Meningitis (Bacterial & Viral) Diagnosis & Treatment

To find out if your teenager has meningitis, their doctor may ask them to get a procedure called a lumbar puncture, or spinal tap. It’s a key way to get a diagnosis.

The doctor injects an area of your teen’s lower back with an anesthetic, a drug that suppresses pain while the procedure is going on. The doctor then slips a needle between two vertebrae in the lower spine to get a small sample of spinal fluid. The fluid is normally clear, so if the lab shows it is cloudy and has white blood cells in it, your teen may have meningitis.

Lab tests will help figure out which type of meningitis your teen has — bacterial, viral, or fungal. Your teen’s doctor may also need to get samples of their blood or urine. Because the disease can move quickly, treatment sometimes starts right away, even before the test results come back.

Bacterial Meningitis

The bacterial form of meningitis can be life-threatening and needs to be treated quickly. Your teen will likely stay in a hospital to get antibiotics put into their veins through an IV until the doctor gets the results of a spinal tap.

If the spinal fluid tests show your teen has bacterial meningitis, they’ll need to keep up with the antibiotics until the infection goes away, possibly for as long as 2 weeks. Because bacterial meningitis can spread easily to others, they’ll probably stay in an isolated room for at least 48 hours.

Meningitis can make the eyes sensitive to light, so your teen may prefer a darkened room. They’ll get plenty of liquids and drugs to relieve headache and fever. To keep them from getting reinfected, doctors will look for a source of the infection, such as an infected sinus.

If your teen has a type of bacterial meningitis called meningococcal meningitis, there’s a risk that people close to them can get infected. The doctor may suggest they take an antibiotic to prevent them from getting the disease.

Viral Meningitis

Antibiotics can’t treat viral meningitis and, in most cases, the infection goes away on its own with time.

Viral meningitis is usually much less severe than other types. Your teen may need to be in the hospital a few days (if at all).  When they’re there, they’ll get fluids through an IV to prevent dehydration, as well as painkillers.

Fungal Meningitis

Though very rare, fungal meningitis usually affects people with other underlying medical conditions.If your teen has fungal meningitis, they’ll get antifungal medications in the hospital that can fight this rare type of infection. They’ll also need to get liquids to prevent dehydration and drugs to control pain and fever.

Bacterial Meningitis | Cedars-Sinai

Not what you’re looking for?

What is bacterial meningitis?

Meningitis is an infection of the membranes (meninges) that protect the spinal cord
and brain. When the membranes become infected, they swell and press on the spinal
cord or brain. This can cause life-threatening problems. Meningitis symptoms strike
suddenly and worsen quickly.

What causes bacterial meningitis?

Bacteria or a virus can cause meningitis. Viral meningitis is more common, but
bacterial meningitis is often more serious. It can lead to brain damage, seizures,
paralysis, or stroke. In some cases, it can be fatal.

Many
different types of bacteria can cause meningitis
. Vaccines are available that
target many of these bacteria. For this reason, it’s important to know what’s causing
meningitis. Even though all types affect the same area of the body, they can have
different outcomes and need different treatments.

Who is at risk for bacterial
meningitis?

Experts don’t always know why meningitis happens. Some people get it when their immune
system is weak or they’ve recently been sick. A head injury may also increase risk.

Bacterial meningitis is more common in infants younger than age 1 and people ages
16
to 21. College students living in dorms or other close quarters are at increased risk.
Also at risk are adults with certain medical problems, including those without a
spleen.

What are the symptoms of bacterial meningitis?

The most common symptoms of bacterial meningitis are:

• Painful, stiff neck with limited range of motion
• Headaches
• High fever
• Feeling confused or sleepy
• Bruising easily all over the body
• A rash on the skin
• Sensitivity to light

These are symptoms to look for in children:

• Irritability
• Vomiting from a high fever
• Frequent crying
• Swelling of the head
• Lack of appetite
• Seizures (sometimes also seen in adults if the meningitis is advanced)

Symptoms typically come on quickly, in as little as a couple of hours or up to a day
or
two. If you think you or your child may have meningitis, go to an emergency room (ER)
right away.

How is bacterial meningitis diagnosed?

To
diagnose this condition, a healthcare provider will do a spinal tap (lumbar puncture)
to
take a sample of fluid from around the spinal cord. The fluid is then tested for
bacteria. The provider will also ask about your symptoms and do a physical exam.

Other tests may include:

• Brain
  imaging such as a CT scan or MRI
• Blood and urine testing
• Swab of fluids from your nose or throat

How is bacterial meningitis treated?

Prompt treatment of bacterial meningitis is crucial. It can save your life. Antibiotics
that can treat a broad range of bacteria are given right away. The antibiotics can
be
changed once the specific bacteria is found.

Antibiotics are given through a needle placed into a vein (usually in the arm or hand).
They may also be given along with a corticosteroid to help reduce inflammation and
swelling. Treatment also includes plenty of fluids to prevent dehydration.

What are possible complications of
bacterial meningitis?

With quick treatment, many people with bacterial meningitis don’t have any permanent
problems. However, even with prompt treatment, some may battle seizures, brain damage,
hearing loss, and disability for the rest of their lives. Meningitis can be fatal
and some people with this infection will die.

What can I do to prevent bacterial
meningitis?

Vaccines are available to help prevent certain forms of bacterial meningitis. Children
now routinely get a meningitis vaccine around ages 11 to 12. A booster shot is given
at
age 16. Ask your healthcare provider if you or your children should be vaccinated.

Bacterial meningitis is contagious. If you’ve been around someone who has it, call
your provider to talk about how to keep from getting sick.

Key points about bacterial meningitis

• If you feel like you’ve got the flu with unusual stiffness in your neck, it could
  be meningitis.
• Get any symptoms checked out and treated as soon as possible to help ward off complications.  
• Ask your healthcare provider about vaccines that may protect you from bacterial meningitis.
• If
  you’ve been around someone who has bacterial meningitis, call your provider to talk
  about how to keep from getting sick.

Next steps

Tips
to help you get the most from a visit to your healthcare provider:

• Know
  the reason for your visit and what you want to happen.
• Before
  your visit, write down questions you want answered.
• Bring
  someone with you to help you ask questions and remember what your provider tells
  you.
• At the
  visit, write down the name of a new diagnosis and any new medicines, treatments, or
  tests. Also write down any new instructions your provider gives you.
• Know
  why a new medicine or treatment is prescribed, and how it will help you. Also know
  what the side effects are.
• Ask if
  your condition can be treated in other ways.
• Know
  why a test or procedure is recommended and what the results could mean.
• Know
  what to expect if you do not take the medicine or have the test or procedure.
• If you
  have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider if you have
  questions.

Medical Reviewer: Joseph Campellone MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Meningitis in Children | Cedars-Sinai

Not what you’re looking for?

What is meningitis in children?

Meningitis is a swelling (inflammation) of the thin membranes that cover the brain and the spinal cord. These membranes are called the meninges.

What causes meningitis in a child?

Meningitis is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid (CSF). CSF is the fluid that protects and cushions the brain and spinal cord. A fungus or parasite may also cause meningitis. This is more common only in children with a weak immune system.

Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis is usually more severe and may lead to long-term complications or death.

Viruses that can cause meningitis include polioviruses, the mumps virus (paramyxovirus), the flu virus, and West Nile virus.

Bacteria that can cause meningitis include group B streptococcus, E. coli, Haemophilus influenzae type b (Hib), and a strep bacteria that causes pneumonia. Syphilis, tuberculosis, and Lyme disease bacteria can also cause meningitis. The bacteria, viruses, and fungi that cause meningitis usually grow in a person’s respiratory tract. A child may have no symptoms at all, but may carry the organism in his or her nose and throat. They may be spread by:

• Close contact with someone carrying the infection
• Touching infected objects, such as doorknobs, hard surfaces, or toys, and then touching nose, mouth, or eyes
• Droplets from a sneeze, close conversation, or kissing

An infection usually starts in the respiratory tract. In a child, it may first cause a cold, sinus infection, or ear infection. It can then go into the bloodstream and reach the brain and spinal cord.

