The Inflamed Brain | NIH News in Health

April 2019

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Recognizing Encephalitis and Meningitis

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When you get sick, some germs can attack the brain or the protective lining that surrounds the brain. This can cause swelling and lead to severe illness, or even death. It’s important to recognize the symptoms so you can get medical help as quickly as possible.

When the brain swells, it’s called encephalitis. When the lining of the brain, or meninges, becomes inflamed, it’s called meningitis. The symptoms can be similar for both.

At first, you might get a fever, feel tired, and sometimes have a rash. “Those things can last a day or two, or a little bit longer,” explains Dr. Avindra Nath, a neurologist at NIH. “Then, you may have a headache, along with fever, neck stiffness, and you can get sensitivity to light. ”

Other symptoms include nausea or vomiting, double vision, drowsiness, and confusion. More severe illnesses can cause speech, hearing, or vision problems. If it’s left untreated, you could develop cognitive difficulties with progressive loss of consciousness, seizures, or muscle weakness.

You need to get immediate medical help if you have symptoms of encephalitis or meningitis. Early treatment is important for the best recovery. Treatment will depend on the cause. Viruses, bacteria, parasites, and fungi can all cause encephalitis and meningitis. The most common causes can be different depending on where you live.

“Worldwide, the most common cause of meningitis is bacterial meningitis,” Nath explains. “Now in the United States, we don’t see a lot of bacterial meningitis because we have certain vaccines. So, the most common cause of meningitis is viral meningitis.”

Early treatment for bacterial causes may be antibiotics and other medicines to treat swelling and other symptoms of the illness. There aren’t any specific anti-viral treatments for most viral causes. But treating the symptoms can affect the course of the illness. More severe illnesses may require hospitalization.

Anyone can get these conditions. Protecting yourself and your family from germs and staying up-to-date on vaccines is the best way to guard against both encephalitis and meningitis. Vaccines are available to prevent some bacterial causes of meningitis, including Haemophilus influenzae, pneumococcal pneumonia, and meningococcal disease.

NIH-funded researchers are looking for other ways to prevent or treat encephalitis and meningitis. Some are studying how to stop germs from infecting the brain or its lining.

Nath’s team is testing compounds that may block Zika virus from getting into brain cells grown in the lab. His team hopes that these may block other viruses that are transmitted by insects and parasites, too.

Many scientists are trying to develop broad antivirals, Nath says. “Broad” means the antiviral would stop many viruses rather than just one. This would be helpful, since doctors wouldn’t have to know which virus is causing the problem before starting treatment.

Until we have better treatments, prevention is still the best medicine. Children, older adults, and those with weakened immune systems are most at risk for infections. See the Wise Choices box for tips on protecting yourself and your family.

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Meningitis: Inflammation of membranes around your brain and spinal cord

• By

  Dana Sparks

  September 17, 2020

Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck.

This article is written by Mayo Clinic staff. Find more health and medical information on mayoclinic.org.

____________________________________

Most cases of meningitis in the United States are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergency antibiotic treatment.

Seek immediate medical care if you suspect that someone has meningitis. Early treatment of bacterial meningitis can prevent serious complications.

Symptoms

Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.

Possible signs and symptoms in anyone older than the age of 2 include:

• Sudden high fever
• Stiff neck
• Severe headache that seems different than normal
• Headache with nausea or vomiting
• Confusion or difficulty concentrating
• Seizures
• Sleepiness or difficulty waking
• Sensitivity to light
• No appetite or thirst
• Skin rash (sometimes, such as in meningococcal meningitis)

Signs in newborns

Newborns and infants may show these signs:

• High fever
• Constant crying
• Excessive sleepiness or irritability
• Inactivity or sluggishness
• Poor feeding
• A bulge in the soft spot on top of a baby’s head (fontanel)
• Stiffness in a baby’s body and neck

Infants with meningitis may be difficult to comfort, and may even cry harder when held.

