Meningitis (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, MD

Overview
Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. Usual causes are bacteria and viruses. Other not common causes include fungi, head injury, or brain tumor. The infection can affect children, teens, and young adults, especially people with immunodeficient diseases and immunosuppression. Usual symptoms are fever and chills, nausea, vomiting, diarrhea, photophobia, severe headache, stiff neck, and mental status changes. Cultures of blood and cerebral spinal fluid (CSF) are very valuable for the diagnosis. Treatment opinion of mengitis depends on the origin of the infection. The effective preventive measurements include a good life habit and vaccines. The prognosis of meningitis varies from person to person. It depends on the origin of the infection, start time of treatment and patient's general healthy status.

What are the symptoms of Meningitis?
There are four types of meningitis: bacterial meningitis, viral meningitis, fungal meningitis and non-infectious meningitis. General speaking, symptoms of bacterial meningitis usually appear suddenly. Symptoms of viral meningitis may appear suddenly or develop gradually over a period of days. Symptoms caused by fungal meningitis and non-infectious meningitis may develop relatively gradually. The most common symptoms of each type of meningitis include:
 * Fever and chills
 * Nausea, vomiting and diarrhea
 * Photophobia
 * Severe headache
 * Stiff neck
 * Mental status changes, such as lethargy, irritability, confusion, difficulty to concentrate, sleepiness or difficulty waking up
 * Skin rashes

Who is at highest risk?

 * Bacterium: Neisseria meningitidis is one of the leading causes of bacterial meningitis in children and young adults in the United States. Other bacterium include group B streptococci, haemophilus influenzae, streptococcus pneumoniae, s. pneumoniae, n. meningitidis and mycobacteria.
 * Virus: Mumps, Epstein-Barr virus, herpes simplex viruses, varicella-zoster virus.
 * Fungi: Patinets at higher risk of fungal meningitis include those who have AIDS, leukemia, or other forms of immunodeficient diseases and immunosuppression. Cryptococcus is the most common fungi for these patients. Other fungi caused meningitis include histoplasma and coccidioides.
 * Brain tumor
 * Brain surgery
 * Head injury
 * Systemic lupus erythematosus (Lupus)

When to seek urgent medical care?
If you or your child experience either of the symptoms of meningitis, seeking urgent medical care as soon as possible.

Diagnosis
The goal of tests is to identify the type of the meningitis.
 * Medical history and physical examinations
 * Blood culture: This test is very important to identify bacterial meningitis. If bacteria are present, they can be cultured in the lab.
 * Gram-stain and culture of cerebral spinal fluid (CSF): The doctor may order this test to identify the origin of the infection. It helps determine the best course of treatment. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor insert a spinal needle into the lower back area to measure CSF pressure and collect a sample. The patient is often asked to lie down for a while after the process.
 * Head images such as CT or MRI: These images can help show the brain structure and exclude other brain diseases.

Treatment options
The main treatment opinion of mengitis depends on the origin of the infection.
 * Bacterial meningitis: Bacterial meningitis can be treated with effective antibiotics. The results of cerebral spinal fluid (CSF) or blood culture can supply help for the selection of the antibiotics. The earlier the treatment be started, the better outcome will get.
 * Viral meningitis: There is no specific treatment for viral meningitis. For this kind of meningitis, it is very important to treat on complications.
 * Fungal Meningitis: Fungal meningitis is treated with antifungal medications. The course of treatment depends on the type of fungus and the patients' immune system status.
 * Non-infectious meningitis: The treatment of non-infectious meningitis depends on the underlying causes.

Where to find medical care for Meningitis?
Directions to Hospitals Treating Meningitis

Prevention of meningitis

 * Avoiding a close contact with people who are sick
 * Wash your hands thoroughly and often
 * Avoid bites from mosquitoes and other insects that carry diseases that can infect humans.
 * Clean contaminated surfaces
 * Vaccines: Some vaccines such as meningococcal vaccines, pneumococcal vaccines, pneumococcal vaccines, MMR vaccine, and varicella-zoster vaccine may help protect children against meningitis.
 * For HIV-infected people, antifungal prophylaxis may be helpful for those living in a geographic area where the incidence of fungal infections is very high.

What to expect (Outlook/Prognosis)?
The prognosis of meningitis depends on:
 * Whether the patient is diagnosed and treated early.
 * The origin of the infection: Viral meningitis is usually not serious, and symptoms will disappear within two weeks.
 * The patient's general condition: The prognosis of patients who have AIDS, leukemia, or other forms of immunodeficient diseases and immunosuppression is poor.

Possible complications

 * Brain damage
 * Buildup of fluid between the skull and brain (subdural effusion)
 * Hearing loss
 * Hydrocephalus
 * Seizures

Diseases with similar symptoms

 * Encephalitis
 * Brain abscess
 * Brain tumor