Which children are at risk for meningitis?

A child is more at risk for meningitis if he or she has an infection caused by a number of viruses, bacteria, or fungi. Children with a weakened immune system are at great risk.

What are the symptoms of meningitis in a child?

The symptoms of meningitis vary depending on what causes the infection. The symptoms may start several days after your child has had a cold and runny nose, or diarrhea and vomiting. Symptoms can occur a bit differently in each child. Symptoms may appear suddenly. Or they may develop over several days.                                                                                                                                         

In babies, symptoms may include:

• Irritability
• Fever
• Sleeping more than usual
• Poor feeding
• Crying that can’t be soothed
• High-pitched cry
• Arching back
• Bulging soft spots on the head (fontanelles)
• Changed temperament
• Purple-red splotchy rash
• Seizures
• Vomiting

In children age 1 or older, symptoms may include:

• Neck pain
• Back pain
• Headache
• Sleepiness
• Confusion
• Irritability
• Fever
• Refusing to eat
• Reduced level of consciousness
• Seizures
• Eyes sensitive to light (photophobia)
• Nausea and vomiting
• Neck stiffness
• A purple-red splotchy rash

The symptoms of meningitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is meningitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:

• Lumbar puncture (spinal tap). This is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain is measured. A small amount of cerebral spinal fluid (CSF) is removed and sent for testing to see if there is an infection or other problems.
• Blood tests. These can help diagnose infections that cause meningitis. 
• CT scan or MRI.  These are tests that show images of the brain. A CT scan is sometimes done to look for other conditions that may cause similar symptoms as meningitis. An MRI may show inflammatory changes in the meninges. These tests give more information. But meningitis can’t be diagnosed using these tests alone.
• Nasal, throat, or rectal swabs. These tests help diagnose viral infections that cause meningitis.

How is meningitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.                                         

Treatment varies by type of meningitis. The treatments by type include:

• Bacterial meningitis. Treatment is started as quickly as possible. The healthcare provider will give your child IV (intravenous) antibiotics, which kill bacteria. Your child will also get a corticosteroid medicine. The steroid works by decreasing the swelling (inflammation) and reducing pressure that can build up in the brain. Steroids also reduce the risk for hearing loss and brain damage. 
• Viral meningitis. Most children get better on their own without treatment. In some cases, treatment may be done to help ease symptoms. There are no medicines to treat the viruses that cause viral meningitis. The only exception is herpes simplex virus, which is treated with IV antiviral medicine. Babies and children with a weakened immune system may need to stay in the hospital.
• Fungal meningitis. Your child may get IV antifungal medicine.
• Tuberculous (TB) meningitis. Your child will be treated with a course of medicines over 1 year. Treatment is done with several medicines for the first few months. This is followed by other medicines for the remaining time.
  

While your child is recovering from meningitis, he or she may also need:

• Bed rest
• Increased fluid intake by mouth or IV fluids in the hospital
• Medicines to reduce fever and headache. Don’t give aspirin or medicine that contains aspirin to a child younger than age 19 unless directed by your child’s provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.
• Supplemental oxygen or breathing machine (respirator) if your child has trouble breathing

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are the possible complications of meningitis in a child?

Bacterial meningitis is usually more severe and may lead to long-term complications. Some children may have long-term problems with seizures, brain damage, hearing loss, and disability. Bacterial meningitis can also cause death.

How can I help prevent meningitis in my child?

Several vaccines are available to prevent some of the bacterial infections that can cause meningitis. These include:

• H. influenzae type b vaccine (Hib). This is given as a 3- or 4-part series during your child’s routine vaccines starting at 2 months old.
• PCV13 pneumococcal vaccine. The American Academy of Pediatrics recommends this vaccine for all healthy children younger than age 2. PCV13 can be given along with other childhood vaccines. It is recommended at ages 2 months, 4 months, 6 months, and 12 to 15 months. One dose is also advised for older children who did not get the 4-dose series, and for those at high risk for pneumococcal disease.
• PPSV23
  pneumococcal vaccine. This vaccine is also recommended for older children at high risk for pneumococcal disease.
• Meningococcal vaccine. This vaccine is part of the routine vaccine schedule. It is given to children ages 11 to 12, with a booster given at age 16. It is given to teens entering high school if they were not vaccinated at age 11 or 12. A booster is also given at age 16 to 18, or up to 5 years later. Babies and young children at increased risk may also have this vaccine. Ask your child’s healthcare provider about the number of doses and when they should be given.

Vaccines that protect against viruses such as measles, mumps, chickenpox, and the flu can prevent viral meningitis.                                                    

Talk with your child’s healthcare provider if you have questions about the vaccines.  

You and your child can do other things to prevent the spread of infections. Proper handwashing and staying away from people who are sick can help prevent meningitis.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

• Not received vaccines
• Contact with someone who has meningitis
• Symptoms that don’t get better, or get worse
• New symptoms

Key points about meningitis in children

• Meningitis is an inflammation of the thin membranes that cover the brain and the spinal cord.
• It is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid. A fungus or parasite may also cause meningitis.
• Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis is usually more severe and may lead to long-term complications or death.
• An infection usually starts in the respiratory tract. In a child, it may first cause a cold, sinus infection, or ear infection. It can then go into the bloodstream and reach the brain and spinal cord.

• A lumbar puncture (spinal tap) is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal.

• Several vaccines are available to prevent some of the bacterial and viral infections that can cause meningitis.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Not what you’re looking for?

Diagnosis, Initial Management, and Prevention of Meningitis

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Meningitis | Michigan Medicine

Condition Overview

What is meningitis?

Meningitis is inflammation of the lining around the brain and spinal cord. It is usually caused by an infection.

The infection occurs most often in children, teens, and young adults. Also at risk are older adults and people who have long-term health problems, such as a weakened immune system.

There are two main kinds of meningitis:

• Viral meningitis is fairly common. It usually doesn’t cause serious illness. In severe cases, it can cause prolonged fever and seizures.
• Bacterial meningitis isn’t as common, but it’s very serious. It needs to be treated right away to prevent brain damage and death.

What causes meningitis?

Viral meningitis is caused by viruses. Bacterial meningitis is caused by bacteria.

Meningitis can also be caused by other organisms and some medicines, but this is rare.

Most forms of meningitis are contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact.

What are the symptoms?

The most common symptoms among teens and young adults are:

• A stiff and painful neck, especially when you try to touch your chin to your chest.
• Fever.
• Headache.
• Vomiting.
• Trouble staying awake.
• Seizures.

Children, older adults, and people with other medical problems may have different symptoms:

• Babies may be cranky and refuse to eat. They may have a rash. They may cry when held.
• Young children may act like they have the flu. They may cough or have trouble breathing.
• Older adults and people with other medical problems may have only a slight headache and fever.

It is very important to see a doctor right away if you or your child has these symptoms. Only a doctor can tell whether they are caused by viral or bacterial meningitis. And bacterial meningitis can be deadly if not treated right away.

How is meningitis diagnosed?

Your doctor will ask questions about your health, do an exam, and use one or more tests.

Lumbar puncture is the most important lab test for meningitis. It is also called a spinal tap. A sample of fluid is removed from around the spine and tested to see if it contains organisms that cause the illness.

Your doctor may also order other tests, such as blood tests, a CT scan, or an MRI.

How is it treated?

Bacterial meningitis is treated with antibiotics in a hospital. You may also get dexamethasone, a type of steroid medicine. And you will be watched carefully to prevent serious problems such as hearing loss, seizures, and brain damage.

But viral meningitis is more common, and most people with this form of the illness get better in about 2 weeks. With mild cases, you may only need home treatment. Home treatment includes taking medicine for fever and pain and drinking enough fluids to stay hydrated.

Can meningitis be prevented?

