Meningitis is a very serious condition that could ultimately affect anyone. More commonly referred to as an infection of the brain, it is an infection of the meninges, which is the membrane that covers the brain and the spinal cord. Meningitis has a high risk of death and it can also leave considerable long-term complications, or better referred to as sequalae. This illness is considered to be a significant worldwide public health challenge.

According to the World Health Organization (WHO), meningitis can be caused by various organisms, such as bacteria, viruses, parasites and fungi. Also, meningitis could be ignited by other conditions, such as infections, cancer, injuries or by taking some specific drugs, such as NSAIDs (non-steroidal anti-inflammatory drugs).

The most harmful type of meningitis is considered to be bacterial meningitis. The studies show that 1 out of 10 affected persons dies and 1 out of 5 remains with long-term complications. There are epidemics of meningitis worldwide, but one very challenging hotspot is the Sub-Saharan Africa.

Meningitis symptoms

The main symptoms of meningitis are listed below:

• Feeling sick;
• Stiff neck;
• High fever;
• Headache;
• Seizures;
• High sensibility to light;
• Drowsiness;
• Rash.

You can suffer from all of the above-mentioned symptoms in case of meningitis, but it is not a rule. You could have meningitis and fever could be the one and only symptom that you present. The symptoms ultimately vary from patient to patient.

Types of meningitis

The types of meningitis based on what has caused it are as follows: 

• Bacterial meningitis
• Viral meningitis
• Fungal meningitis
• Parasitic meningitis
• Amebic meningitis
• Non-Infectious Meningitis

Bacterial meningitis

The bacterial meningitis is an actual infection of the meninges, the membrane that covers the brain, that could burst out in just a couple of hours.

Bacterial meningitis could affect almost anybody. The categories of people that are at risk to develop bacterial meningitis are:

• Children younger than 2 years;
• Adult persons who are already suffering from chronic nose or ear infections, head injuries or pneumonia.
• Persons who have weak immune systems.
• Persons who got a spleen removal or spinal or brain surgery;
• Persons who suffered a widespread blood infection;
• Adults who are consuming excessively alcohol are at risk, as well.

Bacterial meningitis is a common condition among students or military personnel as they are in close contact with other people on a daily basis.

Bacterial meningitis symptoms

The symptoms of bacterial meningitis could be slightly different, depending on age.

For example, young children might start to vomit and to refuse to eat, due to fever. Also, they can get truly irritable as the fluid that protects the brain could get blocked and the head starts to swell.

Normally, in adults and teenagers, the symptoms that announce bacterial meningitis are related to fever, headaches and neck stiffness. Moreover, those who suffer from bacterial meningitis could easily become confused and they could appear very irritable. The risk of strokes and seizure could also appear.

Bacterial meningitis causes

The causes for bacterial meningitis are sometimes unknown, as it can occur with no reason, as, usually, the bacteria that stimulates meningitis is already present in the patient’s body since a long time before.

Even if the acute bacterial meningitis is the most common type of meningitis, each patient that suffers from it has 10% risks of death.  If bacterial meningitis is timely diagnosed, and the effective treatment is also started early, the outcome should be positive in most of the cases.

The estimations are that about 25% of people with meningococcal disease, will have complications, such as:

• Seizures;
• Memory and concentration problems;
• Movement, balance and co-ordination problems;
• Learning difficulties;
• Speech problems;
• Loss of sight;
• Loss of hearing.

Bacterial meningitis diagnosis

Bacterial meningitis could be diagnosed through a physical check. During this examination, the specialist will look for reddish or purple rash and will also test the knee flexion and the hip. The stiffness of the neck is another symptom for which the specialist will look for. In order to determine which kind of meningitis the patient suffers from; the specialist must perform a test analysis of the spinal fluid. Moreover, samples of blood and urine might be needed, too, along with samples of mucous from both the nose and throat.

The earlier the patient goes to hospital for diagnosis and to seek medical care, the less chances of long-term or even permanent complications he has.

Bacterial meningitis treatment

Bacterial meningitis could be normally treated with antibiotics. As soon as the symptoms of meningitis occur, the doctor will prescribe a general intravenous antibiotic with corticosteroid, with the purpose of reducing the inflammation and calming down the infection. This prescription is often made before the results of the examination are received. When the results of the tests are received, the doctor might change the antibiotic with a more specific one, targeting the exact bacteria that set off the meningitis.

