Understanding Meningitis

When meningitis strikes, it can be confusing and difficult to identify the symptoms because they are very similar to symptoms one would experience having the flu or a cold. This Understanding Meningitis section is a guide to helping you learn about the various types of meningitis, how they affect the body, how meningitis can be contracted, treated and prevented.

WHAT IS MENINGITIS?

Meningitis is the inflammation of the membranes (meninges) surrounding a person’s brain and spinal cord. The inflammation is typically caused an infection of the cerebral fluid.

Meningitis is typically caused by a bacteria, viruses, fungus or parasites that lead to an infection. Meningitis can also be caused by injury, illness or substances. When meningitis occurs, the membranes (meninges) become inflamed. Meninges are a collection of membranes the cover the brain and spinal cord. Their primary purpose is to protect the central nervous system. Inflammation of the meninges is caused by an infection of the fluid (cerebrospinal fluid) surrounding the brain and spinal cord. The most common form of meningitis is viral meningitis. The severity of meningitis varies depending on its form. There are 5 categories of meningitis – bacteria, viral, parasitic, fungal and non-infectious meningitis. Knowing the cause of meningitis is important because the ineffectiveness, spread, danger and treatment can differ.

Types of Meningitis

VIRAL
Viral meningitis is the most common type of infectious meningitis in the United States. Viral meningitis is generally less severe and resolves without specific treatment. Viral meningitis is rarely fatal, but can be debilitating and have long term after effects. Some people only feel the symptoms for 7-10 days while others may have symptoms lasting for 3-4 months, which can lead to hospitalization and prolonged absence of school or work. Viral meningitis is most often caused by enteroviruses and generally are at their highest risk of transmission during the summer to fall seasons.

Enteroviruses are a group of viruses associated with several syndromes and diseases. Enterovirus exposure is extremely high but less than 1 out of 1,000 infections become viral meningitis. Not all people with enteroviruses develop meningitis. Neonates, infants, and adults are all at risk of contracting viral meningitis.

Viral meningitis is spread through the exchange of respiratory and throat secretions (kissing, coughing, sneezing, and sharing a cup, utensil, lip gloss, or cigarettes). Viral meningitis can also be contracted by coming in physical contact with another person’s bodily fluids who has meningitis, most likely through ingestion. Viral meningitis is also found in one’s stool. Herpes simplex and genital herpes can cause viral meningitis as well as chicken pox, rabies and HIV. The incubation period of viral meningitis may range from a few days to several weeks from the time of infection until the development of symptoms. Risk factors for development are exposure to someone with a recent viral infection or a suppressed immune system.
Viral meningitis is often referred to as spinal meningitis, aseptic meningitis and sterile meningitis interchangeably.

Mollaret’s Meningitis is a form of viral meningitis that is recurring. Mollaret’s meningitis is considered rare. However, recent research and studies have categorized it has being more common than initially thought. Mollaret’s meningitis has the same characteristics as other forms of meningitis except they are recurring and often are accompanied with long-term irregularity of the nervous system. Mollaret’s meningitis has been suggested to be cause by the herpes simplex virus, HSV-2 and HSV-1.

BACTERIAL
Bacterial meningitis can be quite severe and may result in brain damage, hearing loss, limb loss or learning disability. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because specific antibiotics would need to be administered.

Bacterial meningitis is extremely dangerous and can be life threatening. Bacterial meningitis is caused by bacteria instead of a virus as with viral meningitis. Age plays a large factor in the type of bacteria that causes meningitis. Group B Streptococci,Listeria monocytogenes, meningococcus and streptococcus pneumoniae are all form of bacterial meningitis. Bacterial meningitis is especially dangerous because it can spread quickly causing an epidemic. College students living in dormitories are at increased risk. Weakened immune systems from diseases, medication and surgical procedures can cause an individual to be considered high risk for bacterial meningitis. Travelers to foreign nations such as the sub-Saharan desert in Africa can be susceptible to meningitis. Head trauma can also potentially lead to meningitis if nasal bacteria is able to enter the meningeal space. Symptoms can appear quickly within 3-7 days. Seizures and comas are often a symptom of severe bacterial infection. Health people may carry the bacteria that causes meningitis in their nasal cavity and throat without becoming ill.