The best way to protect your child from meningitis is to make sure he or she gets all the standard immunizations for children. These include shots for measles, chickenpox, Haemophilus influenzae type B (Hib) disease, and pneumococcal infection.

Talk to your doctor about whether you or your child also needs the meningococcal vaccine, which is a shot to prevent bacterial meningitis. Two doses are recommended for all adolescents. And at least one dose is recommended for anyone 6 weeks of age and older who has immune system problems or a damaged or missing spleen. The vaccine is also needed for travel to countries known to have meningitis outbreaks, such as the countries in Africa south of the Sahara Desert.

Cause

Most meningitis is caused by bacteria and viruses that often live in our bodies. Usually these germs stay in the intestines or in the nose and throat, where they may or may not make us sick. But if they spread to the tissues (meninges) that surround the brain and spinal cord, they cause inflammation. This inflammation is called meningitis.

The germs that can lead to meningitis are contagious, which means they can be passed from one person to another.

Viral meningitis

Viral meningitis is the most common and the least dangerous. It’s caused by viruses, most often enteroviruses that live in the intestines. These viruses can be spread through food, water, or contaminated objects. Meningitis caused by enteroviruses occurs most often in babies and young children.

Bacterial meningitis

Bacterial meningitis is caused by bacteria. It is a very serious illness. These germs are usually passed from one person to another through infected saliva or mucus. Most people who get bacterial meningitis get it from one of two types of bacteria:^{footnote 1}

• Streptococcus pneumoniae. This is a common type of bacteria that causes a number of illnesses besides meningitis, such as ear and sinus infections and pneumonia.

• Neisseria meningitidis
  . This is bacteria you can have in your throat without getting sick. But you can pass it to others, who may then get seriously ill with meningitis.

In the United States, bacterial meningitis mainly affects adults.^{footnote 2}

Other types of bacteria that sometimes cause meningitis are:

• Group B streptococci. This type of meningitis occurs most often in newborns, who can become infected during or after birth.
• Listeria monocytogenes. This type of meningitis occurs most often in newborns and in older adults.

• Haemophilus influenzae type b. This type of meningitis occurs in both children and adults. It usually happens after an upper respiratory infection, such as a sinus infection.

The Centers for Disease Control and Prevention (CDC) recommends screening for group B streptococci in all pregnant women at 35 to 37 weeks. Women who have the bacteria are given antibiotics during labor in order to prevent infection in their newborns.^{footnote 3}

In rare cases, other kinds of bacteria cause meningitis, usually in people with long-term medical conditions. Meningitis also can be caused by other organisms, such as a fungus, and by conditions such as cancer or lupus. Meningitis also can be a complication of an injury (particularly to the skull or face), or brain surgery.

How meningitis is spread

Germs that cause meningitis can be spread:

• During birth. A mother can pass germs that cause meningitis to her baby even if the mother doesn’t have symptoms. Delivering a baby by cesarean section rather than through the birth canal doesn’t always protect the baby from getting the infection. Both bacteria and viruses can be transmitted this way.
• Through stool. Stool could have enteroviruses or certain types of bacteria in it. Washing hands on a regular basis can help prevent you and your children from getting infected this way. More children than adults get meningitis this way.
• Through coughing and sneezing. Infected people can pass certain bacteria that are normally found in saliva or mucus in their noses and throats.
• Through kissing, sexual contact, or contact with infected blood. Some viruses also can cause meningitis and can be passed from an infected person to another person through blood, sexual contact, or kissing.
• From eating certain foods. Eating food contaminated with Listeria monocytogenes bacteria can cause meningitis. Those at greater risk for this include pregnant women and people with weakened immune systems.
• From rodents and insects (rare). For example, leptospirosis is a disease caused by bacteria that is spread through water or plants contaminated by the urine of infected mice, hamsters, and rats. And the St. Louis encephalitis and West Nile viruses are spread through mosquito bites.

Symptoms

Symptoms of bacterial meningitis usually appear suddenly.

Symptoms of viral meningitis may appear suddenly or develop gradually over a period of days. For example, the symptoms of viral meningitis after mumps may take several days or weeks to develop.

The most common symptoms of either form of meningitis include:

• Fever.
• Severe and persistent headache.
• Stiff and painful neck, especially when trying to touch the chin to the chest.
• Vomiting.
• Confusion and decreased level of consciousness.
• Seizures.

Less common symptoms include:

• Sluggishness, muscle aches and weakness, and strange feelings (such as tingling) or weakness throughout the body.
• Eye sensitivity and eye pain from bright lights.
• Dark purple and blotchy skin rash.
• Dizzy spells.

Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.

• In babies, the signs of meningitis may be a fever, irritability that is difficult to calm, decreased appetite, rash, vomiting, and a shrill cry. Babies also may have a stiff body and bulging soft spots on the head that aren’t caused by crying. Babies with meningitis may cry when handled.
• Young children with meningitis may act like they have the flu (influenza), cough, or have trouble breathing.
• Older adults and people with other medical conditions may have only a slight headache and fever. They may not feel well and may have little energy.

Other conditions with symptoms similar to meningitis include viral hepatitis and flu.

What Happens

The course of meningitis often depends on your age, general health, and the organism causing the infection. The illness can range from mild to severe.

Viral meningitis is more common in the late summer and early fall. It usually doesn’t cause serious illness. A visit to the doctor followed by home treatment may be all you need.

You may get better within 2 weeks. But some people may feel lightheaded and tired for several months after the illness.

Bacterial meningitis occurs most often from late winter to early spring. It usually causes serious illness and can be life-threatening. The symptoms usually develop suddenly and last for 2 to 3 weeks. A person with bacterial meningitis is treated with antibiotics in a hospital.

Complications

Complications, short-term and long-term, are more common with bacterial than with viral meningitis. People with bacterial meningitis can die if not treated right away. People who are more likely to have these problems include:

The risk of dying from bacterial meningitis is also higher for adults who:^{footnote 1}

• Have seizures during the first 24 hours of illness.
• Are in shock or in a coma when admitted to the hospital.
• Can’t breathe without help from a machine.

Most survivors recover completely.

What Increases Your Risk

A risk factor is anything that makes you more likely to get a certain disease. Risk factors for meningitis include:

• Genetics. Some people may inherit the tendency to get meningitis. If they come in contact with organisms that can cause the infection, they may be likely to get infected.
• Crowded living conditions. People in camps, day care centers, schools, and college dormitories are more likely to get meningitis.
• Being exposed
  to insects and rodents. People who live in or visit areas of the world where insects or rodents carry germs that cause meningitis risk getting the disease.
• Not getting
  childhood immunizations. People who didn’t get shots for mumps, Hib disease, or pneumococcal infections before age 2 are more likely to get meningitis.
• Being an older adult who hasn’t gotten a pneumococcal vaccine.
• Not having a working spleen, which is part of the body’s immune system.
• Travel to areas where meningitis is common. For example, people traveling to the “meningitis belt” in sub-Saharan Africa should get a meningococcal shot.

Medical problems that can increase your risk include:

• Having a birth defect of the skull, a head injury, or brain surgery.
• Having kidney dialysis.
• Having other infections, such as upper respiratory infections, mumps, tuberculosis (TB), syphilis, Lyme disease, and illnesses caused by herpes viruses.
• Having a cochlear implant for severe hearing loss. Studies show that children with cochlear implants have an increased risk for bacterial meningitis.^{footnote 4, footnote 5}
• Being born to a mother infected with an organism that causes meningitis. Viruses such as the enteroviruses and herpes viruses, as well as some bacteria, can be passed from an infected mother to a baby during birth.
• Having had meningitis in the past. Some people who have had meningitis are more likely than others to get it again. These include people with birth defects or injuries to the skull and face, impaired immune systems, or unexpected reactions to some medicines.

When To Call

Call
911
or other emergency services right away if:

• You or your child has symptoms of severe meningitis, such as fever, seizures, and confusion.
• Your baby has signs of severe meningitis, such as trouble breathing or fever with a bulging soft spot on the head not caused by crying.