During treatment, it is highly recommended to drink as much water as possible, as the body might get dehydrated due sweating, vomiting or diarrhea.

It is truly important to know that bacterial meningitis could be contagious. Normally, if you suffer of bacterial meningitis, after 24 hours since the treatment with antibiotic, you should not be able to transmit it anymore. Everyone that has been in close touch with you, in the period before detecting the bacterial meningitis, should start a preventive treatment. You might need to inform relevant healthcare authorities as per country policy.

Bacterial meningitis vaccine

The bacterial meningitis could be avoided by vaccine. There are two types of vaccine for bacterial meningitis. The first type of vaccine is referred to as a meningococcal conjugate, while the second type of vaccine is referred to as Serogroup B meningococcal.

The first type of vaccine, the meningococcal conjugate is recommended to children between 11 and 12 years old (and they should also receive a booster dose at 16 years old) or any other person, no matter the age, who also suffers of immunodeficiency diseases.

The second type of vaccine, the meningococcal conjugate, is recommended to any person that could be exposed to bacterial meningitis.

Before getting the vaccine, you must discuss about your health history with your medic, as the vaccine is not recommended to those who already suffers of allergies to some components of the vaccine, neither to pregnant women.

Viral meningitis

The viral meningitis is the most widespread type of meningitis as it is caused by a non-polio enterovirus. The most affected categories of people by this type of infection are the children younger than 5 years old and those who suffer of immune deficiency, due to other heath-care conditions.

Causes of Viral meningitis

Having a close contact with someone infected with the virus might lead to your infection, as well. Nevertheless, contracting the virus does not mean necessarily that you will develop meningitis.

Viral meningitis is not stimulated by a single virus. There are more viruses that can set off this type of meningitis:

• Herpesviruses, including Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus;
• West Nile virus;
• Measles virus;
• Influenza virus;
• Mumps virus;
• Lymphocytic choriomeningitis virus.

Symptoms of Viral meningitis

The symptoms of viral meningitis in babies, children and adults are mostly the same as the symptoms of bacterial meningitis. The symptoms of viral meningitis normally are:

• Fever;
• Headache;
• Stiff neck;
• Nausea;
• Irritability;
• Vomiting;
• Lack of appetite
• Sensibility to light;
• Fatigue and difficulties in waking up from sleep.

The main characteristic of viral meningitis is that those who suffer of it usually recover in 7 to 10 days, without being prescribed a treatment.

Viral meningitis diagnosis

If you have any of the symptoms above mentioned, do not wait and get to the doctor as soon as possible, as meningitis could be very harmful.

Once your doctor starts the diagnosis process, he will check the reflex of the knee and will ask about any stiffness of the neck. In order to identify the viral meningitis, there will be needed further lab tests. These would include urine, stool and blood samples along with fluid extracted from around the spinal cord and samples of mucous from the throat and nose.

Viral meningitis treatment

Normally, those who suffer of viral meningitis recover in about 7 to 10 days. In this period, the treatment is mainly based on antiviral medicine.

As this type of meningitis is caused by a virus, the antibiotics would not prove to be effective, as they are not able to treat viral infections.

In the situation of becoming severely ill, the treatment might need to include medical care at the hospital.

Prevention of Viral meningitis

The viral meningitis cannot be prevented with a vaccine, as in the case of bacterial meningitis. Therefore, in order to prevent yourself and the other persons around you, you should follow strictly a cleanliness routine:

• Wash your hands frequently and efficiently, especially after touching different objects which could be prone to contain viruses or after shaking hands with persons that are feeling sick. Also, try to avoid any close contact with a person who is not feeling well.
• Keep the objects and surfaces of your household and other spaces where you spend time clean, by disinfecting them frequently.
• If you or your children are feeling sick you should avoid to expose it to other persons. This could mean to avoid going to the workplace or school or kindergarden in case of the children.
• Avoid contact with any animal or insect that can carry viruses, such as mosquitos or mice and rats.

