BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMeningitisMeningitis - bacterial; Meningitis - viral; Meningitis - fungal; Meningitis - vaccineMeningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges. Causes The most common causes of meningitis are viral infections. These infections usually get better without treatment. But, bacterial meningitis infections are very serious. They may result in death or brain damage, even if treated. A lumbar puncture (or spinal tap) is required to determine the specific cause.Meningitis may also be caused by:Chemical irritation Drug allergies Fungi Parasites Tumors Many types of viruses can cause meningitis:Enteroviruses: These are viruses that also can cause intestinal illness. Herpes viruses: These are the same viruses that can cause cold sores and genital herpes. However, people with cold sores or genital herpes do not have a higher chance of developing herpes meningitis. Cold soresOral herpes is an infection of the lips, mouth, or gums due to the herpes simplex virus. It causes small, painful blisters commonly called cold sore...ImageRead Article Now Book Mark Article Genital herpesGenital herpes is a sexually transmitted infection. It is caused by the herpes simplex virus (HSV). This article focuses on HSV type 2 infection....Read Article Now Book Mark Article HIV. Mumps virus. West Nile virus: This virus is spread by mosquito bites and is an important cause of viral meningitis in most of the United States. West Nile virusWest Nile virus causes a viral disease and is spread by mosquitoes. The condition ranges from mild to severe.ImageRead Article Now Book Mark Article Symptoms Enteroviral meningitis occurs more often than bacterial meningitis and is milder. It usually occurs in the late summer and early fall. It most often affects children and adults under age 30. Symptoms may include:Headache Sensitivity to light (photophobia) PhotophobiaPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Slight fever Upset stomach and diarrhea Fatigue Bacterial meningitis is an emergency. You will need immediate treatment in a hospital. Symptoms usually come on quickly, and may include:Fever and chills Mental status changes Mental status changesConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Nausea and vomiting Sensitivity to light Severe headache Stiff neck Other symptoms that can occur with this disease:Agitation AgitationAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Bulging fontanelles in babies Bulging fontanellesA bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).ImageRead Article Now Book Mark Article Decreased alertness Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Poor feeding or irritability in children Rapid breathing Unusual posture, with the head and neck arched backward (opisthotonos) OpisthotonosOpisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...Read Article Now Book Mark Article You cannot tell if you have bacterial or viral meningitis by how you feel. Your health care provider must find out the cause. Go to a hospital emergency department right away if you think you have symptoms of meningitis. Exams and Tests Your provider will examine you. This may show:Fast heart rate Fever Mental status changes Stiff neck If the provider thinks you have meningitis, a lumbar puncture (spinal tap) should be done to remove a sample of spinal fluid (cerebrospinal fluid, or CSF) for testing.Spinal tapCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Other tests that may be done include:Blood culture Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article CT scan of the headCT scan of the headA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Treatment Antibiotics are used to treat bacterial meningitis. Antibiotics do not treat viral meningitis. But antiviral medicine may be given to those with herpes meningitis.Other treatments will include:Fluids through a vein (IV) Medicines to treat symptoms, such as brain swelling, shock, and seizuresShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Outlook (Prognosis) Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications. Possible Complications Without prompt treatment, meningitis may result in the following: Brain or neurologic damage Buildup of fluid between the skull and brain (subdural effusion) Subdural effusionA subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...Read Article Now Book Mark Article Hearing loss Hearing lossHearing loss is being partly or totally unable to hear sound in one or both ears.ImageRead Article Now Book Mark Article Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) HydrocephalusHydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...ImageRead Article Now Book Mark Article Seizures Death When to Contact a Medical Professional If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome. Prevention Certain vaccines can help prevent some types of bacterial meningitis: Haemophilus vaccine (HiB vaccine) given to children helps. HiB vaccineAll content below is taken in its entirety from the CDC Hib (Haemophilus Influenzae Type b) Vaccine Information Statement (VIS): www. cdc. gov/vaccin...ImageRead Article Now Book Mark Article