When to see a health care provider

Seek immediate medical care if you or someone in your family has meningitis symptoms, such as:

• Fever
• Severe, unrelenting headache
• Confusion
• Vomiting
• Stiff neck

Bacterial meningitis is serious, and can be fatal within days without prompt antibiotic treatment. Delayed treatment increases the risk of permanent brain damage or death.

It’s also important to talk to your doctor if a family member or someone you work with has meningitis. You may need to take medications to prevent getting the infection

Causes

Viral infections are the most common cause of meningitis, followed by bacterial infections and, rarely, fungal infections. Because bacterial infections can be life-threatening, identifying the cause is essential.

Bacterial meningitis

Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or, rarely, after some surgeries.

Several strains of bacteria can cause acute bacterial meningitis, most commonly:

• Streptococcus pneumoniae (pneumococcus). This bacterium is the most common cause of bacterial meningitis in infants, young children and adults in the United States. It more commonly causes pneumonia or ear or sinus infections. A vaccine can help prevent this infection.
• Neisseria meningitidis (meningococcus). This bacterium is another leading cause of bacterial meningitis. These bacteria commonly cause an upper respiratory infection but can cause meningococcal meningitis when they enter the bloodstream. This is a highly contagious infection that affects mainly teenagers and young adults. It may cause local epidemics in college dormitories, boarding schools and military bases. A vaccine can help prevent infection.
• Haemophilus influenzae (haemophilus).  Haemophilus influenzae type b (Hib) bacterium was once the leading cause of bacterial meningitis in children. But new Hib vaccines have greatly reduced the number of cases of this type of meningitis.
• Listeria monocytogenes (listeria). These bacteria can be found in unpasteurized cheeses, hot dogs and lunchmeats. Pregnant women, newborns, older adults and people with weakened immune systems are most susceptible. Listeria can cross the placental barrier, and infections in late pregnancy may be fatal to the baby.

Viral meningitis

Viral meningitis is usually mild and often clears on its own. Most cases in the United States are caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps, West Nile virus and others also can cause viral meningitis.

Chronic meningitis

Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) that invade the membranes and fluid surrounding your brain cause chronic meningitis. Chronic meningitis develops over two weeks or more. The signs and symptoms of chronic meningitis — headaches, fever, vomiting and mental cloudiness — are similar to those of acute meningitis.

Fungal meningitis

Fungal meningitis is relatively uncommon and causes chronic meningitis. It may mimic acute bacterial meningitis. Fungal meningitis isn’t contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS. It’s life-threatening if not treated with an antifungal medication.

Other meningitis causes

Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies, some types of cancer and inflammatory diseases such as sarcoidosis.

Immunizations

Some forms of bacterial meningitis are preventable with the following vaccinations:

• Haemophilus influenzae type b (Hib) vaccine. Children in the United States routinely receive this vaccine as part of the recommended schedule of vaccines, starting at about 2 months of age. The vaccine is also recommended for some adults, including those who have sickle cell disease or AIDS and those who don’t have a spleen.
• Pneumococcal conjugate vaccine (PCV13). This vaccine also is part of the regular immunization schedule for children younger than 2 years in the United States. Additional doses are recommended for children between the ages of 2 and 5 who are at high risk of pneumococcal disease, including children who have chronic heart or lung disease or cancer.
• Pneumococcal polysaccharide vaccine (PPSV23). Older children and adults who need protection from pneumococcal bacteria may receive this vaccine. The Centers for Disease Control and Prevention recommends the PPSV23 vaccine for all adults older than 65; for younger adults and children age 2 and older who have weak immune systems or chronic illnesses such as heart disease, diabetes or sickle cell anemia; and for anyone who doesn’t have a spleen.
• Meningococcal conjugate vaccine.  The Centers for Disease Control and Prevention recommends that a single dose be given to children ages 11 to 12, with a booster shot given at age 16. If the vaccine is first given between ages 13 and 15, the booster is recommended between ages 16 and 18. If the first shot is given at age 16 or older, no booster is necessary.This vaccine can also be given to children between the ages of 2 months and 10 years who are at high risk of bacterial meningitis or who have been exposed to someone with the disease. It’s also used to vaccinate healthy but previously unvaccinated people who have been exposed in outbreaks.

