Meningitis: what is it?

Meningitis is an inflammation of the brain and spinal cord membranes, typically caused by an infection. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Most cases of meningitis in the U.S. are caused by a viral infection, but bacterial and fungal infections are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergent antibiotic treatment. Seek immediate medical care if you suspect that someone has meningitis. Early treatment of bacterial meningitis can prevent serious complications. Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.

These early symptoms may include sudden high fever, stiff neck, severe headache that seems different than normal, headache with nausea or vomiting, confusion or difficulty concentrating, seizures, sleepiness or difficulty waking, sensitivity to light, no appetite or thirst, and a skin rash. Signs in newborns are often high fever, constant crying, excessive sleepiness or irritability, inactivity or sluggishness, poor feeding, a bulge in the soft spot on top of baby’s head, and stiffness in a baby’s body and neck. You should seek immediate fever if you have any of the following symptoms. Bacterial meningitis is serious, and can be fatal within days without prompt antibiotic treatment. Delayed treatment increases the risk of permanent brain damage or death. It’s also important to talk to your doctor if a family member or someone you work with has meningitis.

You may need to take medications to prevent getting the infection. Viral infections are the most common cause of meningitis, followed by bacterial infections and, rarely, fungal infections. Because bacterial infections can be life-threatening, identifying the cause is essential. Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or, rarely, after some surgeries. Viral meningitis is usually mild and often clears on its own. Most cases in the United States are caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps, West Nile virus and others also can cause viral meningitis. Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) that invade the membranes and fluid surrounding your brain cause chronic meningitis. Chronic meningitis develops over two weeks or more.

The symptoms of chronic meningitis — headaches, fever, vomiting and mental cloudiness — are similar to those of acute meningitis. Fungal meningitis is relatively uncommon and causes chronic meningitis. It may mimic acute bacterial meningitis. Fungal meningitis isn’t contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS. It’s life-threatening if not treated with an antifungal medication. Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies, some types of cancer and inflammatory diseases such as sarcoidosis. Risk factors for getting meningitis are skipping vaccinations, age, living in a community setting, pregnancy, or compromised immune system. Meningitis complications can be severe.

The longer you or your child has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including hearing loss, memory difficulty, learning disabilities, brain damage, gait problems, seizures, kidney failure, shock, and death. Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette. Steps like washing your hands and good hygiene could even prevent you from getting meningitis. Your family doctor or pediatrician can diagnose meningitis based on a medical history, a physical exam and certain diagnostic tests. During the exam, your doctor may check for signs of infection around the head, ears, throat and the skin along the spine. CSF analysis may also help your doctor identify which bacteria caused the meningitis. If your doctor suspects viral meningitis, he or she may order a DNA-based test known as a polymerase chain reaction (PCR) amplification or a test to check for antibodies against certain viruses to determine the specific cause and determine proper treatment.

The treatment depends on the type of meningitis you or your child has. f the cause of your meningitis is unclear, your doctor may start antiviral and antibiotic treatment while the cause is determined. Chronic meningitis is treated based on the underlying cause. Antifungal medications treat fungal meningitis and a combination of specific antibiotics can treat tuberculous meningitis. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal. Chronic meningitis is treated based on the underlying cause. Noninfectious meningitis due to allergic reaction or autoimmune disease may be treated with corticosteroids. In some cases no treatment may be required, because the condition can resolve on its own. Cancer-related meningitis requires therapy for the individual cancer.

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