Pneumococcal vaccine is given to children and adults. ChildrenContent below is taken in its entirety from the CDC Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-statements/pcv. htmlImageRead Article Now Book Mark Article AdultsAll content below is taken in its entirety from the CDC Pneumococcal Polysaccharide Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/v...ImageRead Article Now Book Mark Article Meningococcal vaccine is given to children and adults; some communities hold vaccination campaigns after an outbreak of meningococcal meningitis. Children and adultsAll content below is taken in its entirety from the CDC Meningococcal ACWY Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-st...ImageRead Article Now Book Mark Article Household members and others in close contact with people who have meningococcal meningitis should receive antibiotics to prevent becoming infected.Open ReferencesReferencesHasbun R, Van de Beek D, Brouwer MC, Tunkel AR. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 384.AllVideoImagesTogBrudzinski's sign of meningitis - illustration One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.Brudzinski's sign of meningitisillustrationKernig's sign of meningitis - illustration One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.Kernig's sign of meningitisillustrationLumbar puncture (spinal tap) - illustration A lumbar puncture, or spinal tap, is a procedure to collect cerebrospinal fluid to check for the presence of disease or injury. A spinal needle is inserted, usually between the third and fourth lumbar vertebrae in the lower spine. Once the needle is properly positioned in the subarachnoid space (the space between the spinal cord and its covering, the meninges), pressures can be measured and fluid can be collected for testing.Lumbar puncture (spinal tap)illustrationMeninges of the brain - illustration The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the brainillustrationMeninges of the spine - illustration The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the spineillustrationHaemophilus influenza organism - illustration This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenzae, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenzae vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenzae (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.Haemophilus influenza organismillustrationBrudzinski's sign of meningitis - illustration One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.Brudzinski's sign of meningitisillustrationKernig's sign of meningitis - illustration One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.Kernig's sign of meningitisillustrationLumbar puncture (spinal tap) - illustration A lumbar puncture, or spinal tap, is a procedure to collect cerebrospinal fluid to check for the presence of disease or injury. A spinal needle is inserted, usually between the third and fourth lumbar vertebrae in the lower spine. Once the needle is properly positioned in the subarachnoid space (the space between the spinal cord and its covering, the meninges), pressures can be measured and fluid can be collected for testing.Lumbar puncture (spinal tap)illustrationMeninges of the brain - illustration The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the brainillustrationMeninges of the spine - illustration The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the spineillustrationHaemophilus influenza organism - illustration This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenzae, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenzae vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenzae (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.Haemophilus influenza organismillustrationRelated Information Meningitis - cryptococcal(Condition)Syphilitic aseptic meningitis(Condition)H influenzae meningitis(Condition)Meningococcal meningitis(Condition)Pneumococcal meningitis(Condition)Staphylococcal meningitis(Condition)Meningitis - tuberculous(Condition)Gram-negative meningitis(Condition)Acute(Special Topic)Hearing loss(Symptoms)Ventriculoperitoneal shunt - discharge(Discharge) Review Date: 12/4/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
MeningitisMeningitis - bacterial; Meningitis - viral; Meningitis - fungal; Meningitis - vaccineMeningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges. Causes The most common causes of meningitis are viral infections. These infections usually get better without treatment. But, bacterial meningitis infections are very serious. They may result in death or brain damage, even if treated. A lumbar puncture (or spinal tap) is required to determine the specific cause.Meningitis may also be caused by:Chemical irritation Drug allergies Fungi Parasites Tumors Many types of viruses can cause meningitis:Enteroviruses: These are viruses that also can cause intestinal illness. Herpes viruses: These are the same viruses that can cause cold sores and genital herpes. However, people with cold sores or genital herpes do not have a higher chance of developing herpes meningitis. Cold soresOral herpes is an infection of the lips, mouth, or gums due to the herpes simplex