The brain and spinal cord are covered by layers of tissue. These layers are called the meninges. Bacterial meningitis is an infection of the meninges and cerebrospinal fluid (CSF), a clear fluid that surrounds and protects the brain and spinal cord.
Bacterial meningitis is a serious infection. It is a medical emergency, requiring immediate treatment. Depending on the severity of the infection, it can result in death within hours.
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Bacterial meningitis can be caused by many different bacteria. The likelihood of having one type of bacteria over another varies by age group. Severity of the infection depends on the bacteria causing it and the overall health of your immune system.
Transmission of the bacteria usually occurs by direct contact with oral or respiratory secretions, such as inhaling droplets from someone who sneezes or coughs, or by kissing. The spread of the bacteria depends on the time of the year, crowding, and the presence other respiratory infections.
Bacterial meningitis is more common in infancy and childhood. For adults, the risk increases as you age. Other factors that may increase your chance of getting bacterial meningitis include: Not having recommended vaccinationsCommunity living arrangements, such as a college dormitory or military base
People in close and prolonged contact with people with meningitisSupressed immune system caused by certain health conditions or medicationsPenetrating head traumaPrevious brain surgery, or cerebrospinal fluid shuntsBirth defects, such as dermal sinus or myelomeningocele, a type of spina bifidaA history of epidural steroid injections or other invasive spinal procedures
Alcohol use disorderSmoking, or exposure to second-hand smoke
Classic symptoms can develop over several hours or may take 1-2 days: High feverHeadacheVery stiff, sore neck
Other symptoms may include: Red or purple skin rashBluish skin colorNauseaVomitingSensitivity to bright lightsSleepinessMental confusionSeizures
In newborns and infants, symptoms are hard to notice. As a result, infants under 3 months old with a fever are often checked for meningitis. Symptoms in newborns and infants may include: InactivityUnexplained high fever or any form of temperature instability, including a low body temperatureIrritabilityVomiting
Yellowing of the skin or eyesFeeding poorly or refusing to eatTightness or bulging of soft spots between skull bonesDifficulty awakening
Complications of bacterial meningitis include: Systemic infection—sepsisShock—very low blood pressureSeizuresBrain swellingFluid build up in the brain—hydrocephalusHearing lossVision problemsParalysisComaDeath
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with: Blood tests and culturesUrine testsTests of mucous and pus from your skinLumbar puncture
Imaging tests of the brain and spinal cord may be done with an
More than 90% of all people with this infection survive with immediate care, including: Antibiotics and corticosteroids—often given togetherFluids
Antibiotics are given through an IV. This is started as soon as the infection is suspected. The antibiotics may be changed once tests find the exact bacterial cause.
People usually stay in the hospital until the fever has fallen
and the fluid around the spine and the brain is clear of infection.
This may require a hospital stay of several days.
These are usually given by IV early in treatment, but are generally used for specific causes of meningitis.
Corticosteroids control brain pressure and swelling. They also reduce the body’s production of inflammatory substances. This treatment can prevent further damage.
Specifically, it reduces the risk of hearing loss and neurological complications.
Fluids can be lost due to fever, sweating, or vomiting. They may be replaced through an IV. It will be done carefully to avoid complications of fluid overloading.
Your doctor may also recommend: Pain relieversSedatives
Medications to help reduce brain swellingGlycerol to reduce the risk of hearing loss and neurological complications
To help reduce your chance of getting bacterial meningitis: If you have been exposed to meningitis, or are a carrier or healthcare worker, you may need to take prophylactic antibiotics to prevent infection.
Make sure your vaccinations are up to date. Check on the vaccination status of your family members as well.
Buy pasteurized milk and milk products.Talk to your doctor if you are pregnant so you can be monitored.
Diagnosis, initial management, and prevention of meningitis.
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Last reviewed September 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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