Meningitis can occur due to a viral, bacterial, or fungal infection and requires emergency medical treatment. Symptoms may include stiff neck, sleepiness, and headache, among others.
Meningitis is an inflammation of the fluid and three membranes (meninges) surrounding your brain and spinal cord.
The most common causes of meningitis are viral and bacterial infections. Other causes may include:
- cancer
- fungi
- drug-induced reactions
The symptoms of viral and bacterial meningitis can be similar in the beginning. However, bacterial meningitis symptoms are usually more severe. The symptoms also vary depending on your age.
Viral meningitis symptoms
Viral meningitis may cause:
- headaches
- fever
- stiff neck
- seizures
- sensitivity to bright light
- sleepiness
- lethargy
- nausea and vomiting
- decreased appetite
- altered mental state
Bacterial meningitis symptoms
Bacterial meningitis symptoms develop suddenly. They may include:
- altered mental status
- nausea
- vomiting
- sensitivity to light
- irritability
- headache
- fever
- chills
- stiff neck
- purple areas of skin that resemble bruises
- sleepiness
- lethargy
Seek immediate medical attention if you experience these symptoms. Bacterial and viral meningitis can be deadly. There’s no way to know if you have bacterial or viral meningitis just by judging how you feel. A doctor needs to perform tests to determine which type you have.
Fungal meningitis symptoms
Symptoms of fungal meningitis resemble the other types of this infection. These may include:
- nausea
- vomiting
- sensitivity to light
- neck stiffness
- fever
- headache
- a general sense of being unwell
- confusion or disorientation
Chronic meningitis symptoms
You’re diagnosed with chronic meningitis when your symptoms last for longer than 4 weeks.
Chronic meningitis symptoms are similar to other forms but may develop more slowly.
Babies who develop meningitis may show different symptoms than adults. These can include:
- fever
- body or neck stiffness
- high-pitched crying
- inconsolable behaviors
- sleepy and difficulty waking
- irritable and grumpy
- doesn’t feel well and has a weak suck during feeding
Viruses that cause colds, cold sores, flu, and diarrhea can also cause viral meningitis.
Bacterial meningitis typically spreads from a severe infection in a nearby area of the body. For example, bacteria from a severe ear infection or sinus infection can enter the bloodstream and travel to the brain or spinal cord.
Meningitis becomes more common in children as they grow older and reach high school and college ages. Symptoms of viral and bacterial meningitis in children are similar to symptoms in adults. These include:
- sudden fever
- body and neck aches
- confusion or disorientation
- nausea
- vomiting
- tiredness or fatigue
Having Neisseria meningitidis, one bacterial cause of meningitis, in your bloodstream may cause a faint rash.
Bacteria from a meningococcal meningitis infection reproduce in the blood and
People with darker skin may have a harder time seeing a meningitis rash. Lighter areas of skin, such as the palms of hands and the inside of the mouth, may show signs of a rash more easily.
As the infection worsens and spreads, the rash can become more visible. The spots usually grow darker and larger.
Though meningitis refers to inflammation of the fluid and membranes around the brain and spinal cord, experts categorize it based on the type of infection that causes it.
Viral meningitis
Viral meningitis is the most common type of meningitis. Viruses in the Enterovirus category cause about 52% of cases in adults and 58% in infants, more commonly during the summer and fall. Viruses include:
- coxsackievirus A
- coxsackievirus B
- echoviruses
Though viruses in the Enterovirus category cause about
Other viruses can also cause meningitis. These
- West Nile virus
- influenza
- mumps
- HIV
- measles
- herpes viruses
- Coltivirus, which causes Colorado tick fever
Viral meningitis typically goes away without treatment. However, some causes do need treatment.
Bacterial meningitis
Bacterial meningitis is contagious and caused by infection from certain bacteria. It can be fatal if left untreated. About
Common bacterial causes include:
- Streptococcus pneumoniae, which is typically found in the respiratory tract, sinuses, and nasal cavity and can cause what’s called “pneumococcal meningitis”
- Neisseria meningitidis, which is spread through saliva and other respiratory fluids and causes what’s called “meningococcal meningitis”
- Listeria monocytogenes, which are foodborne bacteria
- Staphylococcus aureus, which is typically found all over the skin and in the nasal passages, and causes “staphylococcal meningitis”
Pneumococcal meningitis
Pneumococcal meningitis is a rare but serious and life threatening form of bacterial meningitis.
About 40% of people carry bacteria called Streptococcus pneumoniae in their throat and the back of the nose. These bacteria are responsible for common illnesses like pneumonia, sinus infections, and ear infections.
