Meningitis is a serious infection with bacterial, fungal, parasitic, and viral causes., and it produces inflammation of the membranes that protect the brain and spinal cord. Bacterial meningitis is the most serious form of the infection, and many cases are potentially life-threatening, requiring immediate treatment in the hospital. To diagnose meningitis, doctors perform a physical exam, though blood tests, a spinal tap (lumbar puncture), and imaging studies will also be performed to aid in the diagnosis. Treatment for meningitis depends on its cause. Bacterial meningitis is most frequently diagnosed in young adults in their teens and twenties. It typically requires urgent treatment with intravenous antibiotics and corticosteroids.
While viral cases can't be treated with antibiotics, patients with mild forms may recover with a few weeks of bed rest and adequate hydration, though sometimes doctors may prescribe anticonvulsants. Viral meningitis is most common in patients under the age of five. Vaccines are available to protect against many forms of bacterial meningitis. Several of these vaccines are part of the childhood vaccination schedule for children under two years old in the United States, and preteens and teenagers are typically given at least one dose of the meningococcal conjugate vaccine when they are between eleven and sixteen years old. Meningitis can cause lifelong complications, including hearing loss, kidney failure, brain damage, seizures, and memory issues.
Excessive sleepiness is an early symptom of meningitis that may occur in both newborns and older patients. The patient may initially be drowsy, and they could fall asleep while performing activities such as driving or eating. As the condition progresses, the patient might sleep for prolonged periods of time, and they may eventually become difficult to wake. In cases of bacterial meningitis, excessive sleepiness may worsen rapidly (within a few hours), and some patients could fall into a coma. Newborns with this symptom may also be irritable or sluggish. If a family member or caregiver notices it is difficult to wake the patient and they are becoming less and less responsive, emergency medical services should be called.
Sudden High Fever
A sudden high fever is one of the classic symptoms of meningitis. Typically, the fever associated with this illness will be at least 100 degrees Fahrenheit, and it is sometimes higher than 103 degrees Fahrenheit. The fever may be accompanied by sensitivity to loud noises, and patients might also deal with confusion or delirium. Sometimes, the patient's heart rate and respiration rate may be elevated, and shivering and chills are common.
The patient should have their temperature checked at least once an hour, and urgent care should be sought for patients with a worsening temperature. If a patient has a fever accompanied by a rash, sensitivity to light, fatigue, or a stiff neck, they should be taken to the emergency room. This is true even if the fever is between 100 and 103 degrees Fahrenheit; low-grade fevers are common in the early stages of meningitis and are easily dismissed.
Neck stiffness is perhaps the most well-known symptom of meningitis. It is normally an early symptom of the condition, and the degree of stiffness worsens as the infection spreads. The stiffness is usually concentrated in the upper part of the patient's neck, and it is frequently accompanied by pain that does not resolve with a change of position. To assess the severity of neck symptoms, patients may wish to check whether they can turn their neck from side to side and whether they can comfortably touch their chin to their chest.
If any of these motions cause discomfort and the patient also has a fever or other possible symptoms of meningitis, an urgent medical evaluation should be completed. In addition to a stiff neck, many meningitis patients also experience muscle aches throughout the body. Rarely, some patients with this infection have reported back pain as well.
Although a sudden headache is a classic symptom of meningitis, many patients who have the condition present with mild or moderate headaches. These types of headaches cause pain across the entire head, and they may progress in severity. All types of headaches associated with meningitis are unrelenting; they cause constant pain that does not come and go.
Headaches are not easily detected in infants, but parents may notice the child's fontanel (a normal soft spot on a baby's skull) appears swollen as a result of the inflammation and fluid accumulation caused by this infection. Infants with headaches may cry excessively or be unusually fussy, and adults with headaches due to meningitis may experience mood swings and irritability. Since headache pain is subjective, doctors will also look for other signs of meningitis when assessing patients with sudden headaches.
Nausea Or Vomiting
Patients with this infection frequently experience nausea or vomiting. These symptoms occur even for patients with mild forms of meningitis, and patients may also have diminished hunger and thirst or a general disinterest in food. In particular, infants with meningitis may eat and drink noticeably less than usual. Since nausea and vomiting may lead to dehydration and electrolyte imbalances, it is important for patients with these and other signs of meningitis to be promptly evaluated so treatment can begin.