Fungal meningitis

The fungal meningitis is another way in which the meninges could get infected. This time, the inflammation is caused by a fungal infection that has spread to the brain or spinal cord.

This type of meningitis is not contagious from a person to another, though a person could get the infection started just by breathing in the respective fungi.

The fungal meningitis can be stimulated by various fungi which are found pretty much everywhere around us. For example:

• Cryptococcus neoformans and Cryptococcus gattii are both found in soil and they are the most widespread fungi. Coccidioides are also found in the soil.
• Blastomyces is another fungus that can stimulate cough and fever if it is breathed in. This type of fungus lives in moist soil and in decomposing matter, just like woods and leaves. If the infection that it causes is not timely treated, it could lead to fungal meningitis.
• Candida is another fungus that can represent the cause of fungal meningitis, though it already exists in the organism alike the other above-mentioned fungi, which all live in the surrounding environment. Sometimes, candida can get into the bloodstreams and other internal organs. In such scenarios, it causes an infection.

Breathing in the any of these fungi that live in the outdoors could ignite the lungs infection, which can lead to fungal meningitis. These fungi are so tiny, that actually they cannot even be detected with a microscope. Not everybody who inhales them will get to develop a lung infection that could lead to meningitis. Many people out of those who inhale them could easily not even realize that they actually did it.

The fungal meningitis can be developed by anybody, but the persons who have a significant risk of developing it are those who already have their immune systems weakened, such as those who suffer of HIV infection, cancer. Furthermore, there are also medications that can make the immune system weaker, such as:

• Those that are taken after an organ transplant, such as: tacrolimus, prednisone, mycophenolate; sirolimus or everolimus.
• Anti-tumor necrosis factor (Anti-TNF), which could be prescribed for treating rheumatoid arthritis and other autoimmune conditions, as well.

Also, babies that are born prematurely are at risk of getting Candida into the bloodstream.

Fungal meningitis symptoms

The symptoms of fungal meningitis are usually the following:

• Headache;
• Fever;
• Stiffness of the neck;
• Nausea;
• Vomiting;
• Photophobia or sensibility to light;
• Confusion, which is the result of an alteration of the mental capabilities.

Diagnosis of Fungal meningitis

The first thing that the doctor will do in order to determine the cause of the meningitis is to collect samples of blood, urine and of the fluid that surrounds the spinal cord and send them to the laboratories.

The results of the tests are sent back to the doctor and they help him determine which kind of fungus has stimulated the meningitis This is very important, as each type of fungal infection is treated differently. For example, the Valley Fever (also referred to as coccidioidomycosis), which is caused by the Coccidioides fungus, never has the same treatment as for Candidiasis, which is the infection caused by the Candida fungus.

Treatment for Fungal meningitis

Any fungal meningitis is normally treated with long courses of high-dose antifungal medications, that are usually administered into the vein, using an IV. Once this stage of treatment is finished, the suffering patients are required to take antifungal medication orally. There is no specific duration of the treatment. The duration of the treatment totally depends on the strength of the patient’s immune system and on the type of fungus that causes the infection. For example, for a patient that is also suffering of AIDS or cancer, the treatment will take longer than for a person who does not suffer of other health conditions.

Prevention of Fungal meningitis

Unfortunately, there is no medical procedure that can prevent the fungal meningitis. Therefore, if you know that your immune system is weaker than it should be, you might consider the following pieces of advice, in order to decrease your risks of developing such an infection:

• Keep away from construction sites or any other places where there is a lot of dust. If you truly need to be in such an area, you should wear mask.
• Avoid any type of activity that is performed in a dusty environment or which means to have direct contact with dust, even gardening or just digging.
• Use indoors air filters within your household.
• Avoid dust storms.
• Always clear the skin injuries with water and soap as soon as they occur, especially if you live in an area known for existent fungi.
• Discuss with your doctor about taking a preventive antifungal medicine.

Parasitic meningitis

Parasitic meningitis is way less common than bacterial meningitis or viral meningitis. Also, the way that the parasites are contracted is different than contracting a virus or a fungus.

As well as the meningitis can be caused by parasites, the parasites can also seriously harm the brain and the nervous system in other ways.