Meningococcal Disease is the combination of meningococcal meningitis (bacterial infection of the meninges of the brain and spinal cord) and meningococcemia (a blood infection). Meningococcal bacteria (neisseria meningitides bacteria) is the cause of meningococcal meningitis infections. Meningococcal meningitis requires immediate attention as it can cause severe damage and even death within 24-48 hours. Meningococcal meningitis survivors often times suffer severe long term effect. Everyone is susceptible to meningococcal meningitis unless vaccinated. However, there are cases that have not been preventable through vaccination.

Pneumococcal meningitis is cause when pneumonia bacteria (Streptococcus pneumonia) have infected the bloodstream and infect the meninges surrounding the brain and spinal cord. Pneumococcal meningitis may cause septicemia leading to severe damage to the organs. Like other forms of meningitis, pneumococcal meningitis is carried in the back of the nasal cavity and throat. It can be transmitted through coughing, saliva and the exchange of respiratory fluids within close quarters. If suspected, pneumococcal meningitis should be treated quickly. 1 in 5 people who become sick with pneumococcal meningitis will die. 25-50% will experience long term brain and neurological complications. Vaccinations are available. Upon the recommendation from a physician, those at risk such as children, the elderly and those susceptible to pneumococcal infections should be vaccinated.

FUNGAL
Fungal meningitis develops after a fungus has spread through the bloodstream. The most common form of fungal meningitis is cryptococcal fungal meningitis. Fungal meningitis is often prevalent in those with weakened immune systems such as those with Cancer and AIDS. Fungal meningitis is not transmittable from person to person. Fungal meningitis occurs when fungus has been introduced to the boy through medications administered via injections such as steroids. Fungal meningitis is also thought to be contracted through inhalation in environments heavily contaminated with bird feces. Although not contagious, fungal meningitis carries the same symptoms as other forms of meningitis and it diagnosis will also need to be done by lumbar puncture.
PARASITIC
Parasitic meningitis is caused by Naegleria fowleri. Naegleria fowleri is found in warm bodies of freshwater and can enter the body through the nose. Naegleria fowleri causes primary amebic meningoencephalitis (PAM). PAM is a brain infection that destroys brain tissue. Naegleria fowleri is found worldwide. Parasitic meningitis caused by PAM is rare and little is known about the treatment and after effects of parasitic meningitis as most infections have been fatal.
NON-INFECTIOUS
Non-infectious meningitis is a form of meningitis that is not spread person to person. Non-infectious meningitis can be cause by disease, medication, drugs, head injury or surgery. Cancer and Lupus are common causes of non-infectious meningitis. The symptoms for non-infectious meningitis are similar to other forms of meningitis which may include: nausea, headaches, photophobia and vomiting.

Chemical meningitis is also classified as non-infectious meningitis. Neoplastic meningitis (meningitis carcinomatosa, leptomeningeal carcinomatosis) is directly related to cancerous cells.

Signs & Symptoms

Symptoms

The symptoms for all types of meningitis are often the same. It is difficult if not impossible to diagnose the type of meningitis a person may have without having the proper medical procedure. Meningitis symptoms may include:

  • High Fever
  • Severe headache
  • Nausea
  • Vomiting
  • Stiff neck
  • Photophobia (sensitivity to light)
  • Altered mental state

It can be tough to detect or might not even occur in neonates and infants. Parents that notice these symptoms should seek medical attention immediately! In children, symptoms such as:

  • High temperatures
  • Drowsiness
  • Rashes
  • High-pitched cry
  • Dislike to being held
  • Lethargy

The onset of seizures, may not be a confirmation of meningitis but it is a sign that there is an immediate need for medical attention.

Diagnosis

Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. All types of meningitis are diagnosed by growing bacteria from a sample of the infected person’s spinal fluid, which is collected by performing a lumbar puncture (spinal tap). Results show whether or not the cerebral spinal fluid (CSF) has increased white blood cells. Blood tests are also conducted to determine whether or not there is a significant increase or decrease in the white blood cell count.

Treatment

Viral Meningitis Treatment

There are no effective treatments for most viruses that cause meningitis. Medical doctors recommend plenty of rest, relaxation, fluids, and medicine to relieve a fever or headache.

Bacterial Meningitis Treatment

Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis, although cases have varied person to person.

Fungal Meningitis Treatment

Fungal meningitis is treated with a antifungal medications. The medications are administered through an IV and the length of treatment can vary from patient to patient.

Parasitic Meningitis Treatment

It is unclear the effectiveness of treatment for parasitic meningitis as survivorship has been rare.