virus. It causes small, painful blisters commonly called cold sore...ImageRead Article Now Book Mark Article Genital herpesGenital herpes is a sexually transmitted infection. It is caused by the herpes simplex virus (HSV). This article focuses on HSV type 2 infection....Read Article Now Book Mark Article HIV. Mumps virus. West Nile virus: This virus is spread by mosquito bites and is an important cause of viral meningitis in most of the United States. West Nile virusWest Nile virus causes a viral disease and is spread by mosquitoes. The condition ranges from mild to severe.ImageRead Article Now Book Mark Article Symptoms Enteroviral meningitis occurs more often than bacterial meningitis and is milder. It usually occurs in the late summer and early fall. It most often affects children and adults under age 30. Symptoms may include:Headache Sensitivity to light (photophobia) PhotophobiaPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Slight fever Upset stomach and diarrhea Fatigue Bacterial meningitis is an emergency. You will need immediate treatment in a hospital. Symptoms usually come on quickly, and may include:Fever and chills Mental status changes Mental status changesConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Nausea and vomiting Sensitivity to light Severe headache Stiff neck Other symptoms that can occur with this disease:Agitation AgitationAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Bulging fontanelles in babies Bulging fontanellesA bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).ImageRead Article Now Book Mark Article Decreased alertness Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Poor feeding or irritability in children Rapid breathing Unusual posture, with the head and neck arched backward (opisthotonos) OpisthotonosOpisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...Read Article Now Book Mark Article You cannot tell if you have bacterial or viral meningitis by how you feel. Your health care provider must find out the cause. Go to a hospital emergency department right away if you think you have symptoms of meningitis. Exams and Tests Your provider will examine you. This may show:Fast heart rate Fever Mental status changes Stiff neck If the provider thinks you have meningitis, a lumbar puncture (spinal tap) should be done to remove a sample of spinal fluid (cerebrospinal fluid, or CSF) for testing.Spinal tapCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Other tests that may be done include:Blood culture Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article CT scan of the headCT scan of the headA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Treatment Antibiotics are used to treat bacterial meningitis. Antibiotics do not treat viral meningitis. But antiviral medicine may be given to those with herpes meningitis.Other treatments will include:Fluids through a vein (IV) Medicines to treat symptoms, such as brain swelling, shock, and seizuresShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Outlook (Prognosis) Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications. Possible Complications Without prompt treatment, meningitis may result in the following: Brain or neurologic damage Buildup of fluid between the skull and brain (subdural effusion) Subdural effusionA subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...Read Article Now Book Mark Article Hearing loss Hearing lossHearing loss is being partly or totally unable to hear sound in one or both ears.ImageRead Article Now Book Mark Article Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) HydrocephalusHydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...ImageRead Article Now Book Mark Article Seizures Death When to Contact a Medical Professional If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome. Prevention Certain vaccines can help prevent some types of bacterial meningitis: Haemophilus vaccine (HiB vaccine) given to children helps. HiB vaccineAll content below is taken in its entirety from the CDC Hib (Haemophilus Influenzae Type b) Vaccine Information Statement (VIS): www. cdc. gov/vaccin...ImageRead Article Now Book Mark Article Pneumococcal vaccine is given to children and adults. ChildrenContent below is taken in its entirety from the CDC Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-statements/pcv. htmlImageRead Article Now Book Mark Article AdultsAll content below is taken in its entirety from the CDC Pneumococcal Polysaccharide Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/v...ImageRead Article Now Book Mark Article Meningococcal vaccine is given to children and adults; some communities hold vaccination campaigns after an outbreak of meningococcal meningitis. Children and adultsAll content below is taken in its entirety from the CDC Meningococcal ACWY Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-st...ImageRead Article Now Book Mark Article Household members and others in close contact with people who have meningococcal meningitis should receive antibiotics to prevent becoming infected.Open ReferencesReferencesHasbun R, Van de Beek D, Brouwer MC, Tunkel AR. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 384.