Learn more about risks, complications and prevention.

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Inflammation of the meninges – diagnosis and treatment at 100med

What kind of disease is this

Meningitis is often referred to as inflammation of the meninges. In the event of its occurrence, the protective layers of the spinal cord and brain become inflamed. This occurs under the influence of simple microorganisms, bacteria, fungal or viral infections. In some cases, the cause of inflammation can be medication or an injury.

Symptoms

Symptoms of inflammation of the meninges:

• increase in body temperature;

• the occurrence of hearing problems;

• significant headaches;

• nausea;

• loss of consciousness;

• vomit;

• the appearance of a rash on the skin;

• neck stiffness;

• drowsiness;

• convulsions;

• mental problems, including apathy, hallucinations, anxiety, agitation and other types.

Causes

Causes of inflammation of the meninges:

• influence of the simplest microorganisms;

• the presence of fungal infections;

• bacterial types of infections;

• viral diseases;

• a combination of several types of pathogens.

Diagnostics

Diagnosis of inflammation of the meninges is carried out as follows:

• general, PCR and biochemical blood tests;

• neurological examination;

• electroencephalography;

• puncture of the cerebrospinal type;

• CT study.

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Our expert’s opinion

Meningitis occurs in acute, fulminant and chronic forms, so only with the right approach can a correct and timely diagnosis be made. Such a complex disease requires complex treatment and high professionalism of medical personnel.

Treatment

Therapy of inflammation of the meninges is carried out in the complex:

• the use of antiviral agents;

• the appointment of antipyretics;

• the use of painkillers;

• antifungal treatment;

• antibacterial therapy.

Also during the treatment of meningitis, it is important to maintain the body’s water balance and adhere to the diet recommended by the specialist.

Prevention

Prevention and treatment of inflammation of the meninges includes vaccination recommended for children, patients with immunodeficiency and persons in contact with carriers of the disease. Also, to prevent illness, it is important to maintain a healthy lifestyle, regularly visit the fresh air, exercise, temper and avoid sources of infection. A balanced diet and the use of vitamin and mineral complexes can be a significant step in the prevention of inflammation of the meninges.

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What is meningitis and how can you recognize it?

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What is meningitis and how to recognize it?

27. 04.2022

What is meningitis?

Meningitis is an infectious inflammation of the meninges of the brain and spinal cord, accompanied by intoxication, fever, increased intracranial pressure syndrome, meningeal syndrome, and inflammatory changes in the cerebrospinal fluid (cerebrospinal fluid).

The meninges are membranous connective tissue formations that cover the brain and spinal cord. Distinguish between the dura mater, arachnoid and soft. The hard shell of the brain has a dense texture and a thickness of 0.2-1 mm, in some places it fuses with the bones of the skull. The arachnoid is a thin, translucent, vascularless connective tissue plate that surrounds the brain and spinal cord. The pia mater is a thin connective tissue plate directly adjacent to the brain, corresponds to its relief and penetrates into all its recesses. In its thickness is the vascular network of the brain. The most common inflammation of this particular meningeal membrane, which is called meningitis.

Causes of meningitis

Meningitis can occur on its own or as a complication after an infection. The disease is transmitted by airborne, contact-household or alimentary (with food) way.

Purulent inflammation of the meninges can be caused by various bacterial flora, for example, meningococci, pneumococci, less often by other pathogens. The cause of serous meningitis is viruses, bacteria, fungi.