Symptoms of pneumococcal meningitis can include:
- chills
- high fever
- vomiting
- light sensitivity
- headache
- stiff neck
- confusion
- weakness
- disorientation
Fungal meningitis
Fungal meningitis is rare. It occurs when a fungus enters the body and spreads from the bloodstream to the brain or spinal cord.
People with a weakened immune system are
Common funguses related to fungal meningitis include:
- Cryptococcus is inhaled from dirt or soil contaminated with bird droppings, especially pigeons and chickens, or rotting vegetation.
- Blastomyces is another type of fungus found in soil, particularly in the Midwestern United States.
- Histoplasma is found in environments heavily contaminated with bat and bird droppings, especially in the Midwestern States near the Ohio and Mississippi Rivers.
- Coccidioides is found in soil in specific areas of the U.S. Southwest and South and Central America.
Parasitic meningitis
Parasitic meningitis is less common than viral or bacterial meningitis. It’s caused by parasites in dirt, feces, and on some animals and food, like:
- snails
- raw fish
- poultry
- produce
One type of parasitic meningitis is rarer than others. It’s called eosinophilic meningitis (EM). Three main parasites are responsible for EM. These include:
- Angiostrongylus cantonensis
- Baylisascaris procyonis
- Gnathostoma spinigerum
Parasitic meningitis is not passed from person to person. Instead, these parasites enter an animal or hide out on food that a human then eats. An infection may occur if the parasite or parasite eggs are infectious when ingested.
Amebic meningitis is a very rare type of parasitic meningitis that causes a life threatening infection.
It occurs when one of several types of ameba enters the body through the nose. The most commonly recognized species is Naegleria fowleri. Infection can occur while swimming in lakes, rivers, or ponds that contain these amoebas. The parasite can destroy brain tissue and may eventually cause hallucinations, seizures, and other serious symptoms.
Non-infectious meningitis
Non-infectious meningitis is not an infection. Instead, it is inflammation caused by other medical conditions or treatments, including:
- lupus
- a head injury
- brain surgery
- cancer
- certain medications
Chronic meningitis
Doctors call meningitis chronic if the inflammation lasts longer than 4 weeks. Causes can include:
- fungi
- rheumatological conditions
- cancer
Treating the underlying cause (i.e., managing rheumatoid arthritis) may help relieve chronic meningitis.
Each type of meningitis has a slightly different cause, but each ultimately acts in the same way:
A bacterium, fungus, virus, or parasite spreads through the body (via the bloodstream, nerve endings, or even a dormant reactivation in the nervous system) until it reaches the brain or spinal cord. There, it spreads within the lining or fluids around these vital body parts and starts developing into a more advanced infection.
Non-infectious meningitis results from a physical injury or other condition; it doesn’t involve an infection.
Some groups may have an increased risk of meningitis. This can include:
People with weakened immune systems
Certain health conditions and treatments can weaken your immune system. These include:
- HIV
- autoimmune disorders
- cancer or chemotherapy
- organ or bone marrow transplants
- immunosuppressive medication
Community living
Meningitis often spreads more easily if people live or work in close quarters, such as:
- college dormitories
- barracks
- boarding schools
- day care centers
- assisted living facilities
Pregnancy
Pregnancy can increase the risk of listeriosis, an infection caused by the Listeria bacteria, which can result in meningitis.
Age
Children under 5 may have an increased risk of viral meningitis, while infants have a higher risk of bacterial meningitis. Older adults can also be at an increased risk of infections that can cause meningitis.
Working with animals
People who work closely with animals may have an increased risk of Listeria infection.
Vaccines are available for several types of bacterial meningitis, including meningococcal meningitis, caused by Neisseria meningitidis. These include:
Meningococcal conjugate (MenACWY) vaccine
The meningococcal conjugate, or MenACWY vaccine (often called by brand names such as Menactra, Menveo, and MenQuadfi) features a vaccine that targets four of the most common types of bacterial serotypes. It lasts longer and offers greater protection, especially if you maintain booster shots.
The
- Children 11 to 12 years old, with a booster dose at 16 years old
- All children and adults who may be at an increased risk of meningococcal disease
Serogroup B meningococcal (MenB) vaccine
The Serogroup B meningococcal, or MenB, vaccine targets one specific strain and has a much shorter protection window. The CDC recommends that anyone 10 years old or older at an increased risk for meningococcal disease get the MenB vaccine.
This may include:
- People 16 to 23 who are not an increased risk of meningococcal disease
- People 10 and older who may have an increased risk of meningococcal disease
Vaccine side effects
Side effects of a meningitis vaccine
- soreness, skin discoloration, and burning at the injection site.
- low grade fever for a day or two following the injection
- chills
- headache
- joint pain
- fatigue
Depending on the vaccine, these side effects usually improve in
While viral meningitis is more common, bacterial meningitis can be more dangerous if not diagnosed and treated quickly.
