Welcome to Information Source on Meningitis
There are various types of Meningitis . . .
What is Aseptic Meningitis?
Aseptic meningitis is an illness characterized by headache, fever and inflammation of the lining of the brain . . . meninges. Aseptic meningitis looks like bacterial meningitis, bacteria do not grow in cultures of the cerebrospinal fluid, which is fluid around the brain and spinal cord.
With aseptic meningitis a person has signs and symptoms of meningitis, but bacteria do not grow in culture. Many different things can cause aseptic meningitis including viruses, fungi, tuberculosis, some medications and infections near the brain or spinal cord, such as epidural abscesses.
Coxsackie virus and echovirus, two members of a family of viruses called enteroviruses, account for about half the cases of aseptic meningitis. Other enteroviruses, herpes viruses, and mumps are additional causes. The rate of these enteroviral infections increases in summer and early fall.
West Nile virus is a cause of aseptic meningitis that has recently spread across the United States. Usually, West Nile virus causes a self-limited meningitis, which gets better on its own, without treatment. Infrequently, it causes a more severe illness, which may include encephalitis, which is inflammation in the actual brain tissue or paralysis similar to that seen in polio. These severe forms usually occur in elderly people or people with lowered immunity.
Enteroviruses are spread by hand-to-mouth contact and coughing. To a lesser extent, they also spread by contact with fecal matter. Mumps is spread by coughing or contact with secretions from the mouth and throat, with increased incidence in the spring.
Herpesvirus, both type 1 . . . herpes simplex or herpes labialis, and type 2 . . . genital herpes can cause meningitis in children, especially infants. Chicken pox can also cause aseptic meningitis. Rabies virus causes inflammation of both the brain and meninges (meningoencephalitis). HIV can cause aseptic meningitis, especially soon after exposure (acute HIV syndrome).
Some fungi and mycobacteria can cause aseptic meningitis, although this is much less common. Certain medications can also cause aseptic meningitis, including antibiotics and some over-the-counter anti-inflammatory medications.
Risk factors for aseptic meningitis include exposure to someone with a recent viral infection, exposure to children in a day care setting, being a health care worker, or having a suppressed immune system .
Symptoms of Aseptic Meningitis
General discomfort, uneasiness, or ill feeling
Nausea and vomiting
Abnormal sensitivity to light
Exams and Tests for Aseptic Meningitis
For any patient with meningitis, it is important to perform a lumbar puncture, known as a spinal tap, where a sample of spinal fluid is obtained and sent to the lab for testing.
Tests may reveal the following:
High or low white blood cell count in the blood
High white blood cell count in spinal fluid (usually lymphocytes, a type of white blood cells)
Bacterial cultures of spinal fluid do not grow any bacteria. Other cultures or other special tests of spinal fluid may detect viruses, or other forms of infection.
Treatment for Aseptic Meningitis
Treatment is needed for fungal or mycobacterial causes of aseptic meningitis. Herpesvirus/varicella (chicken pox) virus can be treated with anti-viral medicines. Supportive treatment for non-infectious causes consists of pain medications and management of complications, if they occur.
No specific treatment is available for enteroviral aseptic meningitis.
Outlook/Prognosis for Aseptic Meningitis
Aseptic meningitis is usually a harmless disease, and people usually have full recovery in 5 to 14 days after symptoms start.
Fatigue and light-headedness may persist longer in some people.
Possible Complications of Aseptic Meningitis
Encephalitis (infection of brain itself) may develop, though this is rare. Infection may last much longer in a person with a depressed immune system.
When to Contact a Medical Professional
Call your health care provider if symptoms of aseptic meningitis occur.
Prevention of Aseptic Meningitis
Good hand washing, immunization against mumps or chicken pox, for example, and other general good health measures may reduce the risk of developing an infection that can progress to meningitis.
What is Bacterial Meningitis?
Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People often refer to it as spinal meningitis. Meningitis is usually caused by a viral infection or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ. Viral meningitis is generally less severe and resolves without specific treatment, while Bacterial Meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability.
For Bacterial Meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of Bacterial Meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of Bacterial Meningitis.
What are the Signs and Symptoms of Meningitis?
- High fever
- stiff neck
Above are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
How is Meningitis Diagnosed?
Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal is readily accessible. Identification of the type of bacteria responsible is important for selection of correct antibiotics.
Can Meningitis be Treated?
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 to below 15%, although the risk is higher among the elderly.
Is Meningitis Contagious?
Yes, some forms of Bacterial Meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease.