According to the prognosis, tuberculous meningitis is the most dangerous, which occurs if there is a tuberculous lesion in the body. The development of the disease takes place in two stages. At the first stage, the pathogen with blood flow affects the choroid plexuses of the ventricles of the brain with the formation of a specific granuloma in them. On the second, inflammation of the arachnoid and soft membranes is observed (as a rule, the membranes of the base of the brain are affected), which causes acute meningeal syndrome.

The process of development of meningococcal meningitis also consists of several stages:

• entry of the pathogen into the mucous membrane of the nasopharynx

• entry of meningococcus into the blood

• penetration of the pathogen through the hematoliquor barrier

• irritation of pia mater receptors by toxic factors

• inflammation

The course of the infectious process depends on the pathogenic properties of the pathogen (the ability to cause disease) and the state of the human immune system.

Preceding viral illness, sudden climate change, hypothermia, stress, comorbidities, and immunosuppressive therapy are essential to the onset and course of meningitis.

Symptoms and syndromes of meningitis

There are a number of syndromes common to all meningitis:

• meningeal syndrome is manifested by rigidity (increased tone) of the occipital muscles and long muscles of the back, hyperesthesia (increased sensitivity) of the sense organs, headache, vomiting, changes in the cerebrospinal fluid;

• cerebral syndrome is manifested by drowsiness, impaired consciousness, nausea, vomiting, dizziness, psychomotor agitation, hallucinations;

• asthenovegetative syndrome is manifested by weakness, decreased ability to work;

• convulsive syndrome;

• general infectious syndrome is manifested by chills and fever.

Symptoms of meningitis :

Types of meningitis

According to the type of pathogen, meningitis is divided into five types:

1. Viral – influenza, parainfluenza, adenovirus, herpetic, arbovirus (tick-borne), mumps, enteroviral ECHO and Coxsackie.

2. Bacterial – meningococcal, tuberculosis, pneumococcal, staphylococcal, streptococcal, syphilitic, brucellosis, leptospirosis.

3. Fungal – cryptococcal, candidal, etc.

4. Protozoal – toxoplasmosis, malarial.

5. Mixed.

The most common among purulent meningitis is meningococcal . The incubation period of such meningitis is from 1 to 10 days. The disease usually begins acutely and unexpectedly or soon after nasopharyngitis. Patients are worried about chills, temperature above 38 ℃, severe bursting headache, aggravated by any noise and movement of the head, pain in various parts of the body, even from light touch. Vomiting is not associated with eating and does not bring relief. Such meningitis develops rapidly and is dangerous because it can lead to sepsis. Infants cry constantly, they may experience bulging fontanelles and gastrointestinal disorders.

Pneumococcal meningitis, as a rule, is observed in young children against the background of existing pneumonia, sinusitis.

With streptococcal meningitis, the liver and spleen are enlarged, kidney and adrenal insufficiency, petechial rash appears (hemorrhages due to capillary damage, causing blood, spreading under the skin, forms rounded spots up to 2 mm in size).

For serous tuberculosis meningitis is characterized by a gradual onset. The patient feels fatigue, weakness, irritability, moderate headache, sleep is disturbed. The temperature usually does not rise above 38℃. On the fifth or sixth day of the illness, the temperature rises above 38℃, the headache intensifies, nausea, vomiting, and drowsiness appear. Unconsciousness develops rapidly. There may be divergent strabismus, a low position of the upper eyelid in relation to the eyeball, dilated pupils.

For enteroviral meningitis is characterized by two- and three-wave fever with intervals between waves of one or two or more days. Almost always there are other manifestations of enterovirus infection, for example, muscle pain, skin rash, herpangina.

Disease prevention

Protection against meningitis is vaccination. Since the disease is caused by different types of viruses and bacteria, there is no single vaccination against all types of meningitis. It is recommended to be vaccinated against meningococcal, hemophilic and pneumococcal infections, measles and mumps. Significantly reduces the risk of complications with an annual flu shot.

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