Meningococcal meningitis
Gram negative - meningococcusMeningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Read Article Now Book Mark ArticleBacteria are one type of germ that can cause meningitis. The meningococcal bacteria are one kind of bacteria that cause meningitis.
Causes
Meningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus).
Meningococcus is the most common cause of bacterial meningitis in children and teens. It is a leading cause of bacterial meningitis in adults.
The infection occurs more often in winter or spring. It may cause local epidemics at boarding schools, college dormitories, or military bases.
Risk factors include recent exposure to someone with meningococcal meningitis, complement deficiency, use of eculizumab, spleen removal or a spleen that does not function, and exposure to cigarette smoking.
Symptoms
Symptoms usually come on quickly, and may include:
- Fever and chills
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Mental status changes
Mental status changes
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
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- Purple, bruise-like areas (purpura)
Purpura
Purpura is purple-colored spots and patches that occur on the skin, and in mucus membranes, including the lining of the mouth.
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Rash, pinpoint red spots (petechiae)
Rash
Rashes involve changes in the color, feeling or texture of your skin.
Read Article Now Book Mark ArticlePetechiae
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
Read Article Now Book Mark Article - Sensitivity to light (photophobia)
- Severe headache
- Stiff neck
Other symptoms that can occur with this disease:
- Agitation
-
Bulging fontanelles in infants
Bulging fontanelles
A bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).
Read Article Now Book Mark Article - Decreased consciousness
- Poor feeding or irritability in children
- Rapid breathing
- Unusual posture with the head and neck arched backwards (opisthotonus)
Opisthotonus
Opisthotonos 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...
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Exams and Tests
The health care provider will perform a physical exam. Questions will focus on symptoms and possible exposure to someone who might have the same symptoms, such as a stiff neck and fever.
If the provider thinks meningitis is possible, a lumbar puncture (spinal tap) will likely be done to obtain a sample of spinal fluid for testing.
Spinal tap
Cerebrospinal 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...
Read Article Now Book Mark ArticleOther tests that may be done include:
-
Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the head
CT scan of the head
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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White blood cell (WBC) count
White blood cell (WBC) count
A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood. It is a part of a complete blood count (CBC). WBCs are a...
Read Article Now Book Mark Article - Gram stain or, other special stains, and culture of the spinal fluid
Treatment
Antibiotics will be started as soon as possible.
- Ceftriaxone is one of the most commonly used antibiotics.
- Penicillin in high doses can be effective for susceptible bacteria.
- If there is an allergy to penicillin, chloramphenicol may be used.
Sometimes, corticosteroids may be given.
People in close contact with someone who have meningococcal meningitis should be given antibiotics to prevent infection.
Such people include:
- Household members
- Roommates in dormitories
- Military personnel who live in close quarters
- Those who come into close and long-term contact with an infected person
Outlook (Prognosis)
Early treatment improves the outcome. Death is possible. Young children and adults over age 50 have the highest risk of death.
Possible Complications
Long-term complications may include:
- Brain damage
- Hearing loss
- Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus)
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...
Read Article Now Book Mark Article - Buildup of fluid between the skull and brain (subdural effusion)
Subdural effusion
A 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 - Inflammation of the heart muscle (myocarditis)
Myocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
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Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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When to Contact a Medical Professional
Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
- Feeding difficulties
- High-pitched cry
- Irritability
- Persistent unexplained fever
Meningitis can quickly become a life-threatening illness.
Prevention
Close contacts in the same household, school, or day care center should be watched for early signs of the disease as soon as the first person is diagnosed. All family and close contacts of this person should begin antibiotic treatment as soon as possible to prevent spread of the infection. Ask your provider about this during the first visit.
Always use good hygiene habits, such as washing hands before and after changing a diaper or after using the toilet.
Vaccines for meningococcus are effective for controlling spread. They are currently recommended for:
Vaccines for meningococcus
All content below is taken in its entirety from the CDC Serogroup B Meningococcal Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis...
Read Article Now Book Mark Article- Adolescents
- College students in their first year living in dormitories
- Military recruits
- Travelers to certain parts of the world
Although rare, people who have been vaccinated can still develop the infection.
References
Centers for Disease Control and Prevention website. Meningitis. About bacterial meningitis. www.cdc.gov/meningitis/about/bacterial-meningitis.html. Updated January 9, 2024. Accessed June 17, 2024.
Pollard AJ, Sadarangani M. Neisseria meningitides (meningococcus). In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 218.
Stephens DS. Neisseria meningitidis. 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 211.
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Meninges 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 brain
illustration
-
Meninges 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 spine
illustration
-
Meningococcal lesions on the back - illustration
Meningococcemia is a life-threatening infection that occurs when the bacteria Neisseria meningitidis invades the blood stream. Bleeding into the skin (petechiae and purpura) usually occurs and the tissue may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring.
Meningococcal lesions on the back
illustration
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Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
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CSF cell count - illustration
CSF (cerebrospinal fluid) is a clear fluid that circulates in the space surrounding the spinal cord and brain. A CSF cell count is a test to measure the number of red and white blood cells that are in CSF.
CSF cell count
illustration
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Brudzinski'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 meningitis
illustration
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Kernig'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 meningitis
illustration
-
Meninges 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 brain
illustration
-
Meninges 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 spine
illustration
-
Meningococcal lesions on the back - illustration
Meningococcemia is a life-threatening infection that occurs when the bacteria Neisseria meningitidis invades the blood stream. Bleeding into the skin (petechiae and purpura) usually occurs and the tissue may die (become necrotic or gangrenous). If the patient survives, the areas heal with scarring.
Meningococcal lesions on the back
illustration
-
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
-
CSF cell count - illustration
CSF (cerebrospinal fluid) is a clear fluid that circulates in the space surrounding the spinal cord and brain. A CSF cell count is a test to measure the number of red and white blood cells that are in CSF.
CSF cell count
illustration
-
Brudzinski'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 meningitis
illustration
-
Kernig'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 meningitis
illustration
Review Date: 9/10/2022
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.