Are there Vaccines against Meningitis?
Yes, there are vaccines against Hib, against some serogroups of N. meningitidis and many types of Streptococcus pneumoniae. The vaccines against Hib are very safe and highly effective.
There are two vaccines against N. meningitidis available in the U.S. Meningococcal polysaccharide vaccine (MPSV4 or Menomune®) has been approved by the Food and Drug Administration (FDA) and available since 1981. Meningococcal conjugate vaccine (MCV4 or MenactraT) was licensed in 2005. Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the U.S. (serogroup C, Y, and W-135) and a type that causes epidemics in Africa (serogroup A). Meningococcal vaccines cannot prevent all types of the disease. But they do protect many people who might become sick if they didn't get the vaccine. Meningitis cases should be reported to state or local health departments to assure follow-up of close contacts and recognize outbreaks.
MCV4 is recommended for all children at their routine preadolescent visit (11 to 12 years of age). For those who have never gotten MCV4 previously, a dose is recommended at high school entry. Other adolescents who want to decrease their risk of meningococcal disease can also get the vaccine. Other people at increased risk for whom routine vaccination is recommended are college freshmen living in dormitories, microbiologists who are routinely exposed to meningococcal bacteria, U.S. military recruits, anyone who has a damaged spleen or whose spleen has been removed; anyone who has terminal complement component deficiency (an immune system disorder), anyone who is traveling to the countries which have an outbreak of meningococcal disease, and those who might have been exposed to meningitis during an outbreak. MCV4 is the preferred vaccine for people 11 to 55 years of age in these risk groups, but MPSV4 can be used if MCV4 is not available. MPSV4 should be used for children 2 to 10 years old, and adults over 55, who are at risk.
Although large epidemics of meningococcal meningitis do not occur in the United States, some countries experience large, periodic epidemics. Overseas travelers should check to see if meningococcal vaccine is recommended for their destination. Travelers should receive the vaccine at least 1 week before departure, if possible. Information on areas for which meningococcal vaccine is recommended can be obtained by calling the Centers for Disease Control and Prevention at (404)-332-4565.
There are vaccines to prevent meningitis due to S. pneumoniae (also called pneumococcal meningitis) which can also prevent other forms of infection due to S. pneumoniae. The pneumococcal polysaccharide vaccine is recommended for all persons over 65 years of age and younger persons at least 2 years old with certain chronic medical problems. There is a newly licensed vaccine (pneumococcal conjugate vaccine) that appears to be effective in infants for the prevention of pneumococcal infections and is routinely recommended for all children younger than 2 years of age.
What is Spinal Meningitis?
Meningitis is an infection that causes inflammation of the membranes covering the brain and spinal cord. Non-bacterial meningitis is often referred to as "aseptic meningitis." Bacterial meningitis may be referred to as "purulent meningitis."
Causes, Incidence, and Risk Factors
The most common causes of meningitis are viral infections that usually resolve without treatment. However, bacterial infections of the meninges are extremely serious illnesses, and may result in death or brain damage, even if treated. Meningitis is also caused by fungi, chemical irritation, drug allergies, and tumors.
Types of Meningitis Include:
- Meningitis - cryptococcal
- Syphilitic aseptic meningitis
- Meningitis - H. influenza
- Meningitis - meningococcal
- Meningitis - pneumococcal
- Meningitis - staphylococcal
- Meningitis - tuberculosis
- Aseptic meningitis
- Meningitis gram negative
- Carcinomatous meningitis (meningitis due to cancer)
- Acute bacterial meningitis is a true medical emergency, and requires immediate hospital-based treatment. Bacterial strains that cause meningitis include Streptococcus pneumonia, Haemophilus influenza, Neisseria meningitides (meningococcus), Listeria monocytogenes, and many other types of bacteria. In the U.S. almost 20,000 cases of bacterial meningitis occur yearly.
Viral Meningitis is milder and occurs more often than bacterial meningitis. It usually develops in the late summer and early fall, often affects children and adults under 30. Seventy percent of the infections occur in children under the age of 5. Most Viral Meningitis is associated with enteroviruses, which are viruses that commonly cause intestinal illness.
However, many other types of viruses can also cause meningitis. For example, Viral Meningitis may occur as a complication in people with genital herpes. Recently, West Nile virus spread by mosquito bites has become a cause of Viral Meningitis in most of the U.S. In addition to causing Viral Meningitis , West Nile virus may cause encephalitis in some patients and a polio-like syndrome in others.
