Meningitis is an inflammation of the meninges, the layer of tissue that surrounds the brain and the spinal cord. The three types of meningitis most commonly heard of are bacterial, viral, and fungal. You can also get parasitic meningitis and meningitis from other causes, such as from cancer, tuberculosis, even chemicals, to name a few.
Meningitis due to an infection can cause a serious condition called sepsis. Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
What is meningitis?
While there are several types of meningitis, this information section describes the three most common ones.
Bacterial meningitis is the most severe type of meningitis. The bacteria are passed from person to person. According to the Centers for Disease Control (CDC), the most common types of bacteria that cause this infection in the United States are Haemophilus influenzae (most often caused by type b, Hib), Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes (in newborns), and Neisseria meningitidis.
Statistics show that between 2003 and 2007, there were approximately 4,100 cases of bacterial meningitis each year in the U.S. Five hundred cases per year result in death.
Viral infections are the most common cause of the infection but viral meningitis is not usually as severe as bacterial meningitis and people generally get better without treatment.
Although anyone can come down with viral meningitis, children under 5 years old and people who have compromised immune systems, either from illness or medications taken to treat some diseases, are at higher risk of doing so.
Viral illnesses such as mumps and influenza (the flu) can lead to viral meningitis.
Fungal meningitis is the rarest of the three. For fungal meningitis to develop, a fungal infection must spread through the blood stream to the spinal canal. A fungal infection can occur by inhaling the fungus or by the fungus being introduced into the body. An outbreak of fungal meningitis began in September 2012 when contaminated medication was injected into the spinal canal of many patients. As with the viral infection, the people at highest risk of developing the fungal type are those who are immunocompromised, such as people who have AIDS or who are being treated for cancer.
Symptoms can come on very suddenly. They include:
- Stiff neck
Other symptoms can include:
- Nausea and vomiting
- Photophobia (sensitivity to light)
Symptoms may be difficult to determine in very young children as they may not be able to tell you what is wrong. Signs that they may be ill may include irritability, difficulty waking, difficult feeding, and fever.
Because you cannot tell what type of infection a person may have, it must be treated as an emergency. Acute bacterial meningitis is a medical emergency and needs treatment in a hospital.
Aside from the symptoms, doctors must do a few tests to make an accurate diagnosis. They may include:
- Blood cultures. This blood test involves placing blood in a special lab dish to see if anything grows. Once something grows, it is checked under a microscope to be identified.
- Chest X-rays
- CT scans of the head
- Lumbar puncture (spinal tap). A sample of cerebrospinal fluid (CSF) is obtained for testing.
Bacterial meningitis must be treated with antibiotics as soon as possible. According to the CDC, “Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk remains higher among young infants and the elderly.” In some cases, patients may be treated with medications called corticosteroids to help reduce the inflammation of the meninges.
Antibiotics do not help in cases of viral infections. People with viral meningitis are watched (monitored) and most recover completely within seven to 10 days.
Fungal meningitis is treated with anti-fungal medications given by intravenous (IV). Depending on how severe the illness is, the treatment can be quite lengthy.
The HiB vaccine (Haemophilus influenzae type B) and pneumococcal vaccines are recommended childhood vaccines and given routinely to children in many countries, including the United States.
The HiB vaccine was introduced to the United States in the 1980s. The vaccine is given in three or four doses, depending on the brand given. The CDC recommends that children receive the first two doses at two months and four months. Some brands then have a third dose at six months. A final dose is given at 12 to 15 months. Since the vaccine has become routine, the incidence of severe HiB infections has dropped by 99 percent.
The pneumococcal vaccine prevents infections caused by Streptococcus pneumoniae, which can cause meningitis. The vaccine is given in early childhood in four doses: at two months, four months, and six months. A booster shot is needed again at 12 to 15 months.
There is also a pneumococcal polysaccharide vaccine that is given to anyone over two years old who have illnesses that affect their immune system and to people over age 65.
Bacterial meningitis from Neisseria meningitidis is spread through close contact, such as kissing or sharing glasses and utensils. Good hygiene practices, including proper hand washing, will decrease the chances of spreading the bacteria. If you have been in close contact with someone who has been diagnosed with the bacterial infection, speak with your doctor. Sometimes, antibiotics may be ordered to prevent illness.
Meningitis, particularly bacterial meningitis, can cause sepsis, which can develop into septic shock, resulting in death.
Survivors may recover completely, while others may be left with complications such as hearing loss, seizures, and more.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Updated September 18, 2020