The brain and spinal cord are covered by layers of tissue. These layers are called the meninges. Certain bacteria can cause an infection in these layers. This is called bacterial meningitis.
It is a serious infection that can cause death within hours. Quick diagnosis and treatment is vital.
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Many times, the bacteria first cause an
upper respiratory tract infection. Then, it travels through the blood stream to the brain.
Worldwide, three types of bacteria cause the majority of cases of acute bacterial meningitis:
- Streptococcus pneumoniae
(the bacteria that causes
- Neisseria meningitidis
- Haemophilus influenzae b
- In the United States, widespread immunization has almost eliminated meningitis due to Hib
Other forms of bacterial meningitis include:
- Listeria monocytogenes
- Escherichia coli
- Mycobacterium tuberculosis
Newborn babies and the elderly are more prone to get sick.
Some forms are spread by direct contact with fluid from the mouth or throat of an infected person. This can happen during a kiss or by sharing eating utensils. In general, meningitis is not spread by casual contact.
Risk factors for meningitis include:
- Age: infancy and early childhood; increased age
People in close and prolonged contact with patients with meningitis due to Hib or
A weakened immune system due to
infection or other conditions
Smoking (for meningitis due to
Neisseria meningitidis) and being exposed to second-hand smoke
Living in close proximity to others, such as in dormitories and military barracks (for meningitis due to
- A history of epidural steroid injections or other invasive spinal procedures
Classic symptoms can develop over several hours or may take one to two days:
- High fever
- Very stiff, sore neck
Other symptoms may include:
- Red or purple skin rash
- Bluish skin color
- Sensitivity to bright lights
- Mental confusion
In newborns and infants, symptoms are hard to see. As a result, infants under three months old with a fever are often checked for meningitis. Symptoms in newborns and infants may include:
- Unexplained high fever or any form of temperature instability, including a low body temperature
(yellow skin color)
- Feeding poorly or refusing to eat
- Tightness or bulging of soft spots between skull bones
- Difficulty awakening
As the illness progresses, seizures and/or
This can happen to patients of all ages.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- Spinal tap—removal of a small amount of
to check for bacteria
- Other cultures—testing samples of blood, urine, mucous, and/or pus from skin infections
- MRI—a test that uses magnetic waves to make pictures of structures inside the body (to be sure the inflammation is not from some other cause, such as a tumor)
- CT—a type of x-ray that uses a computer to make pictures of structures inside the body
More than 90% of all people with this infection survive with immediate care, including:
- Antibiotics and corticosteroids—often given together
Talk with your doctor about the best plan for you.
Antibiotics are given through an IV. This is started as soon as the infection is suspected. The antibiotics may be changed once tests name the exact bacterial cause. Patients usually stay in the hospital until a fever has fallen. The fluid around the spine and the brain must also be clear of infection.
These are usually given by IV early in treatment. They control brain pressure and swelling. They also reduce the body’s production of inflammatory substances. This treatment can prevent further damage.
Fluids can be lost due to fever, sweating, or vomiting. They may be replaced through an IV. It will be done carefully to avoid complications of fluid overloading.
- Pain medications and sedatives may be used
- Anticonvulsants may be prescribed to prevent seizures
To help reduce your chances of getting bacterial meningitis, consider the following steps:
Talk to your doctor to find out which vaccines you and your child need. Examples include:
- If you are a healthcare worker or have close contact with someone who is infected, take preventive antibiotics.
Buy pasteurized milk and milk products. This can prevent meningitis due to
Listeria monocytogenes .
- If you are pregnant, your doctor will monitor you to make sure the infection is not passed to your baby.
Beers MH, Berkow R.
The Merck Manual of Diagnosis and Therapy. 17th ed. Hoboken, NJ: John Wiley & Sons;1999.
10/2/2009 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Centers for Disease Control and Prevention. Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease.
2009;58(37):1042-1043. Centers for Disease Control and Prevention, MMWR website. Available at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm. Published September 25, 2009. Accessed October 2, 2009.
4/22/2011 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Lee CC, Middaugh NA, Howie SR, Ezzati M. Association of secondhand smoke exposure with pediatric invasive bacterial disease and bacterial carriage: a systematic review and meta-analysis. PLoS Med.
Last reviewed October 2012 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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