Meningitis | Symptoms & Causes
What causes meningitis?
Meningitis is usually caused by a bacterial or viral infection that invades the cerebral spinal fluid (CSF), the fluid within the open spaces of the brain that protect and cushion the brain and spinal cord. A fungus or parasite may also cause meningitis. More specifically:
Bacteria that can cause meningitis include:
- Group B streptococcus
- Escherichia coli (or E. coli)
- Listeria monocytogenes
- Streptococcus pneumoniae
- Neisseria meningitides (meningococcal meningitis)
- Haemophilus influenzae type b or H. influenzae
- syphilis
- tuberculosis (TB)
Viruses that can cause meningitis include:
Other microorganisms that can cause meningitis are:
- Borrelia burgdorferi (Lyme disease)
- Fungi such as candida, aspergillus, or cryptococcus neoformans
Bacterial meningitis can be spread through coughing or sneezing, kissing, or sharing drinks. In addition, you increase your chances of catching meningitis by:
- Having been in close contact with someone who has bacterial meningitis (especially when it’s due to meningococcus, a type of bacteria that is more contagious than others)
- Having a compromised immune system
- Having traveled to an area of the world where meningitis is widespread (consult your doctor for the recommended vaccinations before traveling overseas)
What are the symptoms of meningitis?
The symptoms of meningitis vary depending on what that caused the infection and the age of your child. They also may surface several days after your child has had a cold and runny nose, or diarrhea and vomiting. Your child may not display all of the signs and symptoms, but if you think your child is sick, seek medical attention immediately.
The most symptoms common include:
- In infants (symptoms may be difficult to identify):
- In children older than 1 year:
- Neck and/or back pain
- Headache
- Sleepiness
- Confusion
- Irritability
- Fever
- Refusing to eat
- Decreased level of consciousness
- Seizures
- Sensitivity to light
- Nausea and vomiting
- Neck stiffness
Meningitis | Diagnosis & Treatments
How is meningitis diagnosed?
In addition to a complete medical history, physical exam, and blood tests, your child’s doctor may need to perform other procedures to confirm that your child has meningitis, including:
Lumbar puncture (spinal tap)
- A special needle is placed into your child’s lower back into the spinal canal.
- It measures the pressure in the spinal canal and brain.
- A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems.
- We don’t recommend this if your child is very ill.
Computerized tomography scan
- Also called a CT or CAT scan
- Uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body
- Shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
- More detailed than general X-rays
How do we treat meningitis?
Early treatment with antibiotics can reduce swelling and inflammation in your child's brain. Timing is crucial. If your child has symptoms of bacterial meningitis, go to the nearest emergency room right away.
If someone is in close contact with a person who has bacterial meningitis, such as a roommate, parent, sibling, daycare worker, classmate, or boyfriend or girlfriend, they are at an increased risk and should go to the doctor for antibiotics to prevent bacterial meningitis before symptoms occur.
Traditional treatments for meningitis
Treatment depends on the type of meningitis, but can include:
Bacterial meningitis
- Intravenous (IV) antibiotics
- The earlier the treatment starts, the better your outcome
- Antibiotics can start before the results of the lumbar puncture are available
- A corticosteroid, or steroid, such as dexamethasone can decrease inflammation and reduce pressure that can build up in the brain
Viral meningitis
- Tylenol can relieve symptoms.
- With the exception of the herpes simplex virus, there are no medications to treat the organisms that cause viral meningitis.
- Most children with viral meningitis recover on their own without treatment.
Fungal meningitis
- Anti-fungal intravenous (IV) medication
Tuberculosis (TB) meningitis
- A long course (one year) of medications
- Usually involves several different medications for the first few months, followed by other medications
How Boston Children’s Hospital approaches meningitis
Boston Children’s is constantly working to prevent, identify and treat meningitis is a more effective way. Some innovations by Children’s include:
- Development of the Haemophilus influenzae b (Hib) vaccine in 1990 has practically eliminated the most common cause of bacterial meningitis in children.
- A simple algorithm developed at Boston Children’s and the University of California, Davis, Health System in 2007 helps doctors rapidly distinguish infants and children with viral meningitis from those with bacterial meningitis — potentially reducing unnecessary hospital admissions and prolonged antibiotic treatment.
- The Children’s Hospital Informatics Program created HealthMap, an online resource and smart phone app that helps track the spread of contagious diseases in real time, including meningitis.