Call your doctor right away if:

• You or your child has symptoms of meningitis, such as severe and persistent headache, stiff neck, fever, rash, nausea, and vomiting.
• You or your child has viral meningitis and does not get better with home treatment after 3 days.
• You or your child is being treated for viral meningitis and develops signs of complications, such as a fever that lasts longer than 3 full days and does not go down during home treatment.
• Your baby has a fever that comes and goes, diarrhea, vomiting, a swollen abdomen, and a shrill cry.

Call a doctor
soon if you think you may have been exposed to meningitis. You can be treated with antibiotics, which may keep you from getting the illness.

Watchful waiting

Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment.

Watchful waiting isn’t appropriate if you think that you or your child has meningitis, because you can’t tell what type of meningitis it may be. Call your doctor as soon as symptoms appear.

Who to see

The following health professionals can diagnose and treat meningitis:

Specialists may be needed to treat meningitis, especially if complications develop:

Exams and Tests

Diagnosis of meningitis is based on a medical history, a physical exam, and tests.

Your doctor will almost always do a lumbar puncture. This is done by inserting a long, thin needle into the spinal canal. The doctor uses the needle to collect samples of spinal fluid to check for bacteria and viruses.

Other tests that may be done include:

Treatment Overview

Most people with viral meningitis usually start getting better within 3 days of feeling sick, and they recover within 2 weeks. With mild cases of viral meningitis, you may only need home treatment, including drinking extra fluids and taking medicine for pain and fever.

Bacterial or severe viral meningitis may require treatment in a hospital, including:

• Medicines such as antibiotics, corticosteroids, and medicines to reduce fever.
• Oxygen therapy, if you have trouble breathing. To learn more, see Other Treatment.
• Supportive care. In the hospital, doctors watch the person closely and provide care if needed. For example, you may need to drink extra liquids or get fluids in a vein (IV). To learn more, see Other Treatment.

Follow-up care

Most healthy adults who have recovered from meningitis don’t need follow-up care.

But adults who have other medical problems that make them more likely to have long-term complications or get meningitis again should see their doctors after recovery.

Babies and children always need follow-up care after recovery. They need to be checked for long-term complications such as hearing loss.

Prevention

Vaccines

Childhood vaccinations are the best way to prevent meningitis. These shots prevent germs from causing some of the diseases that can lead to meningitis. They include shots for:

For more information about immunizations, see the topic Immunizations.

Cochlear implants

A link has been found between meningitis and cochlear implants for severe hearing loss. To help protect against meningitis, experts recommend that people with cochlear implants get a pneumococcal shot. Also, some people with implants have ear infections before they get meningitis, so it’s important to treat ear infections right away with antibiotics.

Lowering your risk

Take steps to lower your risk of getting or spreading meningitis:

• Stay away from people who have it.
• Keep people with meningitis separate from other people in the home.
• Wash your hands often if you have meningitis or are taking care of someone who does. Wash your hands after using the toilet or helping a sick child use the toilet, after changing a sick baby’s diaper, and after handling used bedsheets, towels, clothes, or personal items of a sick person.
• Avoid contact with wild animals. And take steps to prevent bites from bugs, such as mosquitoes and ticks, that might carry disease-causing bacteria or viruses.
• If you come in close contact with someone who has bacterial meningitis, call your doctor. Taking antibiotics may keep you from getting the illness. If your contact is only casual—for example, at school or at work—you don’t need to take antibiotics.

Self-Care

Home treatment usually is all that is needed for most people who have viral meningitis. It includes:

• Resting. Rest promotes healing and provides relief from symptoms such as headache. Quiet activities, such as reading books, playing board games, watching videos, or listening to music, help pass the time.
• Reducing fever. Cool washcloths to the forehead, cool baths, and medicines such as acetaminophen (Tylenol) or ibuprofen (Advil) can be used to reduce fever, if needed. Be safe with medicines. Read and follow all instructions on the label.
• Relieving headaches and muscle aches. Minor pain usually can be relieved with medicines such as acetaminophen (Tylenol) or ibuprofen (Advil).
• Preventing
  dehydration
  . Drink liquids such as water, juices, teas, and rehydration drinks to keep from getting dehydrated. Children may enjoy frozen juice bars or snow cones. If a person vomits, he or she needs to avoid solid food and take frequent small sips of water or other liquids.
• Watching for signs of complications during illness. The most common complications include fever lasting for longer than expected and seizures. Some people with complications during illness may need to be treated in a hospital.

When you or your child is recovering at home, watch for signs of long-term complications of meningitis, such as hearing loss.

Medicines

The decision about what medicine to use depends on the organism causing the infection, the extent of the infection, and the person’s age and general health.

Medicine choices

Medicines used for treating meningitis include:

• Antibiotics to treat bacterial infection. Often two antibiotics are given together. Antibiotics aren’t given for viral meningitis.
• Medicines to treat seizures.
• Medicines to treat pressure on the brain.
• Medicines to treat fever and muscle aches. The most common ones are nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol).

Other Treatment

People who are very sick may need to be treated in the intensive care unit of a hospital. They may need one or both of these additional treatments:

• Oxygen therapy, to help them breathe and to reduce the amount of work on the heart. A pulse oximeter often is used to measure the amount of oxygen in the blood. Also, if people are too sick to breathe on their own, they may need a machine called a ventilator.
• Suctioning, to remove mucus from the bronchial tubes. A small plastic tube is inserted into the mouth or nose. The tube is attached to a machine that gently sucks out mucus. Other treatments, such as breathing exercises and massage, also can be used to remove mucus.

References

Citations

1. Roos KL, Tyler KL (2015). Meningitis, encephalitis, brain abscess, and empyema. In DL Kasper et al., eds., Harrison’s Principles of Internal Medicine, 19th ed., vol. 2, pp. 883–906. New York: McGraw-Hill Education.
2. Tunkel AR, et al. (2010). Acute meningitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., pp. 1189–1229. Philadelphia: Churchill Livingstone Elsevier.
3. Verani JR, et al. (2010). Prevention of perinatal group B streptococcal disease: Revised guidelines from CDC, 2010. MMWR, 59(RR-10): 1–36. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w.
4. Reefhuis J, et al. (2003). Risk of bacterial meningitis in children with cochlear implants. New England Journal of Medicine, 349(5): 435–445.
5. Biernath KR, et al. (2006). Bacterial meningitis among children with cochlear implants beyond 24 months after implementation. Pediatrics, 117(2): 284–289.

Credits

Current as of:
September 23, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
W. David Colby IV MSc, MD, FRCPC – Infectious Disease

Current as of: September 23, 2020

Author:
Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & W. David Colby IV MSc, MD, FRCPC – Infectious Disease

Roos KL, Tyler KL (2015). Meningitis, encephalitis, brain abscess, and empyema. In DL Kasper et al., eds., Harrison’s Principles of Internal Medicine, 19th ed., vol. 2, pp. 883-906. New York: McGraw-Hill Education.

Tunkel AR, et al. (2010). Acute meningitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., pp. 1189-1229. Philadelphia: Churchill Livingstone Elsevier.

Verani JR, et al. (2010). Prevention of perinatal group B streptococcal disease: Revised guidelines from CDC, 2010. MMWR, 59(RR-10): 1-36. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w.

Reefhuis J, et al. (2003). Risk of bacterial meningitis in children with cochlear implants. New England Journal of Medicine, 349(5): 435-445.

Biernath KR, et al. (2006). Bacterial meningitis among children with cochlear implants beyond 24 months after implementation. Pediatrics, 117(2): 284-289.

Meningitis (for Teens) – Nemours KidsHealth

Meningitis can be a serious infection, and it can be contagious — which is why outbreaks make the news. However, it’s also pretty rare.

What Is Meningitis?

Meningitis is

inflammationof
membranesaround the brain and spinal cord called the meninges (pronounced: muh-NIN-jeez).

What Causes Meningitis?

Most cases are caused by bacteria or viruses, but some can be due to certain medicines or illnesses.