Medication to prevent nausea and reduce vomiting can be given at urgent care centers and hospitals. Patients may also be given fluids and other medicines to maintain a proper balance of electrolytes. Doctors will examine any vomit for signs of blood or other abnormalities that could need additional treatment.
Sensitivity To Light
Sensitivity to light is a common symptom of all types of meningitis. Patients with this symptom are usually sensitive to bright light, including sunlight. This symptom usually appears suddenly, and it can occur in conjunction with a severe headache. Since meningitis progresses so rapidly, patients who notice sensitivity to light without any obvious cause should see a doctor urgently, particularly if they have flu-like symptoms or a stiff neck.
Doctors will ask the patient when this symptom began and if anything makes it worse or better. They can check the patient's sensitivity by shining a light into their eyes, and they will also look for other meningitis symptoms such as a skin rash or high fever. If meningitis is suspected, the patient may need to have a lumbar puncture, and immediate hospitalization could be required.
The skin rash associated with meningitis is most often seen in cases of bacterial meningitis. It typically appears as purplish-reddish dots, and it may resemble a bruise or look like pinprick marks or blotches. The rash is actually a sign of bleeding underneath the skin, and it can occur in both children and adults with meningitis. The skin rash is usually not elevated above the surface of the skin, so areas with the rash will often still feel smooth; the rash does not normally feel rough or bumpy. When pressed with a glass, the rash will not change color.
This symptom tends to develop in the later stages of meningitis, and the rash often spreads quickly to cover large areas of the body. Patients may have meningitis without a skin rash, so it is important to seek medical care immediately for any symptoms that could be associated with this condition.
Seizures are most likely to occur in cases of viral meningitis, and they tend to develop in the later stages of this condition. A seizure is a sudden period of abnormal electrical activity in the brain, and it can cause a patient to lose consciousness. The patient may jerk their arms and legs violently and repeatedly, some end up biting their tongue or losing bladder control during a seizure. After a seizure, the patient generally has no memory of the event, and they may not remember some of the events that immediately preceded the seizure. Confusion, anxiety, and a sense of deja vu could be present. Most seizures last for thirty to 120 seconds, and a seizure that lasts more than five minutes is considered a medical emergency.
Since seizures can have many causes, an ambulance should be called for anyone who has experienced a seizure for the first time, and emergency medical treatment is also necessary if the patient displays symptoms associated with meningitis. Doctors can administer injectable medications to try to stop a seizure, and patients may need to have an electroencephalogram to determine the underlying cause of the seizure. If an infection is suspected as a cause of the seizure, a lumbar puncture might be performed as well.
Confusion may develop with any form of meningitis, and it typically occurs in advanced cases of the condition. Patients could become disoriented, and they may not know where they are, what day it is, or what time it is. They could have difficulty paying attention or concentrating, and confusion may progress to delirium. The patient could experience a sudden change in behavior, and they may not be able to understand what is happening. When the infection is confined to the meninges, the patient might only experience intermittent confusion and difficulty focusing.
Delirium and disorientation are more likely in cases where the infection has advanced beyond the meninges and into the brain itself. Known as encephalitis, a brain infection could cause the patient to experience lasting complications such as fatigue, reduced cognitive function, sleep disturbances, and vision changes. If a patient appears confused for any reason, they should be taken to the emergency room. Doctors can perform tests to check the patient's mental status, and imaging studies and a lumbar puncture may be performed if meningitis is suspected.
Muscle pain is an early symptom of meningitis, and it can occur with any form of the condition. Patients with muscle pain caused by meningitis could initially think they have the flu, and they usually report widespread soreness and tenderness over many areas of the body. Patients with the bacterial form of meningitis could experience back pain, and this often worsens while bending the legs close to the chest. Muscle pain associated with this condition could be present all the time, and it may increase with any change of posture or position.
Individuals with meningitis may notice their muscle pain occurs together with other early-stage symptoms such as a low fever of less than 100 degrees Fahrenheit, a loss of appetite, and nausea or vomiting. Patients with these symptoms should seek immediate medical care. Doctors may ask the patient questions about the location and nature of any muscle pain, and they could ask the patient to perform certain movements to check for pain or tenderness. For example, the patient may be asked to touch their chin to their chest, and the doctor may gently touch areas of reported pain to assess severity.