood; over 60 years of age
- People in close and prolonged contact with patients with meningitis due to Hib or Neisseria meningitidis
- A weakened immune system due to HIV]]> infection or other conditions
- Smoking (for meningitis due to Neisseria meningitidis )
- Living in proximity to others, such as dormitories and military barracks (for meningitis due to Neisseria meningitidis )
Classic symptoms can develop over several hours, or may take 1 to 2 days:
- High fever
- Very stiff, sore neck
Other symptoms may include:
- Red or purple skin rash
- Cyanosis (bluish skin color)
- Photophobia (sensitivity to bright lights)
- Mental confusion
In newborns and infants, symptoms are hard to see. As a result infants under three months old with a fever are often checked for meningitis. Symptoms in newborns and infants may include:
- Unexplained high fever or any form of temperature instability, including a low body temperature
- Jaundice]]> (yellow color to the skin)
- Feeding poorly or refusing to eat
- Tautness or bulging of soft spots between skull bones
- Difficulty awakening
As the illness progresses, seizures and/or ]]>hearing loss]]> can occur. This can happen to patients of all ages.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- Spinal tap]]> —removal of a small amount of cerebrospinal fluid to check for bacteria
- Other cultures—testing of samples of blood, urine, mucous, and/or pus from skin infections
- ]]>MRI scan]]> —a test that uses magnetic waves to make pictures of structures inside the body (to be sure the inflammation is not from some other cause, such as a tumor)
- ]]>CT scan]]> —a type of x-ray that uses a computer to make pictures of structures inside the body
More than 90% of all people with this infection survive with immediate care including:
- Antibiotics and corticosteroids—often given together
- Fluids may also be given
Antibiotics are given through an IV directly into a vein. This is started as soon as the infection is suspected. The antibiotics may be changed once tests name the exact bacterial cause. Patients usually stay in the hospital until fever has fallen. The fluid around the spine and the brain must also be clear of infection.
These are usually given by IV early in treatment. They control brain pressure and swelling. They also reduce the body’s production of inflammatory substances. This treatment can prevent further damage.
Fluids can be lost due to fever, sweating, or vomiting. They may be replaced through an IV. It will be done carefully to avoid complications of fluid overloading.
- Pain medications and sedatives may be used
- Anticonvulsants may be prescribed to prevent seizures
To help reduce your chances of getting bacterial meningitis, consider the following steps:
- Vaccines against Hib]]> —usually for children
- ]]>Pneumococcal polysaccharide vaccine]]>
- All people over age 65
- People ages 2 to 64 with certain chronic medical problems
Pneumococcal conjugate vaccine against
- All children older than 2 years old
- Preventative antibiotics—for healthcare workers or family members in close contact with infected patients
- Buying pasteurized milk and milk products—to prevent meningitis due to ]]>Listeria monocytogenes]]>
- Monitor for maternal infection during and before labor to prevent meningitis in newborns
Centers for Disease Control and Prevention
Meningitis Foundation of American
National Institute of Neurological Disorders and Stroke
Meningitis Research Foundation of Canada
Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy . 17th ed. Hoboken, NJ: John Wiley & Sons;1999.
Diagnosis of acute meningitis in adult patients. American Family Physician website. Available at: http://www.aafp.org/afp/20000115/tips/9.html . Accessed June 24, 2008.
Meningitis and encephalitis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm . Accessed June 24, 2005.
Meningococcal disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm#Are%20there%20vaccines%20against%20meningitis . Accessed November 27, 2005.
Last reviewed January 2009 by ]]>David L. Horn, MD, FACP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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