Special conditions
While most younger children and adults do not need a meningitis vaccine, the
- certain medical conditions
- individuals who work with bacteria for their job
- planned travel to areas where meningitis is common
- anyone who has an increased risk of infection due to an outbreak of meningococcal disease
If you fall into any of the categories above, it’s best to talk with a doctor about vaccination for meningitis.
Meningitis in adults
The risk of several forms of meningitis decreases after young adulthood. Once a young adult ages out of school and university, getting meningitis is less likely.
However, older individuals who are living with underlying diseases or health conditions that weaken the immune systems can be at greater risk. The risk is especially higher in older adults in assisted living facilities.
Teachers, healthcare professionals, and day care staffers also have an elevated risk.
Diagnosing meningitis starts with a health history and physical exam. During the physical exam, your doctor may check you for:
- fever
- skin issues
- increased heart rate
- neck stiffness
- reduced consciousness
They will also order tests to accurately diagnose meningitis. These can include:
- A lumbar puncture, also called a spinal tap, extracts cerebral spinal fluid to look for signs of infection.
- Blood cultures identify bacteria in the blood. Bacteria can travel from the blood to the brain. N. meningitidis and S. pneumonia, among others, can cause both sepsis (a blood infection) and meningitis.
- A complete blood count (CBC) with differential checks your number of red and white blood cells. Meningitis usually causes a raised white blood cell count.
- Chest X-rays can reveal pneumonia, tuberculosis, or fungal infections. Meningitis can occur after pneumonia.
- A CT scan of the head may show problems like a brain abscess or intercranial pressure. Bacteria can spread from the sinuses to the meninges.
Testing can also determine the best antibiotic for treatment.
Treatment for meningitis depends on the cause.
- Bacterial meningitis requires immediate hospitalization. Early diagnosis and treatment with intravenous (IV) antibiotics and steroids may prevent brain damage and death.
- Fungal meningitis requires treatment with antifungal medication.
- Parasitic meningitis may either involve treating just symptoms or the infection directly. If it worsens, a doctor may try to treat the infection itself.
- Viral meningitis may resolve on its own, but doctors treat some causes with IV antiviral medications.
- Chronic meningitis requires treating the underlying cause, such as a fungal infection, or an autoimmune issue, such as rheumatoid arthritis.
Not all types of meningitis are contagious. Fungal, parasitic, and non-infectious meningitis are not contagious.
Viral meningitis is contagious. It’s spread through direct contact with body fluids, including mucus, feces, and saliva. Droplets of infected fluid can spread by sneezing and coughing. You can get viral meningitis without coming into direct contact with someone who has it.
Bacterial meningitis, the most serious form of meningitis, can also be contagious, especially if it’s meningococcal meningitis. It can spread through extended contact with someone who has it. It typically spreads in locations where people are in close quarters.
While it’s difficult to prevent all types of meningitis, you may be able to prevent bacterial meningitis, the most common and serious type, with vaccines.
If you’re at an elevated risk for meningitis due to your age, job, or overall health, consider talking with a doctor about your options for vaccination.
You may be able to reduce your risk of meningitis by:
- avoiding contact with people who are sick
- contacting a doctor immediately if you were in contact with someone who has a bacterial meningococcal infection, as they may be able to prescribe preventive antibiotics
- taking precautions against viral infections, such as frequent handwashing and wearing a mask in crowded places
- taking precautions against foodborne illness, especially if you are pregnant or have a weakened immune system
- avoiding sharing personal items, such as drinks, utensils, toothbrushes
Certain practices may also support your overall immune system health and reduce your risk of illness that could lead to meningitis. This can include:
- quitting smoking if you smoke
- getting enough rest
- eating a balanced diet
- getting regular physical activity
These complications are typically associated with meningitis:
- seizures
- hearing loss
- vision loss
- memory problems
- migraine headaches
- brain damage
- hydrocephalus
- a subdural empyema, or a buildup of fluid between the brain and the skull
A meningitis infection may produce bacteria in the bloodstream. These bacteria multiply, and some release toxins. This can damage blood vessels and leak blood into the skin and organs.
A serious form of this blood infection can be life threatening. Gangrene may damage skin and tissue. In rare cases, amputation may be necessary. Several other serious complications may occur in people with meningitis who do not receive proper treatment.
Meningitis is an inflammation of the fluid and three membranes surrounding the brain and spinal cord. Meningitis can occur when fluid surrounding these membranes becomes infected.
Meningitis can result from viral, bacterial, or fungal infections.
Some forms of meningitis can be dangerous or fatal if not treated quickly.
Vaccines for bacterial meningitis are available for pre-teens and teens, as well as anyone who may be at a higher risk of developing the condition.