Meningitis: Symptoms, Diagnosis, Treatment

The meninges are protective layers enveloping the brain and spinal cord. They provide structure and support to protect the brain and spinal cord from injury.

Meningitis refers to the inflammation of the meninges. Meningitis is more common among babies, children, teenagers, and young adults, although it can affect individuals of any age.

Meningitis is not to be confused with encephalitis. While meningitis is the inflammation of the meninges, encephalitis refers to the inflammation of the brain itself. Meningitis is a serious condition that can be life-threatening if not treated promptly.

What are the causes of meningitis?

Meningitis can be categorised according to causative agents:

Viral meningitis

Viral meningitis is the most common type of meningitis and is often less severe than bacterial meningitis. It is usually caused by viruses that cause illnesses such as chicken pox, influenza, mumps, and measles.

Individuals with a good immune system are generally able to recover on their own. Nevertheless, individuals experiencing symptoms of meningitis should seek medical attention immediately since any form of meningitis can pose a serious threat to health.

Bacterial meningitis

Meningitis due to bacterial infections can be fatal and requires immediate medical intervention. Several types of bacteria can cause meningitis.

Usually, signs of bacterial meningitis emerge within 3 to 7 days following exposure. However, it is important to note that this timeframe does not apply to Tuberculosis (TB) meningitis, which can manifest much later after exposure to the bacteria.

Several of these bacteria can also be linked to another severe condition known as sepsis. Sepsis is the body’s exaggerated response to an infection, constituting a life-threatening medical crisis. It occurs when an infection initiates a cascade of reactions throughout the body. Without prompt treatment, sepsis can rapidly result in tissue damage, organ failure, and death.

Fungal meningitis

Meningitis due to fungal infections is rare. It occurs due to the inhalation of fungal spores from the environment, which find their way to the central nervous system (brain and spinal cord). Fungal meningitis is more common among individuals with weakened immune systems.

Parasitic meningitis

Parasitic meningitis is caused by parasites that normally infect animals and is much less common compared to viral and bacterial meningitis. Consumption of food contaminated with these parasites can lead to parasitic meningitis.

What are the symptoms?

Common symptoms of meningitis include:

Fever
Headache
Nausea and vomiting
Neck stiffness
Light sensitivity (photophobia)
Confusion
Drowsiness
Joint aches
Seizures
Rashes (petechiae)

Babies may not have the same symptoms as adults, and it can be difficult to pinpoint them if they do. Some signs to look out for in babies suspected of meningitis include:

Bulging ‘soft spot’ (fontanelle) on an infant’s head
Poor feeding
Drowsiness or difficulty waking up from sleep
Lethargy
High-pitched cry

What are the risk factors?

Risk factors for meningitis include:

Babies and young children.
Teenagers and young adults.
Older people.
Weakened immune system (e.g. HIV, cancer, medications that suppress the immune system).
Incomplete vaccinations.
Alcohol abuse.

Is meningitis contagious?

While meningitis itself is not contagious, infective organisms causing the disease can be contagious. Most bacterial and viral causes of meningitis can spread from one individual to another.

How is it diagnosed?

Meningitis is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests. During the medical history, the doctor may inquire about symptoms, recent illnesses, and potential exposure to infections.

Physical examination often includes assessing neurological signs such as neck stiffness, altered mental status, and sensitivity to light (photophobia).

Diagnostic tests commonly used to confirm meningitis include:

Lumbar puncture (spinal tap) to test cerebrospinal fluid (CSF) for signs of infection.
Blood tests.
Computerised tomography (CT) scan or magnetic resonance imaging (MRI).

How is it treated?

Management of meningitis depends on the causative agent. These include:

Antibiotics for bacterial meningitis.
Antivirals for certain types of viral meningitis.
Antifungals for fungal meningitis.
Steroids to reduce swelling around the brain, if any.
Medications for pain relief.
Intravenous (IV) fluids to keep hydrated.

Viral meningitis can resolve spontaneously within seven to ten days. After treatment, bacterial and fungal meningitis may last a few days to a week or more. Full recovery from meningitis may require weeks to months, and some individuals can develop long-term health complications.

What are the complications of meningitis?

Partial or complete hearing loss.
Partial or complete vision loss.
Memory and concentration issues.
Recurrent seizures.
Coordination, movement, and balance issues.
Learning difficulties and behavioural issues (in children).
Arthritis (inflammation of one or more joints in the body).
Loss of limbs.

Can meningitis be prevented?

Several measures can be taken to reduce the chances of having meningitis.

Compliance with vaccination schedule (babies, children, teenagers).
Vaccination against bacterial/viral causes of meningitis (for individuals at high risk).
Prophylactic antibiotics for individuals at high risk of bacterial infection.
Practising safe food handling.
Maintain good hygiene.
Avoiding close contact with individuals who are ill.
Avoid swimming in potentially contaminated water.
Avoiding uncooked or undercooked meat and seafood.

Book an appointment at Pantai Hospitals

Meningitis is a serious medical condition that can be life-threatening and lead to long-term health complications. Early treatment can improve the chances of full recovery and reduce the risk of long-term consequences.

A dedicated and expert team of neurologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding meningitis. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.