Many of the

bacteriaand
virusesthat cause meningitis are fairly common and cause other routine illnesses. Both kinds of meningitis spread like most other common infections do — someone who’s infected touches, kisses, or coughs or sneezes on someone who isn’t infected.

Bacterial Meningitis

Bacterial meningitis is rare, but is usually serious and can be life-threatening if not treated right away.

In some cases of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infection or nasal sinus infection (sinusitis).

Viral Meningitis

Viral meningitis (also called aseptic meningitis) is more common than bacterial meningitis and usually less serious.

Many of the viruses that cause meningitis are common, such as those that cause colds, diarrhea, cold sores, and the flu.

What Are the Signs & Symptoms of Meningitis?

Meningitis symptoms vary, depending on the person’s age and the cause of the infection. The first symptoms can come on quickly or start several days after someone has had a cold, diarrhea, vomiting, or other signs of an infection.

Common symptoms include:

• fever
• lack of energy
• irritability
• headache
• sensitivity to light
• stiff neck
• skin rashes

How Is Meningitis Diagnosed?

Bacterial meningitis can be very serious. So if you see symptoms or think you could have meningitis, it’s important to see the doctor right away.

If meningitis is suspected, the doctor will order tests, probably including a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of inflammation and whether the infection is due to a virus or bacteria.

How Is Meningitis Treated?

Most cases of viral meningitis end within 7 to 10 days. Some people might need to be treated in the hospital, although most teens can recover at home if they’re not too ill. Treatment to ease symptoms includes rest, fluids, and over-the-counter pain medicine.

If bacterial meningitis is diagnosed — or even suspected — doctors will start

intravenous(IV) antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.

What Problems Can Happen?

Complications of bacterial meningitis might need extra treatment. Someone with shock or low blood pressure might get more IV fluids and medicines to increase blood pressure. Some may need extra oxygen or mechanical ventilation if they have trouble breathing.

Bacterial meningitis complications can be severe and include neurological problems, such as hearing loss, visual impairment, seizures, and learning disabilities. Because impaired hearing is a common complication, those who’ve had bacterial meningitis should have a hearing test after they recover.

The heart, kidneys, and

adrenal glandsalso might be affected, depending on the cause of the infection. Although some people develop long-lasting neurological problems, most who get a quick diagnosis and treatment recover fully.

Can Meningitis Be Prevented?

Vaccinations

Routine immunization can go a long way toward preventing meningitis. The Hib, measles, mumps, polio, and pneumococcal vaccines can protect against meningitis caused by those germs.

Although bacterial meningitis can seem scary, the chance of getting it is quite low. However, because it can be so serious, doctors now recommend that all teens get vaccinated against meningococcal meningitis. Many colleges actually require their students to get meningitis vaccines.

Avoiding Germs

Wash your hands well and often, particularly before eating and after using the bathroom, and if you work closely with kids (as in a daycare). Avoid close contact with someone who’s obviously ill and don’t share food, drinks, or eating utensils.

In some cases, doctors may give antibiotics to anyone who has been in close contact with a person who has bacterial meningitis to help prevent infection.

When Should I Call the Doctor?

Get medical care right away if you think that you could have meningitis or you have symptoms such as vomiting, headache, tiredness or confusion, neck stiffness, rash, and fever.

If you’ve been near someone who has meningitis, call your doctor to ask whether preventive medicine is recommended.

Causes, Symptoms, Treatment & Prevention

Overview

What is meningitis?

Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. Meningitis can be caused by a bacterial, fungal or viral infection. Meningitis can be acute, with a quick onset of symptoms, it can be chronic, lasting a month or more, or it can be mild or aseptic. Anyone experiencing symptoms of meningitis should see a doctor immediately.

What is bacterial meningitis?

Acute bacterial meningitis is the most common form of meningitis. Approximately 80 percent of all cases are acute bacterial meningitis. Bacterial meningitis can be life threatening. The infection can cause the tissues around the brain to swell. This in turn interferes with blood flow and can result in paralysis or even stroke.

Who gets bacterial meningitis?

Children between the ages of 1 month and 2 years are the most susceptible to bacterial meningitis.

Adults with certain risk factors are also susceptible. You are at higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia.

You are also at higher risk if you have a weakened immune system, have had your spleen removed, are on corticosteroids because of kidney failure or have a sickle cell disease.

Additionally, if you have had brain or spinal surgery or have had a widespread blood infection you are also a higher risk for bacterial meningitis.

Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks.

Symptoms and Causes

What causes bacterial meningitis?

The bacteria most often responsible for bacterial meningitis are common in the environment and can also be found in your nose and respiratory system without causing any harm.

Sometimes meningitis occurs for no known reason. Other times it occurs after a head injury or after you have had an infection and your immune system is weakened.

What are the symptoms of bacterial meningitis?

You want to watch for high fever, headaches, and an inability to lower your chin to your chest due to stiffness in the neck.

In older children and adults, you may see confusion, irritability, increasing drowsiness. Seizures and stroke may occur.

In young children, the fever may cause vomiting and they may refuse to eat. Young children may become very irritable and cry. There may be seizures. Also, because the fluid around the skull may become blocked their heads may swell.

The onset of symptoms is fast, within 24 hours. If allowed to progress, you can die from bacterial meningitis.

Diagnosis and Tests

How is bacterial meningitis diagnosed?

It is important that you seek immediate medical assistance if you suspect meningitis.

Your doctor will conduct a physical exam. Your doctor will look for a purple or red rash on the skin. Your doctor will check your neck for stiffness and will exam hip and knee flexion.

Your doctor will have to decide if the cause is bacterial, viral or fungal and will have to analyze your spinal fluid so a spinal tap will be ordered.

Your blood and urine may also be analyzed as well as the mucous from your nose and throat.

Management and Treatment

How is bacterial meningitis treated?

Bacterial meningitis is treated with antibiotics. A general intravenous antibiotic with a corticosteroid to bring down the inflammation may be prescribed even before all the test results are in. When the specific bacteria are identified, your doctor may decide to change antibiotics. In addition to antibiotics, it will be important to replenish fluids lost from loss of appetite, sweating, vomiting and diarrhea.

Prevention

Is bacterial meningitis contagious?

You should encourage anyone who you have come into close contact with to seek preventative treatment. Anyone who you have had casual contact with should not be affected.

Is there a vaccine for bacterial meningitis?

Yes, there are two kind of vaccines available for meningitis in the United States. One type is called a meningococcal conjugate (MenACWY); brand names are Mentactra® and Menveo®. The other type is a Serogroup B meningococcal (MenB) vaccine; brand names are Bexsero® and Trumenba®. The Centers for Disease Control and Prevention (CDC) agency has specific guidelines regarding who should receive the vaccine.

The CDC recommends MenACWY vaccine for:

• All children aged 11-12 years old, with a booster dose at 16 years old.
• Children and adults who are at higher risk of disease due to:
  • Complement component deficiency
  • Compromised spleen function
  • HIV

The CDC recommends the MenB vaccine be given to people who are 10 years old or older who have risk factors for meningococcal disease.

The CDC does not recommend the vaccine for:

• Anyone who has ever had a severe (life threatening) allergic reaction to a previous dose of meningococcal vaccine.
• Anyone who has a severe (life threatening) allergy to any vaccine component. Tell your doctor if you have any severe allergies.

The CDC recommends that the following individuals wait before receiving the vaccine or talk further with their doctor about the need for the vaccine:

• Anyone who is moderately or severely ill at the time of their scheduled appointment to receive their shot should wait until they recover.
• Anyone who has ever had Guillain-Barre syndrome should discuss getting the vaccine with his or her doctor.
• Pregnant women should only get the vaccine if it is clearly needed. Discuss the need with your doctor.

Outlook / Prognosis

Can bacterial meningitis be cured?

There is a 10 percent death rate from bacterial meningitis, but if diagnosed and treated early enough, most people recover.

