Meningitis

What Is Meningitis?

Meningitis is an inflammation of the meninges (meh-NIN-jeez), the membranes that cover the brain and spinal cord. Some types of meningitis (meh-nen-JYE-tis) can be dangerous and even life-threatening. Routine vaccinations can help prevent it.

Quick treatment of meningitis usually is successful. So it's important to know what symptoms it can cause and to get medical care right away if your child might have the illness.

What Causes Meningitis?

Meningitis is most often caused by a virus (viral meningitis), but sometimes is caused by bacteria (bacterial meningitis). Rarely it can be due to other infections, some medicines, or illnesses (like cancer).

Meningitis caused by germs like bacteria or viruses often starts in another part of the body. The germs then spread through the bloodstream to the meninges.

Both kinds of meningitis spread to other people like most other common infections do — someone who's infected touches, kisses, or coughs or sneezes on someone who isn't infected. And both kinds are more common in people with weak immune systems.

Bacterial Meningitis

Bacterial meningitis is rare, but is usually serious and can be life-threatening if not treated right away.

 Many different types of bacteria can cause it. Besides coming from the bloodstream, the bacteria also can spread to the meninges from nearby areas in the body when someone has had:

• a skull fracture
• brain surgery
• a cochlear implant
• a serious infection in the ear or the sinuses

People of any age can get bacterial meningitis, but it spreads easily among those living in close quarters, so teens, college students, and boarding-school students are at higher risk for infection.

Viral Meningitis

Viral meningitis (also called aseptic meningitis) is more common than bacterial meningitis and usually less serious. Many of the viruses that cause it are common, such as those that cause colds, diarrhea, cold sores, and the flu.

What Are the Signs & Symptoms of Meningitis?

Meningitis symptoms vary, depending on the person's age and its cause. But both kinds of meningitis often cause the same symptoms. The first symptoms can start quickly or several days after someone had a cold, diarrhea, vomiting, or other signs of an infection.

Common symptoms include:

• fever
• headache
• stiff neck
• sensitivity to light (bright light bothers the eyes)
• nausea or vomiting
• poor appetite
• irritability
• lack of energy or drowsiness

Meningitis in Infants

Infants with meningitis might have different symptoms. Babies might be cranky, feed poorly, and be sleepy or hard to wake up. It may be hard to comfort them, even when they're picked up and rocked, and their cry might be more high-pitched than usual. They also may have a fever or a lower-than-normal temperature. Sometimes they can have a stiff neck or a bulging fontanelle (soft spot on head).

How Is Meningitis Diagnosed?

Bacterial meningitis can be very serious. So if you see symptoms or think that your child could have meningitis, it's important to see the doctor right away.

If the doctor thinks it might be meningitis, they'll likely order a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of inflammation and whether the infection is due to a virus or bacteria. The doctor will also order blood tests and other tests to try to find the source of the infection.

How Is Meningitis Treated?

If someone has — or might have — bacterial meningitis, doctors will start intravenous (IV) antibiotics as soon as possible. They also might give steroids to ease inflammation in the brain and IV fluids to replace those lost due to fever, sweating, vomiting, and poor appetite.

No antibiotics are needed when meningitis is caused by a virus (not bacteria). Rarely, doctors give antiviral medicine for specific viruses.

Most children with viral meningitis feel better in 7–10 days and usually can recover at home if they're not too ill. Treatment to ease symptoms includes rest, fluids, and over-the-counter pain medicine. Some people might need treatment in the hospital.

What Problems Can Happen?

Bacterial meningitis can cause serious problems that might need extra treatment, possibly in the hospital ICU. Someone with very low blood pressure might get more IV fluids and medicines to increase blood pressure. Someone might need extra oxygen or mechanical ventilation (breathing machine) if they have trouble breathing.

Problems from bacterial meningitis can be severe and include neurological problems, such as hearing loss, vision problems, seizures, and learning disabilities. Anyone who has had bacterial meningitis should get a hearing test after they recover.

The heart, kidneys, and adrenal glands also might be affected, depending on the cause of the infection. Although some kids develop long-lasting neurological problems, most who get a quick diagnosis and treatment recover fully.

Can Meningitis Be Prevented?

Vaccinations

Routine immunization can go a long way toward preventing meningitis. The Hib, measles, mumps, polio, and pneumococcal vaccines can protect against meningitis caused by those germs.

Kids also should get vaccines to protect against a bacterium called meningococcus. Kids get the meningococcal conjugate vaccine (MenACWY) when they're 11 or 12 years old, with a booster shot at age 16. Kids older than 11 who haven't been vaccinated also should be immunized, particularly if they're going to college, boarding school, camp, or other places where they'll live in close quarters with others.

Kids 2 months to 11 years old who are at higher risk for infection also should get MenACWY. This includes kids who:

• live in or travel to countries where infection is common
• have some types of immune disorders
• are present during an outbreak

A newer type of meningococcal vaccine called MenB protects against a type of meningococcal bacterium not covered by the older vaccine. Kids 10 years and older who have a higher risk for infection should get this vaccine. Others who are not at increased risk may also get it when they're 16–23 years old (preferably when they're 16–18, which is when the risk of getting infected is highest). The decision to get the MenB vaccine should be made together with their parents and the doctor.

Avoiding Germs

Kids and adults should wash their hands well and often, especially before eating and after using the bathroom, and if they work closely with kids (as in a daycare). Avoid close contact with someone who looks ill and don't share food, drinks, or eating utensils.

Preventive Antibiotics

In some cases, doctors may give antibiotics to anyone who has had close contact with a person who has bacterial meningitis to help prevent infection.

When Should I Call the Doctor?

Get medical care right away if you think that your child has meningitis or you see symptoms such as:

• vomiting
• headache
• tiredness or confusion
• neck stiffness
• fever

A baby who has a fever, is cranky, and isn't feeding well should be seen right away by a doctor.

If your child has been near someone who has meningitis, call your doctor to ask about preventive medicine.