Bacterial Meningitis

Meningitis is an inflammation of the fluid and membranes surrounding the spinal cord and brain. It is sometimes referred to as spinal meningitis. Bacterial meningitis is caused by a bacterial infection. It is important to know whether a virus or bacterium is causing your meningitis. This is because the severity of illness and the treatment differ. Viral meningitis is generally less severe and can go away without specific treatment. Bacterial meningitis is treated with antibiotics. Meningitis can also be caused by fungi, parasites, certain medicines, cancer, and autoimmune disorders.

People with lowered immune systems are at greater risk for poor outcomes from meningitis. It is important to get treatment as soon as possible to minimize the impact of a meningitis infection. Long-term complications could include seizures, hearing loss, weakness, paralysis, blindness, or cognitive impairment.

CAUSES

Bacterial meningitis occurs when certain bacteria reach the membranes covering the brain. These bacteria may enter the bloodstream and travel to the brain. They may also reach the brain directly through the nasal cavity or through an open wound in the skull. It is important to know which type of bacteria is causing the meningitis. Antibiotics can prevent some types of meningitis from spreading and infecting other people.

The types of bacteria that commonly cause meningitis vary by age group. Common causes by age group are listed below.

  • Premature babies and newborns up to 3 months

  • Group B streptococcus, which exists in the vaginal tract.

  • Escherichia coli, which exists in the digestive tract.

  • Listeria monocytogenes.

  • Older children

  • Neisseria meningitidis, often refered to as meningococcus.

  • Streptococcus pneumoniae.

  • Haemophilus influenzae type B, in children under 5 years old.

  • Adults

  • Neisseria meningitidis.

  • Streptococcus pneumoniae.

  • Listeria monocytogenes, in adults over 50 years old.

People who have a cerebral shunt, cochlear implant, or any similar device are at increased risk of infection. Rarely, an infection in the head and neck area (such as otitis media or mastoiditis) can lead to meningitis. Tuberculous meningitis is caused by an infection with Mycobacterium tuberculosis. This type of meningitis is more common in countries where tuberculosis is common. It may also occur in people with immune system problems, such as AIDS.

SYMPTOMS

Symptoms can develop over several hours. They may even take 1 to 2 days to develop. Common symptoms of meningitis in people over the age of 2 years include:

  • High fever.

  • Headache.

  • Stiff neck.

  • Irritability.

  • Nausea and vomiting.

  • Decreased appetite.

  • Fatigue.

  • Discomfort from exposure to light.

  • Discomfort from exposure to loud noise.

  • Trouble walking.

  • Altered mental status.

  • Seizures.

A rash may occur in severe cases of meningitis. Meningitis caused by the bacterium Neisseria meningitidis (known as "meningococcal meningitis") may cause a rapidly spreading rash, which appears before other symptoms. The rash consists of many small, irregular purple or red spots (petechiae) on the trunk, lower extremities, mucous membranes, conjunctiva of the eye, and sometimes on the palms of the hands or soles of the feet.

DIAGNOSIS

Early diagnosis and treatment are very important. If you have symptoms, you should see your caregiver right away. Your evaluation may include lab tests of your blood and spinal fluid. A spinal fluid sample is taken through a procedure called a lumbar puncture or spinal tap. During the procedure, a needle is inserted into an area in the lower back. The fluid is examined and cultures are done. The type of bacteria causing the infection will be identified. You may also have a CT scan of your brain as part of your evaluation. If there is suspicion of an infection or inflammation of the brain (encephalitis), an MRI scan may be done.

PREVENTION

Bacterial meningitis is contagious. The bacteria spread from person to person in secretions from the lungs and throat. This may happen when you cough, sneeze, or kiss someone. None of the bacteria that cause meningitis are as contagious as the common cold or the flu. The bacteria are not spread by simply breathing the same air as a person who has meningitis.

The bacteria that cause meningitis can spread through close or prolonged contact with a patient who has certain types of bacterial meningitis. People who are at high risk should receive antibiotics to help prevent them from getting the disease. People at increased risk of getting the infection include:

  • Health care workers.

  • People who share a household with the patient.

  • Day-care center workers.

  • Anyone who has direct contact with the patient's oral secretions.

Some forms of meningitis (such as those associated with meningococcus, Haemophilus influenzae type B, pneumococci, or mumps virus infections) may be prevented by immunization. Talk to your caregiver about specific vaccines that are recommended for adults and children.

TREATMENT

Bacterial meningitis can be treated with many antibiotics. Treatment must be started early in the course of the disease. Antibiotics must be started immediately, even before the exact cause is determined. You will be given specific antibiotics once the exact cause is known. Steroids may also be used to limit swelling of the brain.

HOME CARE INSTRUCTIONS

  • Rest.

  • Drink enough water and fluids to keep your urine clear or pale yellow.

  • Take all medicine as prescribed.

  • Practice good hygiene to prevent others from getting sick.

  • Follow up with your caregiver as directed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a high fever, neck stiffness, or confusion.

  • You have a headache that becomes severe or does not respond to pain medicine.

  • You develop dizziness.

  • You have a fast heartbeat.

  • You have a seizure.

  • You develop a rash.

  • You are taking antibiotics and are not getting better.

  • You develop severe vomiting or are unable to tolerate food or fluids.

  • You have any worsening symptoms.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.