Are there ever complications from meningitis?

Unfortunately, if treatment is not undergone immediately, there may be permanent damage. Seizures, mental impairment, and paralysis may be life-long.

Resources

Where can I learn more about meningitis?

CDC Hotline: 800.232.4636

Meningitis

Key Facts

• Meningitis is a severe disease with high mortality and serious long-term complications.
• Meningitis remains one of the most serious health problems in the world.
• Epidemics of meningitis occur worldwide, especially in sub-Saharan Africa.
• Meningitis can be caused by many microorganisms, including bacteria, viruses, fungi and parasites.
• Bacterial meningitis is of particular concern. Approximately one in ten people die from this type of meningitis, and one in five develops severe complications.
• Safe and inexpensive vaccines are the most effective way to provide long-term protection against disease.
  

This fact sheet focuses on the four major causative agents of acute bacterial meningitis:

• n eisseria meningitidis (meningococcus)
• s treptococcus s treptococcus pneumoniae influenzae (Haemophilus influenzae)
• s treptococcus agalactiae (group B streptococcus)

Globally, more than half of all fatal meningitis cases are caused by these bacteria, which also cause a number of other serious diseases such as sepsis and pneumonia.

Other common meningitis pathogens include other bacteria such as m ycobacterium tuberculosis , s almonella, l isteria, s treptococcus and s taphylococcus ,
some viruses, such as enteroviruses and mumps, some fungi, especially c ryptococcus , as well as parasites, such as amoeba.

Who is at risk?

Meningitis affects people of all ages, but young children are at greatest risk.Newborns are at greatest risk of contracting group B streptococcus, young children are at greatest risk of contracting meningococcus, pneumococcus and haemophilus influenzae .
Adolescents and young adults are more at risk of developing meningococcal disease, while older people are more at risk of developing pneumococcal disease.

Residents of all regions of the world are at risk of developing meningitis. The burden of disease is greatest in sub-Saharan Africa, known as the “African meningitis belt”, which is particularly at risk of developing
epidemics of meningococcal and pneumococcal meningitis.

The risk is greatest when people are in close contact, such as in crowds, in refugee camps, in overcrowded living quarters, or in student, military and other professional environments. Immunodeficiency associated
those with HIV infection or complement deficiency, immunosuppression, active or secondhand smoke can also increase the risk of developing various types of meningitis.

Mechanisms of transmission of infection

The mechanisms of transmission of infection depend on the type of pathogen.Most of the bacteria that cause meningitis, such as meningococcus, pneumococcus and haemophilus influenzae, are present in the human nasopharyngeal mucosa. They are spread by airborne droplets
pathway with respiratory secretions and secretions from the throat. Group B streptococcus is often present in the intestinal or vaginal mucosa and can be passed from mother to child during childbirth.

Carriage of these organisms is usually harmless and leads to the formation of immunity to infection, however, in some cases, invasive bacterial infection can develop, causing meningitis and sepsis.

Clinical signs and symptoms

Depending on the pathogen, the incubation period can be different and in case of bacterial meningitis it can be from two to 10 days. Because bacterial meningitis is often associated with sepsis, the clinical signs and symptoms described apply to both
pathologies.

Clinical signs and symptoms:

• severe headaches
• nape stiffness or neck pain
• severe fever
• photophobia
• confusion, drowsiness, coma
• cramps
• joint pain
• cold extremities
• vomiting

Infants may experience the following symptoms:

• decreased appetite
• drowsiness, lethargy, coma
• irritability, crying when moving
• difficulty breathing, wheezing
• increased body temperature
• neck muscles
• swollen fontanel
• characteristic high pitched cry
• convulsions
• vomiting
• rash
• pallor or spots on the skin

Prevention

The most effective way to reduce the burden neither disease nor mitigation of the negative impact of meningitis on public health is to ensure long-term protection against disease through vaccine prevention.

Antibiotics are also used for prophylactic purposes in the risk group for meningococcal meningitis and meningitis caused by group B streptococcus. Both vaccinations and antibiotics are used to combat epidemics of meningococcal meningitis.

1. Vaccination

There have been registered vaccines on the market for many years against meningococci, pneumococci and h aemophilus influenzae . Several different strains (also called serotypes or serogroups) of these bacteria are known, and vaccines are targeted
to develop immunity to the most dangerous of them.Over time, great strides have been made in terms of strain coverage and vaccine availability, but a universal vaccine against all of these pathogens has not yet been developed.

Meningococci

There are 12 serogroups of meningococci, of which in most cases meningitis is caused by bacteria of serogroups A, B, C, W, X and Y.

There are three types of vaccines:

• Polysaccharide-protein conjugate vaccines are used for prevention and outbreak response:
  • Such vaccines allow the formation of long-term immunity, and also prevent the carriage of infection, thereby reducing the spread of infection and forming herd immunity.
  • They are effective in protecting children under two years of age from disease.
  • These vaccines are available in different forms:
    • monovalent vaccines (serogroups A or C)
    • tetravalent vaccines (serogroups A, C, W, Y).
    • combination vaccines (meningococcus serogroup C and h aemophilus influenzae type b)
• Protein vaccines against meningococcus serogroup B. These vaccines protect against meningitis at any age, but do not appear to prevent carriage and transmission of infection and, thus, do not lead to the formation of population immunity.
• Polysaccharide vaccines are safe and effective to vaccinate children and adults, but have little protection in infants. Formed immunity is short-lived, and population immunity is not formed, since vaccination does not prevent carriage.
  These vaccines are still being used to control outbreaks, but they are being replaced by conjugate vaccines.

Global public health response: Eliminating meningococcal group A meningitis epidemics in the meningitis belt of Africa

) and its inclusion in the calendar of routine vaccinations (since 2016) in the countries of the African meningitis belt, this pathogen caused 80-85%
all epidemics of meningitis. As of April 2021, 24 out of 26 countries in the meningitis belt have conducted massive prevention campaigns among children aged 1–29 years (throughout the national territory or in high-risk areas), and in half
of these, the vaccine has been included in national routine immunization schedules. Among the vaccinated population, the incidence of serogroup A meningitis has decreased by more than 99%, and since 2017.not a single case of the disease caused by
meningococcus serogroup A. It is imperative to continue to include this vaccine in the routine immunization schedule and to maintain high coverage to avoid re-emerging epidemics.

Isolated cases and outbreaks of meningitis due to other serogroups of meningococci other than serogroup B continue to be reported. The introduction of polyvalent meningococcal conjugate vaccines is a public health priority.
the solution of which will allow to achieve the elimination of epidemics of bacterial meningitis in the African meningitis belt.

Pneumococcus

More than 97 serotypes of pneumococci are known, 23 of which cause the majority of cases of pneumococcal meningitis.

• Conjugate vaccines are effective from 6 weeks of age to prevent meningitis and other severe pneumococcal infections and are recommended for vaccination of infants and children under 5 years of age, and in some countries adults over 65 years of age, as well as
  representatives of certain risk groups. Two conjugate vaccines are used that protect against serotypes 10 and 13 of pneumococci.New conjugate vaccines designed to protect against more pneumococcal serotypes are now
  are currently under development or already approved for vaccination in adults. Work continues on the development of protein-based vaccines.
• There is a polysaccharide vaccine designed to protect against 23 serotypes, however, like other polysaccharide vaccines, it is considered less effective than conjugate vaccines. It is mainly used for vaccination
  against pneumonia among people over 65 years old, as well as representatives of certain risk groups.It is not used to vaccinate children under 2 years of age and is less effective in preventing meningitis.

Haemophilus influenzae

There are 6 known serotypes haemophilus influenzae , of which serotype b is the main causative agent of meningitis.

• There are conjugate vaccines that form specific immunity to h aemophilus influenzae serotype b (Hib). They are highly effective in preventing Hib disease and are recommended for inclusion in
  calendars of routine vaccinations for newborns.

Group B streptococcus

There are 10 serotypes of group B streptococci, of which the most common causative agents of meningitis are streptococcus types 1a, 1b, II, III, IV and V.