Prevention

For bacterial meningitis there are vaccinations against certain strains. Vaccinations are available for Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), and Haemophilus influenzae type b (Hib). For those that have come in close contact with someone who has meningococcal meningitis, it may be advised that they take antibiotics to reduce the risk of contracting the disease.

There is no current vaccine available to prevent anyone from developing viral meningitis. A majority of those with enteroviruses aren’t symptomatic, so it’s tough to prevent the spread of viral meningitis. The best protection against viral meningitis is to wash your hands thoroughly and frequently, keep surfaces such as door handles, remote controls and other devices that are touched by multiple people clean, avoid sharing drinking and eating utensils, cosmetics and such with other when you or they are sick and control insect and rodent infestations.

In general there is not a specific course of action to take to avoid fungal meningitis. People with weakened immune systems such as those with HIV are more at risk for contracting fungal meningitis. Those with HIV should avoid high fungi environments such as those with a high level bird droppings and places known to have high levels of fungi.

There is no vaccination or preventable activity against parasitic meningitis. It is found in warm fresh bodies of water such as lakes and rivers and therefore ins unavoidable for those that frequent water sports during warm parts of the year. Recommendations have been to avoid com in gin contact with sediment during water activities. If using irrigation devices to flush out sinuses it is imperative to use water that has been sterilized or distilled.

After Effects of Meningitis

Most people who get meningitis and septicemia survive, often without any after effects, but sometimes these diseases cause a range of disabilities and problems that can alter people’s lives. After effects may be temporary or permanent, physical or emotional.

People respond to their own situations differently, but frequently are unsure of what to expect after meningitis or septicemia. Relatives and friends may also feel the need for information, because the person who is recovering often needs a great deal of support. Getting over meningitis or septicemia makes major demands on people. Fortunately, many problems improve and disappear over time.

After effects most likely to be caused by Meningitis:

  • Memory loss
  • Difficulty retaining information
  • Lack of concentration
  • Clumsiness
  • Coordination problems
  • Residual Headaches
  • Deafness
  • Hearing problems
  • Tinnitus
  • Dizziness
  • Loss of balance
  • Learning difficulties (ranging from temporary learning deficiencies to long term mental impairment)
  • Epilepsy
  • Seizures
  • Weakness
  • Paralysis
  • Spasms of part of the body
  • Cerebral palsy
  • Speech problems
  • Loss of sight
  • Changes in sight

Additional after effects most likely to be caused by Septicemia:

  • Arthritis
  • Stiffness in joints
  • Scarring
  • Skin damage
  • Amputations
  • Kidney damage
  • Lung damage

Emotional after effects that may occur after Meningitis and Septicemia:

  • Clinginess
  • Temper Tantrums
  • Moodiness or aggression
  • Disturbed sleep
  • Nightmares
  • Bedwetting
  • Changes in Character
  • Learning Difficulties
  • Depression
  • Fear of Doctors and Hospitals
  • Other behavioral and emotional problems

Who has after effects?

Most people recover with no after effects and not all after effects are permanent. The likelihood of getting after effects from meningitis or septicaemia depends on several factors including the type and severity of the illness. People who have been desperately ill may have spent a long time in intensive care. Research has shown that intensive care can be a distressing experience both for the person who has the illness and for their family.

Currently the majority of cases of bacterial meningitis and septicaemia are caused by meningococcal infection. This produces severely disabling after effects in about one in twelve survivors, although patients who have severe meningococcal septicaemia tend to have a worse outcome. After meningococcal disease, pneumococcal meningitis is the main type and it is more likely to produce serious damage. Neonatal meningitis occurring in the first month of life also carries a higher risk of after effects than most other forms.

A person recovering from viral meningitis may experience similar problems to someone who has had bacterial meningitis, but will rarely have severe after effects.

Careful and early follow up of patients discharged after meningitis and septicaemia is important. An estimated 25% of people who survive meningitis or septicaemia will have less obvious after effects, such as difficulties with coordination, concentration and memory. These are usually temporary.

Good and Bad Days

Although some people are completely back to normal within a matter of weeks but it can take many months to recover from meningitis and septicaemia. People often find that they have days when they feel very good, and others when they feel so bad that they worry they are becoming ill again. It is important to ‘listen’ to the needs of your body. There is no magic formula to feeling better, because the body needs time to recover fully. It is important to mention to employers and teachers that you may need time off. Help and support from your family doctor can be invaluable, and a doctor’s note will be necessary if you need a longer period of rest.