Symptoms of Spinal Meningitis
- Fever and chills
- Severe headache
- Nausea and vomiting
- Stiff neck (meningismus)
- Sensitivity to light (photophobia)
- Mental status changes
Additional symptoms that may be associated with this disease:
- Decreased consciousness
- Rapid breathing
- Opisthotonos (severe neck stiffness, ultimately resulting in a characteristic arched posture-seen in infants or small children)
- Bulging fontanelles (the soft spots in a baby's skull may bulge)
- Poor feeding or irritability in children
- Meningitis is an important cause of fever in newborn children. For this reason, a lumbar puncture is often done on newborns who have a fever of uncertain origin.
Signs and tests
- Lumbar puncture with CSF glucose measurement and CSF cell count
- Gram-stain and culture of CSF (cerebral spinal fluid)
- Chest x-ray to look for other sites of infection
- Head CT scan looking for hydrocephalus, abscess or deep swelling
Treatment of Spinal Meningitis
Antibiotics will be prescribed for bacterial meningitis; the type will vary depending on the infecting organism. Antibiotics are not effective in Viral Meningitis . Treatment of secondary symptoms including brain swelling, shock, and seizures will require other medications and intravenous fluids. Hospitalization may be required depending on the severity of the illness and the needed treatment.
Expectations / Prognosis of Spinal Meningitis
Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological or spinal damage. Viral Meningitis is usually not serious, and symptoms should disappear within 2-weeks with no residual complications.
Complications of Spinal Meningitis
- Hearing loss or deafness
- Brain damage
- Loss of vision
Calling your Health Care Provider
If you feel that you or your child have symptoms suggestive of meningitis, you must seek emergency medical help immediately. Early treatment is key to a good outcome.
Prevention of Spinal Meningitis
Haemophilus vaccine (HiB vaccine) in children will help prevent one type of meningitis.
The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing Pneumococcal Meningitis.
It's highly recommended household contacts and people with close contact with individuals with meningococcal meningitis receive preventative antibiotics to avoid becoming infected themselves.
Some communities conduct vaccination campaigns following an outbreak of meningococcal meningitis. Military recruits are routinely vaccinated against this form of meningitis because of its high rate of occurrence.
The American Academy of Pediatrics and the American College Health Assn encourage college students (particularly freshmen living in dorms) to consider being vaccinated with the meningococcal vaccine.
How to Deal with Spinal Meningitis?
With the arrival of late summer and early fall Spinal Meningitis raises its ugly head to search for preys–its victims are children below five and adults below thirty. Spinal Meningitis is a lay term for inflammation of the meninges-membranes covering the brain and spinal cord. It affects the brain and spine simultaneously.
‘Purulent Meningitis’ refers to the infection caused by bacteria. ‘Aseptic meningitis’ is non bacterial meningitis- caused by virus, fungi, chemicals and tumors.
The symptoms of both bacterial and non bacterial spinal meningitis are almost alike. The onslaught of the disease is preceded generally by a splitting headache, fever and chills, severe stiff neck, sensitivity to light, vomiting, loss of appetite, and sweating.
Bacterial Meningitis may show some extra symptoms like mental status changes, Dementia, twitching, perturbation, skin rashes and protrusive soft skull spots in case of babies.
If you experience these symptoms seek medical attention right away. Delays can cause incurable secondary defects like blindness, deafness and brain damage or may be life threatening.
Common diagnosis tools that the doctor uses for spinal meningitis include a Lumbar Puncture to inspect cerebrospinal fluid, bacterial culture, chest X-ray and a CT scan of the brain to locate damages.
Bacterial Meningitis is treated with antibiotics administered orally first and then intravenously earlier the disease is detected and treated the better will be the results. Although rarely seen, this form of Meningitis is more serious that than Viral Meningitis. Antibiotics can’t cure Viral Meningitis. The disease usually resolves on its own. Secondary defects can be treated with intravenous fluids.
Golden Seal is a natural tonic that strengthens the spinal nerves and prevents recurrence of spinal meningitis. Black Cohosh is good for spinal meningitis, but its use is unadvisable for pregnant women. Both these medicines should be taken only for short time periods.
Prevention is always better than cure. Through administration of vaccines like Haemophilus vaccine, Meningococcal vaccine and Pneumococcal conjugate vaccinations may prevent some types of Meningitis Disease and Spinal Meningitis.
What is Viral Meningitis?
Viral meningitis, also known as aseptic meningitis is an infection of the brain covering and spinal cord caused by a virus.
