Caused by bacteria and viruses, meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord. It can develop as a result of injury, cancer, or certain drugs. Although meningitis can simply be defined as swelling of the brain and spinal cord membranes, as mentioned, it can still be caused by a number of things, such as parasites, injury, or fungi. It is also believed to be caused by bacterial or viral infections. Bacterial meningitis most commonly affects children.
Apart from viral and bacterial infections, the other causes of meningitis are drug allergies, chemical irritation, and cancer.
Signs and Symptoms
After being exposed to meningitis, patients typically start experiencing symptoms within a week or even several hours. Symptoms may include:
- Sudden high fever
- Stiff neck
- Nausea or vomiting
- Confusion or difficulty in concentrating
- Sleepiness or difficulty in waking up
- Sensitivity to light
- No appetite or thirst
- Skin rashes
- Severe headache
Meningitis shows different signs in newborns and infants. Some of which may include:
- High fever
- Constant crying
- Excessive sleepiness or irritability
- Inactivity or sluggishness
- Poor appetite and feeding
- A bulging fontanelle (the soft spot on top of the baby’s head)
- Body and neck stiffness
Because certain types of meningitis can be deadly and cause irreversible complications, it is important to call or visit a doctor as soon as possible if you experience such symptoms. Bacterial meningitis is serious and can be fatal within days if ignored and without any prompt antibiotic treatment. A delayed treatment increases the risk of having permanent brain damage or even death in some cases. Therefore, it is important to talk to your doctor if a family member or someone you work with has meningitis, as you may be particularly susceptible to contracting the disease.
How is meningitis diagnosed?
- Physical examination - The doctor will perform a thorough physical examination to identify any signs or symptoms related to the infection. Doctors will check for fever, neck stiffness, and irregular heartbeat.
- Blood culture - Apart from physical examination, the doctor will request for a blood culture. The bacteria present in the blood can be identified through a blood culture. Bacteria can travel to the brain via blood. In this instance, the blood samples are placed in a special dish to check for growth of specific microorganisms. A sample of blood can also be collected for microscopic examination.
- Chest X-ray - X-rays of the chest can also be carried out to check for any signs of fungal infection, tuberculosis, or pneumonia. There have been cases reported where meningitis has occurred in patients recovering from pneumonia.
- Complete blood count (CBC) - The doctor can also request for a complete blood count (CBC) to check the count of red blood cells (RBCs) and white blood cells (WBCs) in your body. The white blood cells (WBCs) are the ones that fight any type of infection present in the body.
- Lumbar puncture - A lumbar puncture or spinal tap can also be carried out by the doctor. A spinal tap is needed to collect cerebrospinal fluid (CSF). The CSF of people infected with meningitis often shows a low sugar level along with an increased protein and white blood cell (WBC) count. A CSF analysis helps the doctor to identify which bacteria has caused the infection.
- CT scan - A CT scan can be carried out to show problems such as sinusitis or brain abscess.
Is meningitis contagious?
The answer to this question completely depends on the type and cause of meningitis. Here is an information on the different varieties of meningitis:
This type of meningitis is caused by a fungus known as Cryptococcus. People with weak or compromised immune systems are the most vulnerable to this rare kind of meningitis. Although it is uncommon, fungal meningitis has been proven not to be contagious.
Parasitic meningitis is also uncommon, but it can be a life-threatening disease. It is caused by Naegleria fowleri, a microscopic amoeba. This parasite enters the body through the nose and is normally found in contaminated rivers and lakes. Parasitic meningitis, although serious, is not contagious and cannot be contracted by drinking the contaminated water.
Although viral meningitis is not life-threatening like the other types, it is extremely common. The type of virus (enterovirus) that can cause viral meningitis spreads when patients come in direct contact with infected nasal mucus, saliva, or feces. If you recently had a close contact with a person who has viral meningitis, you are likely to get infected with the virus that made the person sick.
However, you may not develop meningitis from that illness. The reason is that only a small number of people who get infected with the virus that can cause meningitis would actually develop the disease. The virus is therefore easily spread when an infected person sneezes or coughs. Having contact with a meningitis patient either directly or indirectly both pose a high risk of getting the infection.
This type of meningitis is classified as a contagious disease. However, being infected with the virus does not necessarily mean that you will end up developing meningitis as well. Arboviruses, found in ticks and mosquitoes, can also cause meningitis. These infections normally take place during the late summer and the beginning of fall when ticks are most prevalent.
Viruses in the enterovirus category usually cause about 10-15 million infections every year. However, only a small percentage of people who get infected with the virus develop meningitis. Typically, viral meningitis would not require a specific treatment since it usually goes away on its own.
The following are symptoms of viral meningitis in infants:
- Sudden fever
- Low appetite
Adults would experience the following symptoms if infected with viral meningitis:
- Seizures or convulsions
- Frequent and severe headaches
- Loss of appetite
- Stiff neck
- Being very sensitive to light
Meningitis does not always develop due to an infection. Brain surgery, cancer, lupus, certain drugs, and head injuries can also cause meningitis. Non-infectious meningitis is not contagious.
Bacterial meningitis is the most severe form of meningitis. It can be fatal if left untreated. It is mostly caused by the bacteria called Streptococcus pneumoniae or Neisseria meningitidis.
All forms of bacterial meningitis are contagious. Bacterial meningitis can spread from one person to another. Bacteria are spread by exchanging respiratory and throat secretions (saliva or spit) during close or lengthy contact (coughing or kissing), especially if living in the same household and spending the majority of time together with the person possessing it.
Meningococcal bacteria can only live outside the body for a short time. However, having an extended exposure to someone who is infected increases your chances of getting bacterial meningitis. People who are working or spending most of their time at schools and daycare centers should be very concerned about bacterial meningitis and should observe safety measures to prevent the spread of the disease.
