Meningitis
Also called: Bacterial meningitis, Viral meningitis
This can be a medical emergency. Call emergency services for fever with stiff neck, confusion or a rash that does not fade under a glass.
Inflammation of the membranes around the brain and spinal cord, usually from infection. Bacterial meningitis can kill within hours and needs immediate antibiotics.
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Causes
- Bacteria: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Listeria, group B strep in newborns
- Viruses (enteroviruses, herpes) — usually milder
- Tuberculosis and fungi in some settings
Risk factors
- Infants and young adults
- Crowded living (dormitories)
- Weakened immunity or no spleen
- Missing vaccinations
Symptoms
- Fever
- Severe headache
- Stiff neck
- Dislike of bright light
- Vomiting
- Confusion or drowsiness
- Non-blanching purple rash (meningococcal septicaemia)
- Seizures
Diagnosis — tests and examinations
- Blood cultures
- Lumbar puncture (unless contraindicated)
- CT brain if needed first
- PCR tests
Treatment
Medicines and medical treatment
- Immediate intravenous antibiotics (ceftriaxone; add amoxicillin for Listeria risk)
- Dexamethasone for pneumococcal meningitis
- Aciclovir for suspected herpes encephalitis
- Antibiotic prophylaxis for close contacts
Possible complications
- Death
- Hearing loss
- Brain damage and seizures
- Limb loss from septicaemia
Prevention
- Vaccines: MenACWY, MenB, pneumococcal, Hib
- Antibiotics for contacts
Outlook
Viral meningitis usually resolves fully; bacterial meningitis kills about 10% and leaves 1 in 5 with lasting problems.
When to see a doctor
Call emergency services for fever with stiff neck, confusion or a rash that does not fade under a glass.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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