Viral meningitis cases may happen at any time of the year but Viral Meningitis occurs more frequently in the late summer or early fall.
Viral meningitis can be caused by different viruses and is usually not as serious as bacterial meningitis.
Viral menungitis is fairly easily curable and treatable if caught early and well diagnosed by your doctor.
Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis.
Is it Viral Meningitis or Bacterial Meningitis?
Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability. It also is important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.
FAQs on Viral ("Aseptic") Meningitis
Is Viral Meningitis a Serious Disease?
Viral ("aseptic") meningitis is serious but rarely fatal in persons with normal immune systems. Usually, the symptoms last from 7 to 10 days and the patient recovers completely. Bacterial meningitis, on the other hand, can be very serious and result in disability or death if not treated promptly. Often, the symptoms of viral meningitis and bacterial meningitis are the same. For this reason, if you think you or your child has meningitis, see your doctor as soon as possible.
Who gets Viral Meningitis?
Anyone can get viral meningitis but it occurs most often in children.
What Causes Viral Meningitis?
Many different viruses can cause meningitis. About 90% of cases of viral meningitis are caused by members of a group of viruses known as enteroviruses, such as coxsackieviruses and echoviruses. These viruses are more common during summer and fall months. Herpesviruses and the mumps virus can also cause viral meningitis.
How is Viral Meningitis Diagnosed?
Viral meningitis is usually diagnosed by laboratory tests of spinal fluid obtained with a spinal tap. The specific cause of viral meningitis can be determined by tests that identify the virus in specimens collected from the patient, but these tests are rarely done.
How is Viral Meningitis Treated?
No specific treatment for viral meningitis exists at this time. Most patients completely recover on their own. Doctors often will recommend bed rest, plenty of fluids, and medicine to relieve fever and headache.
How is the Virus Spread?
Enteroviruses, the most common cause of viral meningitis, are most often spread through direct contact with respiratory secretions (e.g., saliva, sputum, or nasal mucus) of an infected person. This usually happens by shaking hands with an infected person or touching something they have handled, and then rubbing your own nose or mouth. The virus can also be found in the stool of persons who are infected. The virus is spread through this route mainly among small children who are not yet toilet trained. It can also be spread this way to adults changing the diapers of an infected infant. The incubation period for enteroviruses is usually between 3 and 7 days from the time you are infected until you develop symptoms. You can usually spread the virus to someone else beginning about 3 days after you are infected until about 10 days after you develop symptoms.
Is Viral Meningitis Contagious?
The viruses that cause viral meningitis are contagious. Enteroviruses, for example, are very common during the summer and early fall, and many people are exposed to them. However, most infected persons either have no symptoms or develop only a cold or rash with low-grade fever. Only a small proportion of infected persons actually develop meningitis. Therefore, if you are around someone who has viral meningitis, you have a moderate chance of becoming infected, but a very small chance of developing meningitis.
How can I reduce my Chances of Becoming Infected?
Because most persons who are infected with enteroviruses do not become sick, it can be difficult to prevent the spread of the virus. However, adhering to good personal hygiene can help to reduce your chances of becoming infected. If you are in contact with someone who has viral meningitis, the most effective method of prevention is to wash your hands thoroughly and often (see "Hand washing" in: An Ounce of Prevention: Keeps the Germs Away). Also, cleaning contaminated surfaces and soiled articles first with soap and water, and then disinfecting them with a dilute solution of chlorine-containing bleach (made by mixing approximately ¼ cup of bleach with 1 gallon of water) can be a very effective way to inactivate the virus, especially in institutional settings such as child care centers. (See more about cleaning and disinfecting in general in CDC's Prevention Resources).
What are the Symptoms?
The symptoms may include fever, headache, stiff neck and fatigue. Rash, sore throat and intestinal symptoms may also occur.
How Soon do Symptoms Appear?
Symptoms generally appear within one week of exposure.
Is a Person with Viral Meningitis Contagious?
Some of the enteroviruses that cause viral meningitis are contagious while others, such as mosquito-borne viruses, cannot be spread from person to person. Fortunately, most people exposed to these viruses experience mild or no symptoms. Most people are exposed to these viruses at some time in their lives, but few actually develop meningitis.
Should a Person with a Viral Meningitis be Isolated?
Strict isolation is not necessary for a person with viral meningitis. Since most cases of viral meningitis are due to enteroviruses that may be passed in the stool, people diagnosed should be instructed to thoroughly wash their hands after using the toilet.
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