Bacterial meningitis can also be spread through:
- Contaminated saliva
- Infected mucus
- Sharing of contaminated food utensils
- Eating contaminated food
How long can meningitis be contagious?
It usually depends on which infectious agent is the root cause of meningitis. Viral meningitis is contagious after three days once the infection starts and ten days after the symptoms develop. Bacterial meningitis is contagious depending on the type of bacteria causing the infection. It may be contagious during the incubation period and for about an additional fourteen days. There are chances of the infection being extended for a longer duration if the person becomes the carrier. A timely diagnosis and antibiotic treatment can reduce the symptoms and the duration of the disease.
Below are the common types of bacteria that can cause meningitis:
- Listeria monocytogenes – A foodborne bacterium
- Streptococcus pneumoniae – Bacteria found in the respiratory tract, nasal cavity, and sinuses. This bacterium can cause pneumococcal meningitis.
- Neisseria meningitidis – This bacteria spreads through infected saliva and other respiratory fluids. This bacterium is the causative agent of meningococcal meningitis.
Sometimes, people can have meningitis-causing bacteria in their noses and throats and may spread it to others without being aware of it. This way, the infected patients may not show symptoms but are still contagious.
Complications and Risk Factors of Meningitis
- If a person suffering from meningitis does not seek timely medical help or does not complete the required dose of treatment, then the condition can worsen. It can result in seizures, damage to the brain, loss of hearing, and a buildup of fluid between the brain and skull.
- A weakened immune system is more prone to infections. Certain diseases that require ongoing treatments such as HIV infection and cancer can weaken a person’s immune system, making the patient even more vulnerable to acquiring newer infections. People who are HIV-positive are more prone to contract cryptococcal meningitis, which is caused by a fungus. Hence, one should be very careful when dealing with an existing treatment.
- There are more chances of getting the disease when people are cramped up in small spaces or quarters. Locations such as daycare facilities, boarding schools, and dormitories are the usual places where diseases can be easily spread and acquired.
- Listeriosis is a serious bacterial infection caused by Listeria monocytogenes. Pregnant women are more prone to having the infection than non-pregnant ones. Thus, pregnant women should be very careful with the foods that they eat since eating food that is contaminated by the bacteria is the main cause of infection.
- Children under the age of five are at risk of viral meningitis. Infants are more prone to bacterial meningitis. One should make a note of any changes in the baby’s behavior or sudden changes in body temperature.
Treatment of Meningitis
Treating meningitis is completely dependent on the type and the root cause of meningitis affecting the person. If the person has fungal meningitis, then it can be treated with antifungal agents. If there are signs of viral meningitis, then it doesn’t need any special treatments. It goes away on its own after a couple of days. There are no serious problems associated with viral meningitis.
Bacterial meningitis is a severe case. Thus, it requires immediate medical action if diagnosed on time. Timely treatment would prevent damage to the brain. There is no specific antibiotic for bacterial meningitis since the type of bacteria involved also depends on person-to-person. At times, the treatment is done with intravenous antibiotics. Below are the antibiotics that are commonly used for treating bacterial meningitis:
- Ampicillin - is a penicillin drug used for infections caused by Haemophilus influenzae type b (Hib) and Listeria monocytogenes.
- Vancomycin - is an effective antibiotic that kills many types of bacteria, especially those that are not destroyed by other antibiotics.
Other antibiotic drugs can also be used for the treatment of bacterial meningitis. They include gentamicin, meropenem, and tobramycin, which is an aminoglycoside antibiotic. Doctors may also prescribe ciprofloxacin and rifampin to family members of people who have bacterial meningitis.
Non-infectious meningitis due to an allergic reaction or autoimmune disease is treated with corticosteroids. If a person has cancer-related meningitis, then it would require a certain therapy for its treatment.
Long courses of high dose IV antifungal medications are used to treat fungal meningitis. A combination of specific antibiotics can treat tuberculous meningitis. However, one should note that these medications can have serious side effects. Hence, the treatment would be based on the laboratory test, which would confirm that the cause of meningitis is indeed fungal in origin.
Doctors may also prescribe antifungals depending on the type of infection. Chronic meningitis is treated based on its underlying cause. Diazepam or phenytoin can help treat seizures.
How to Lower Your Risk of Contracting Meningitis
Taking certain precautions may lower your risk of spreading or acquiring the bacteria and viruses that cause meningitis. These precautions include the following:
- Always wash your hands thoroughly with soap and warm water.
- Wash your hands after using the restroom, before eating, and after attending to a sick person.
- Avoid sharing straws, plates, or eating utensils with other people.
- Cover your mouth and nose every time you sneeze or cough.
- Ensure proper immunization with the latest booster shots and vaccines for meningitis.
- Be careful when traveling to places with a high incidence of meningitis.
Should you contract meningitis despite these methods, seek medical advice as soon as you experience any signs and symptoms to get the best treatment possible. With prompt treatment, even patients with severe meningitis can have a good recovery. As this disease is fairly common and can get very severe, it is important to see a doctor if you are unsure whether or not you have meningitis.
Always maintain a healthy and hygienic lifestyle. Get adequate rest, avoid smoking, and getting in contact with sick people are few of the things one should keep in mind to avoid meningitis. Check with your doctor if you’re already dealing with someone who has bacterial meningitis. The antibiotics provided would decrease the chances of you contracting the disease.
There are certain vaccinations that can prevent meningitis. They can also be proactively given to infants since they have weaker immune systems during the early stages. The vaccines include:
- HiB or Haemophilus influenza type b vaccine
- Pneumococcal conjugate vaccine
- Meningococcal vaccine