There are numerous ways that the meninges, or protective membranes around the brain and spinal cord, can become inflamed and turn into meningitis. Viral infections, particularly from enteroviruses, are the most common cause of meningitis. But other types of infections, including those from a wide variety of bacteria, fungi, and parasites, can also cause the disease. There are also many noninfectious causes of meningitis, including head injury, brain surgery, and certain cancers. Despite the range of causes, the symptoms of meningitis are generally the same, whether it’s viral, bacterial, or fungal. If you have a high fever, headaches, and can’t lower your chin to your chest without intense pain, seek medical attention right away. Other common symptoms include:
Nausea and vomitingPhotophobia, or sensitivity to bright lightsAltered mental states, such as confusion and difficulty concentrating
Along with these symptoms, people with viral meningitis may also experience:
Lethargy (lack of energy) or profound fatigueDecreased appetiteSleeping problems, such as sleepiness and difficulty fully rousing from sleep
With viral meningitis, the symptoms are often less severe than with bacterial meningitis and develop at a slower pace. Most cases go away on their own within 7 to 10 days, however, a complete medical assessment is still necessary. The symptoms of bacterial meningitis, which are the same as those of viral meningitis, typically develop rapidly over the course of three to seven days. As with viral meningitis, if you have a high fever, headaches, and can’t lower your chin to your chest, call a doctor right away. Children with bacterial meningitis may experience:
FeverVomiting Respiratory difficulties Seizures or shock
Infants may exhibit these symptoms:
LethargyA bulging fontanelle (a swollen soft spot on the head) Irritability when heldDifficulty focusing the gazeDifficulty being fed (1)
TirednessCognitive difficultiesHearing difficulties, including permanent hearing lossCoordination problemsBehavioral problems (in children)Speech problemsHeadaches
The later stages of bacterial meningitis can cause severe and life-threatening complications, including:
Septicemia (blood poisoning)SeizuresComaStrokeHemorrhage of the adrenal glands, which are glands on top of the kidneys that produce important, regulating hormones (2)
Septicemia due to meningococcal meningitis causes a rash that begins as tiny red spots that, if untreated, turn into larger purplish bruise-like spots. This is due to the blood leaking from damaged blood vessels underneath the skin. There’s a test to see whether this rash may be due to septicemia from meningococcal meningitis: If you press a glass on the rash, and the pressure doesn’t make the bumps fade, it means the rash may be caused by meningococcal meningitis. In darker skin, check for the rash inside the eyelids, on the palms of hands, and on the bottoms of feet. Cold feet and hands are other signs of septicemia.
What Are the Symptoms of Primary Amebic Meningoencephalitis?
An infection from the microscopic amoeba (a single-celled organism) Naegleria fowleri can cause a very rare form of parasitic meningitis called primary amebic meningoencephalitis, or PAM, in which the brain is also inflamed. The initial symptoms of PAM — headache, fever, stiff neck, nausea, and vomiting — begin within the first seven days of becoming infected with the parasite. As the infection progresses, it can cause:
ConfusionLack of attention to people and surroundingsLoss of balanceSeizuresHallucinations
Without treatment, PAM usually results in death about five days after symptoms start. (3)
What Are Neonatal Meningitis Symptoms?
Bacterial meningitis in newborns is called neonatal bacterial meningitis. The condition is very rare and occurs most often in babies with low birth weight. It’s been estimated that neonatal bacterial meningitis affects 2 in every 10,000 babies born full-term, and in 2 out of 1,000 low birth weight infants. (4) The incidence of this disease has decreased over the last few decades, possibly due to increased maternal screenings for the bacteria that is primarily responsible for this disease. (5) That bacteria is Group B streptococcus (GBS). According to research, the following are among the risk factors for neonatal meningitis: (5)
Premature birthGBS infection in the motherFever in the motherLow birth weightFetal monitoring or other invasive procedures, like shunts or catheters
Signs and symptoms of meningitis in newborns include:
FeverDazed effectDifficulties focusing a gazeIrritability, especially when heldConstant cryingFrequent vomitingDifficulty being fedBulging fontanelle (swollen soft spot on the head)Constant sleepiness or trouble waking
Neonatal meningitis caused by GBS may develop in an infant’s first week of life, but most often occurs in an infant’s first three months. (4)
Lumbar punctures (also known as spinal taps)Blood testsImaging studies
Lumbar punctures allow doctors to collect a sample of the fluid that bathes the brain and spinal cord to test for infection. The fluid is then examined to see if there are increased numbers of white blood cells and protein and decreased numbers of glucose. The spinal fluid can also be examined to identify infectious organisms and to see what type of medication would be most effective against that organism. Lumbar punctures and subsequent tests can also determine what kind of infection — bacterial, viral, fungal — is present. Standard blood tests can reveal if you have antibodies or foreign proteins that are indicative of an infection. Magnetic resonance imaging (MRI) and computerized tomography (CT) scans can reveal if you have inflammation, particularly of the meninges. These imaging tests can also show if you have other complications, such as brain damage and internal bleeding, and if you have any issues that may make a lumbar puncture unsafe to perform, including abscesses and brain inflammation. Additional reporting by Carlene Bauer.