Causes of Parasitic meningitis

The parasitic meningitis is also known as eosinophilic meningitis. There are known to be 3 principal parasites that could cause such an infection:

• Angiostrongylus cantonensis (neurologic angiostrongyliasis). This type of parasite is contracted while eating infected and raw or undercooked animal meat.
• Baylisascaris procyonis (baylisascariasis; neural larva migrans). This parasite could be contracted by ingesting its eggs accidentally. For example, the eggs of this parasite could be found in the feces of the raccons. This means that it can also infect the soil.
• Gnathostoma spinigerum (neurognathostomiasis). This type of parasite could be contracted while consuming raw or undercooked fish.

Symptoms, Diagnosis and Treatment of Parasitic meningitis

The symptoms of parasitic meningitis are mostly the same as in the situation of any other kind of meningitis:

• Headache;
• Stiffness of the neck;
• Nausea;
• Vomiting;
• Sensibility to light (photophobia);
• Confusion.

There are two unique aspects for the parasitic meningitis. Those who suffer of this kind of meningitis could also have a tingling or painful feeling in the skin. Also, these persons are at high risk of developing an eye infection, as well, which can cause long term complications:

• Loss of muscle control;
• Loss of coordination;
• Paralysis;
• Permanent disability;
• Death.

The diagnosis of parasitic meningitis consists mainly of the same procedures that are used to detect any other kind of meningitis, such as collecting blood and cerebrospinal fluid samples, along with urine and stool samples. Moreover, as it is very difficult to identify the parasites in these samples, it is very helpful to perform other tests, such as scanning the brain or to obtain the travel or exposure history. In some areas of the world, cases of developing parasitic meningitis could be more usual.

There is no specific treatment for parasitic meningitis. Normally, the treatment is used to improve the symptoms and to reduce the reaction of the body to the parasite. The treatment for infection could work for some of the patients.

Primary amebic meningoencephalitis (PAM)

Primary amebic meningoencephalitis (PAM) is one of the rarest types of brain infection and it is fatal in most of the cases. This infection is caused by the ameba Naegleria fowleri, which exists in soil and fresh warm waters. This ameba could also live in hot springs, or swimming pools that are poorly maintained.

Naegleria fowleri can be contracted while swimming or just by adding contaminated water in the nostrils (for cleansing the nose, for example). Naegleria fowleri can not be contracted from while drinking contaminated water. It can be contracted just through the nose.

Naegleria fowleri enters the body through the nose and gets up to the brain where it attacks the brain tissue.

The symptoms are quite similar to those of bacterial meningitis, with the exception that they occur between 1 and 9 days after contracting Naegleria fowleri. The symptoms that are characteristical to primary amebic meningoencephalitis are the seizures that occur really soon and the hallucinations. Moreover, after 5 days since the first symptoms, the chances of surviving are extraordinarily low. During 10 years, since 2009 to 2019, out of 34 infections, only 3 patients have managed to survive.

As the symptoms are very similar to the symptoms of bacterial meningitis and due to the rarity, this infection is almost impossible to detect.

There are exist some treatments at this moment for primary amebic meningoencephalitis, but their effectiveness is under a question mark, as most of the infections have been fatal.

Non-infectious meningitis

Meningitis can also be stimulated by other conditions of which the patient already suffers from, such as:

• Lupus;
• Cancer.
• Head injuries or brain surgeries.

The symptoms of non-infectious meningitis are the same as for any other kind of meningitis:

• Headache;
• Fever;
• Stiffness of the neck;
• Nausea;
• Vomiting;
• Sensibility to light.
• Confusion.

Conclusion

Unfortunately, meningitis of any kind could be very harmful and even deadly.

An episode of meningitis could change your life forever. If it is not timely treated or left untreated, meningitis could stimulate long-term complications, such as permanent disability, loss of sight, loss of hearing or brain damage. Any of these complications could affect enormously your day-to-day life. Beside the fact that the routines and daily activities could be highly affected, your whole life could be changed forever, as the possible complication could make unable to continue your career, for example.

Therefore, it is truly important for your own safety to get to the doctor as soon as you are suffering of the symptoms above mentioned. The earlier meningitis is detected and the treatment starts, the bigger the chances of healing without complications.

Take care of yourself and of those surrounding you!