Bacterial Meningitis

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Introduction

What is bacterial meningitis?

Bacterial meningitis is an infection, caused by bacteria, of the sac surrounding the brain and spinal cord. Typical symptoms include headache, sensitivity to light, and neck stiffness. Fever is often present.

Most cases of acute bacterial meningitis can be cured with appropriate antibiotic therapy. Identifying the type of bacteria present can be important when choosing which type of antibiotic to use, although therapy is often started right away with a powerful broad-spectrum antibiotic. Luckily, the most common and serious types of acute bacterial meningitis can be prevented through vaccination.

Currently, Streptococcus pneumoniae is the most common cause of bacterial meningitis. Haemophilus influenzae type b (also known as Hib) used to be the most common, but the recommendation for routine vaccination of children has greatly reduced its incidence. The second most common cause of bacterial meningitis is Neisseria meningitidis. In the United States, approximately 6,000 people are diagnosed with pneumococcal meningitis, and 2,600 with meningococcal meningitis, each year.

Bacterial meningitis is a serious disease that can be life threatening. Seek immediate medical care (call 911) for symptoms such as severe headache, unusual neck stiffness, high fever, confusion, lethargy, loss or change in level of consciousness, seizure, and unusual irritability in a small child.

Symptoms

What are the symptoms of bacterial meningitis?

Inflammation accounts for some of the key symptoms of bacterial meningitis, such as headache, sensitivity to light, and neck stiffness.

Common symptoms of bacterial meningitis

Common symptoms of bacterial meningitis include:

  • Difficulty thinking clearly

  • Fever

  • Generalized aches and pains

  • Headache

  • Increased sensitivity to light

  • Irritability in children

  • Loss of appetite or poor feeding in children and infants

  • Malaise or lethargy

  • Neck stiffness

  • Rash

  • Seizure

Serious symptoms that might indicate a life-threatening condition

In some cases, acute meningitis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • High fever (higher than 101 degrees Fahrenheit)

  • Rapid heart rate (tachycardia)

  • Seizure

  • Severe dizziness or sudden loss of balance

  • Severe headache

  • Unusual irritability or poor feeding in children and infants

  • Unusual neck stiffness or pain

Causes

What causes bacterial meningitis?

The most common causes of bacterial meningitis include Haemophilus influenzae type b (also known as Hib), Neisseria meningitidis, and Streptococcus pneumoniae, although Haemophilus influenzae type b is not as common as it once was due to vaccination practices. Other bacteria that can cause bacterial meningitis include Escherichia coli, group B streptococci, Listeria monocytogenes, and Mycobacterium tuberculosis.

Bacterial meningitis is contagious and spreads from person to person through tiny droplets that are sent into the air during talking, laughing, coughing and sneezing. It can also spread by kissing, sharing eating utensils, and hand-to-hand contact. Bacterial meningitis can also be a complication of blood infection or infections in nearby sites, such as the sinuses or ears. Bacterial meningitis tends to occur in settings where people are in close contact with each other, such as daycare and school.

What are the risk factors for bacterial meningitis?

A number of factors increase the risk of developing bacterial meningitis. Not all people with risk factors will get bacterial meningitis. Risk factors for bacterial meningitis include:

  • Attendance or work in a daycare or school setting
  • Close contact with an infected person
  • Infrequent hand washing
  • Lack of vaccination against the disease
  • Living in a dormitory
  • Weakened immune system

Reducing your risk of bacterial meningitis

You may be able to lower your risk of bacterial meningitis by taking preventive steps that include:

  • Getting vaccinated against Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae
  • Washing your hands frequently, especially after contact with someone who has meningitis
Treatments

How is bacterial meningitis treated?

The best treatment for acute meningitis is avoiding it in the first place. Effective vaccines have been developed against the three most common causes of bacterial meningitis, Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumonia.

Treatment for bacterial meningitis

Treatment of bacterial meningitis requires timely treatment with antibiotics. It is important to follow your treatment plan for bacterial meningitis precisely and to take all of the antibiotics as instructed to help avoid complications. Treatment of bacterial meningitis includes:

  • Antibiotic therapy, including powerful antibiotics such as ceftriaxone (Rocephin) and vancomycin (Vancocin)

  • Anticonvulsant medications such as dilantin (Phenytoin) or phenobarbital to prevent seizures in severe meningitis

  • Antinausea medication if needed

  • Corticosteroids to help reduce inflammation and swelling

  • Fever-reducing medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Aspirin use should be avoided in children.

  • Intravenous fluids as needed

  • Oxygen if shortness of breath is present

  • Pain medications to increase comfort if needed

  • Sedatives to increase comfort if needed

  • Surgical drainage of sinuses if needed

What you can do to improve your bacterial meningitis

In addition to following your treatment plan, you may be able to reduce some of the symptoms of bacterial meningitis with comfort measures including:

  • Drinking plenty of fluids

  • Getting plenty of rest

  • Staying in a quiet, dark room

What are the potential complications of bacterial meningitis?

Adults with weakened immune systems and infants are at the highest risk of developing complications. Left untreated, bacterial meningitis can be a serious, even life-threatening infection in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of bacterial meningitis include:

  • Brain damage

  • Loss of hearing

  • Loss of vision or blindness

  • Seizures

  • Sepsis (life-threatening bacterial blood infection)

  • Stroke

  • Unconsciousness and coma

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Meningitis and encephalitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm
  2. Meningococcal Disease. Centers for Disease Control and Prevention. http://www.cdc.gov/meningococcal/about/index.html
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