• Currently, work is underway to create conjugated and protein vaccines for the prevention of group B streptococcal infection in mothers and newborns.

2. Prophylactic use of antibiotics (chemoprophylaxis)

Meningococci

Timely prescription of antibiotics to persons in close contact with patients with meningococcal infection reduces the risk of transmission.Outside the African meningitis belt, chemoprophylaxis is recommended for family members of patients
in close contact with them. In countries of the meningitis belt, it is recommended to prescribe chemoprophylaxis to persons who have had close contacts with patients in the absence of an epidemic. The drug of choice is ciprofloxacin; as an alternative
ceftriaxone is prescribed.

Group B streptococcus

It is recommended in many countries to identify mothers whose children are at risk for group B streptococcus.One of the ways to accomplish this task is universal screening of pregnant women for the carriage of group B streptococcus.
Group B infections in newborns

Diagnosis

Initial diagnosis of meningitis is performed by clinical examination followed by lumbar puncture. In some cases, bacteria can be seen in the cerebrospinal fluid under a microscope.Diagnosis supported or confirmed
culture examination of cerebrospinal fluid or blood samples, rapid tests or polymerase chain reaction (PCR) studies. To select the correct infection control measures, it is important to identify the serogroup of the pathogen and
test for antibiotic susceptibility. Molecular typing and whole genome sequencing can reveal more differences between strains and provide valuable information for making decisions about the necessary anti-epidemic
activities.

Treatment

Meningitis without adequate treatment is fatal in half of patients and should therefore always be considered a medical emergency. Hospitalization is indicated for all patients with meningitis. Usually after 24 hours from the start of treatment
it is not recommended to isolate patients.

For bacterial meningitis, treatment with appropriate antibiotics should be started as soon as possible. Ideally, a lumbar puncture should be performed before starting the course of antibiotics, as antibiotics can make it difficult to perform culture
studies of cerebrospinal fluid.However, the type of pathogen can also be determined by examining a patient’s blood sample, and prompt treatment remains a priority. A wide range of antibiotics are used to treat meningitis,
including penicillin, ampicillin, and ceftriaxone. During epidemics of meningococcal and pneumococcal meningitis, ceftriaxone is the drug of choice.

Complications and consequences of the disease

One in five patients with bacterial meningitis may have long-term consequences of the disease.These include hearing loss, seizures, weakness in the limbs, visual impairment, speech impairment, memory impairment, communication difficulties, and
scars and consequences of limb amputation in case of sepsis.

Support and follow-up

The consequences of meningitis can have tremendous negative impacts on the lives of individuals, families and communities, both financially and emotionally. Sometimes complications such as deafness, learning difficulties, or behavioral disorders
are not recognized by parents, caregivers or healthcare professionals and are therefore left untreated.

The consequences of the transferred meningitis often require long-term treatment. The permanent psychosocial impact of disability acquired as a result of meningitis may create a need for medical assistance in patients
in the field of education, as well as social and human rights support. Despite the heavy burden of the consequences of meningitis on patients, their families and communities, access to services and support for these conditions is often inadequate, especially
in low- and middle-income countries.Persons with disabilities from previous meningitis and their families should be encouraged to seek services and advice from local and national disability societies and other organizations.
people with disabilities, where they can be provided with life-saving counseling on their rights, economic opportunities and social life so that people with disabilities from meningitis can live
full life.

Surveillance

Surveillance – from case detection to investigation and laboratory confirmation – is essential to the success of meningococcal meningitis control.The main objectives of surveillance:

• detection and confirmation of outbreaks;
• Monitoring morbidity trends, including the distribution and evolution of serogroups and serotypes;
• disease burden estimate;
• monitoring the resistance of pathogens to antibiotics;
• Monitoring of circulation, distribution and evolution of individual strains;
• Evaluating the effectiveness of meningitis control strategies, in particular vaccine prevention programs.

WHO activities

WHO, with the support of many partners, has developed a global roadmap for achieving the 2030 meningitis targets.In 2020, this strategy was endorsed in the first-ever World Health Assembly resolution,
dedicated to meningitis, and is unanimously endorsed by WHO Member States.

The roadmap sets a global goal of freeing the world from meningitis, with three ambitious goals:

• Eliminate epidemics of bacterial meningitis;
• Reducing the number of cases of vaccine-preventable bacterial meningitis by 50% and deaths from it by 70%;
• Reducing the incidence of meningitis-related disability and improving the quality of life of people with any type of meningitis.

The roadmap sets out an overall plan to achieve these goals through concerted action across five interrelated areas:

• Epidemic prevention and control, with a focus on developing new low-cost vaccines, achieving high immunization coverage, and improving prevention and response strategies;
• Diagnostics and treatment with an emphasis on prompt confirmation of diagnosis and optimal delivery of medical care;
• disease surveillance to inform solutions for the prevention and control of meningitis;
• Care and support for survivors of meningitis, with a focus on early detection and increased access to care and support for complications of meningitis;
• Advocacy and outreach to raise awareness of meningitis, engage countries in the fight against the disease, and ensure that people’s right to prevention, treatment and follow-up is realized.

As part of another companion initiative, WHO, in consultation with Member States, is working on an intersectoral global plan of action on epilepsy and other neurological disorders to address multiple challenges and fill gaps in
care and service for people with epilepsy and other neurological disorders around the world. The protection of the rights of persons with disabilities is also recognized and addressed in the WHO Global Plan of Action on Disability, prepared in
in line with the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities (CRPD), and the landmark 74 World Health Assembly resolution on achieving the highest standard of health for people with disabilities.

Despite the fact that the roadmap for combating meningitis is dedicated to all types of this disease, it primarily deals with the fight against the main pathogens of acute bacterial meningitis (meningococcus, pneumococcus, haemophilus influenzae and group B streptococcus). In 2019, these bacteria were responsible for more than half of the 250,000 deaths from all forms of meningitis. They are also the causative agents of other serious diseases such as sepsis and pneumonia. Against each of these pathogens
vaccine infections either already exist or, as in the case of group B streptococcus, are expected in the coming years.

Sources:

Defeating meningitis 2030: baseline situation analysis

Achieving 2030 meningitis targets Global Roadmap

Confederation of Meningitis Organizations (comomeningitis.org)

Web Consultation on the first draft of the intersectoral global action plan on epilepsy and other neurological disorders

90,000 Meningitis killed a young man in a day // Watch

In the Voronezh Region, doctors are checking the environment of a 16-year-old student at the Borisoglebsk Agricultural College, who died in the Regional Children’s Hospital No. 2 from a fulminant form of meningococcal infection.

In the Voronezh Region, doctors are checking the environment of a 16-year-old student at the Borisoglebsk Agricultural College, who died in the Regional Children’s Hospital No. 2 from a fulminant form of meningococcal infection. All of his entourage took the necessary tests. The state of students and their parents, as well as teachers, will be monitored for 10 days, “Vesti Voronezh” writes.

According to the press service of the regional health department, the examination is carried out daily.There is no cause for concern, everyone is healthy.

On February 15, a student at the Borisoglebsk Agricultural College felt unwell. The young man’s temperature rose to 40 degrees, a red rash appeared on his body. He fainted several times, after which the students called an ambulance to the hostel. Before that, the young man was in class, did not complain about his health.

At about 14:00, the young man was taken to the district hospital in critical condition. He was placed in intensive care with meningitis, where he was urgently connected to a ventilator.

According to the doctors, the fight for his life lasted for about a day, but the fulminant form of the disease did not respond to treatment, and it was not possible to save the young man.

Meningococcal infection is one of the unpredictable course of lightning. It causes meningitis, a purulent infection of the lining of the brain and spinal cord. It poses the greatest danger to children. The younger the age, the higher the risk of death.

It can be infected by airborne droplets and household contact.The infection is transmitted from person to person within a radius of up to one meter.

Find a specialist in the treatment of diseases of the brain and eyes

Information on the subject area Brain and eyes

Looking for a specialist in the treatment of diseases of the brain and eyes in Germany, Austria or Switzerland? With the help of our search system for the right doctor and clinic, you can find a highly qualified specialist and medical center in the field of treating diseases of the brain and eyes.

What kind of specialists deal with brain problems?

Brain problems are dealt with by specialists in the field of neurology, neurosurgery and neuroradiology. While neurosurgeons deal with the diagnosis of brain diseases and primarily with drug therapy, neurosurgeons are responsible for surgical treatment. Neuroradiologists specialize in specific diagnostic and therapeutic procedures in interventional radiology.For developmental disorders and diseases of the child’s brain, we are talking about neuropediatrics (pediatric neurology).

What diseases do these specialists deal with?

Major diseases of the head and brain:

• Benign and malignant brain tumors (astrocytomas, gliomas, meningiomas, acoustic neuromas, medulloblastomas, pituitary tumors)
• Brain metastases
• Vascular malformations and vasodilation (such as cerebral aneurysms , carotid stenosis, arteriovenous malformations (AVM), cavernomas)
• Movement disorders (Parkinson’s disease, dystonia, torticollis)
• Chronic pain (trigeminal neuralgia)
• Degenerative diseases such as dementia
• Epilepsy
• Circulatory disorders (TIA, (stroke))
• Headache (migraine)
• Inflammatory diseases of the brain
• Multiple sclerosis, meningitis
• Brain diseases in children ( hydrocephalus , skull deformity, meningocele, epilepsy and mental retardation)

What are the options for treating brain diseases?

In addition to drug treatment, interventional procedures or surgery are also performed, the choice of which depends on the brain disease.

Interventional procedures in neuroradiology:

Interventional methods of neuroradiology are used mainly for vascular stenosis, vascular occlusion and vascular malformations. For example, in case of stenosis of the carotid artery, the narrowed areas are dilated with a stent. Vascular malformations such as cerebral aneurysms can be blocked by an experienced neuroradiologist using the minimally invasive Coiling procedure.

Surgical procedures in neurosurgery:

Where can I find an experienced person in this field?

The specialists in the treatment of brain diseases in Germany, Austria or Switzerland are highly qualified and use the latest diagnostic and surgical technologies.They are distinguished from others by many years of work experience and continuous professional development.

Here you can find specialists in the field of treatment of brain diseases in the following cities

What kind of specialists deal with eye diseases?

Ophthalmologists are specialists in the treatment of eye diseases. After successfully completing a medical university, a young doctor must complete an internship for 5 years in a non-educational institution. The content of the internship course regulates the procedure for training a specialist.

What eye diseases do ophthalmologists treat?

Where can I find an experienced ophthalmologist or clinic?

Our specialists have many years of experience in the field of ophthalmology . They participate in scientific research and conduct independent surgical practice in the clinic. They have at their disposal modern diagnostic and surgical equipment. Specialists in ophthalmology can be found in the following cities:

Eye specialist in Mainz

90,000 Trigger and Glass Pose: How to recognize meningitis? – News of Tula and region

The causative agent of meningococcal infection is transmitted from person to person by airborne droplets (aerosol) through direct close communication, close contact (up to 1 m) with an infected person.Meningococcus is unstable in the external environment and its transmission through household items has not been registered.

The incubation period can vary from 1 to 10 days. Get immediate medical attention if you develop any of the following symptoms:

• against the background of the usual manifestation of a cold, an intense headache appears, so severe that it worries more than all other symptoms,
• headache with nausea and vomiting,
• against the background of increased body temperature, pain in the back and neck, aggravated by head movement,
• drowsiness, confusion, nausea, vomiting, convulsions of any intensity and duration
• any rash with fever,
• in children of the first year of life – fever, monotonous crying and bulging fontanelle.

Trigger Pose (or Pointing Dog Pose)

Doctors say that it is difficult for a person with meningitis to tilt their head forward. During sleep or in oblivion, the patient holds his head like this:

Glass and rash

A simple test. It is enough to take a simple clean glass and press it to the body in the place where the rash appeared. “Meningitis rash”, not only has a characteristic appearance, and also does not disappear with pressure.

Feet

The symptoms are as follows.

Upper Brudzinsky symptom . When raising the head from a supine position, the patient’s legs spontaneously bend at the knees.

Körnig’s symptom : It is impossible to straighten the patient’s leg at the knee joint if it is bent at the hip.

The disease can proceed with lightning speed and end
death of the patient.Any suspicion of developing meningitis requires immediate hospitalization and close medical supervision. Hospitalization is carried out in an infectious diseases hospital, where the initial examination of the patient is carried out and the diagnosis of probable meningitis is carried out.

If you find these signs, call the ambulance immediately.

90,000 How to recognize meningitis?

Symptoms of meningitis, which should be a signal for immediate medical attention :

• headache , this is the main symptom of meningitis and has distinctive features – persistent headache; a feeling of bursting of the skull from the inside; the strength of the pain syndrome increases with tilting the head; headache gets worse with loud sounds and bright light;
• Muscle tension in the occiput , the patient cannot lie on his back, he will tilt his head back;
• indigestion , nausea, repeated vomiting appear;
• hyperthermia , fever, chills, weakness, sweating;
• photophobia , the patient cannot look at bright light, this causes a headache;
• impaired consciousness , the patient becomes lethargic, does not respond to treatment;
• mental disorder , the patient may experience hallucinations, aggression;
• convulsive syndrome , the patient may experience convulsions of the lower and upper extremities, in rare cases, voluntary urination and defecation occurs;
• rash , a rash may appear, sometimes reaching large bright burgundy spots all over the body;
• strabismus , if the eye nerves are affected during the inflammatory process, then the patient begins to have a pronounced strabismus;
• muscle pain .

Preventive measures :

timely vaccination; hardening the body and strengthening the immune system; avoid close contact with sick people and crowded places during the epidemic; dress correctly – child’s clothes should be appropriate for age and weather conditions – do not overcool; follow the rules of personal hygiene – wash your hands thoroughly and often with soap and water, especially after coughing or sneezing; carry out wet cleaning of the premises and observe the ventilation mode; wash fruits and vegetables efficiently; observe the drinking regime, avoid water procedures with children in stagnant bodies of water (lakes, ponds, reservoirs).

Information was prepared by Nesterova N.Ye.

90,000 The head of the Department of Health in Kurgan will check after the letter of doctors

Sigidaev took personal control of the situation in the Kurgan BSMP
Photo: Ekaterina Sychkova © URA.RU

The head of the health department of the Kurgan region, Alexei Sigidaev, after a letter from doctors, organized an urgent checkup in an emergency hospital.This was reported to URA.RU by the press service of the regional government.

“The Department of Health is aware of this call. The head of the department, Alexei Sigidaev, instructed to conduct an internal check for the accuracy of the information received. He took the situation under personal control. The results of the check will be announced additionally, ”the press service of the regional government said.

Doctors of the Kurgan emergency hospital wrote a letter to the new head of the regional department of health, Aleksey Sigidaev, with a request to solve the problem of staff outflow.Three surgeons, two resuscitators, two doctors of ultrasound diagnostics, an ENT doctor quit. Nurses and paramedics leave en masse. Due to the low salary, the head of the children’s ENT department resigned, the department itself on the basis of the emergency hospital was closed. Also closed, with the dismissal of employees, the HBO department, where patients underwent treatment and rehabilitation for carbon monoxide poisoning.

Earlier, doctors of the Kurgan emergency hospital reported mass layoffs in the hospital. The authorities replied that those wishing to quit were offered jobs in other hospitals, and some had already agreed.

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Head of the Kurgan Region Health Department Alexei Sigidaev, after a letter from doctors, organized an urgent checkup in an emergency hospital. This was reported to URA.RU by the press service of the regional government. “The Department of Health is aware of this appeal.The head of the department, Alexei Sigidaev, instructed to conduct an internal check for the accuracy of the information received.