Meningitis can occur due to a viral, bacterial, or fungal infection and requires emergency medical treatment. Symptoms may include a stiff neck, sleepiness, and headaches, among others.

Meningitis is an inflammation of the fluid and three membranes (meninges) surrounding your brain and spinal cord.

A cross section of what meningitis looks like in the brainShare on Pinterest
Illustration by Sophia Smith

The most common causes of meningitis are viral and bacterial infections. Other causes may include:

  • cancer
  • fungi
  • drug-induced reactions

Some viral and bacterial meningitis are contagious. They can be transmitted by coughing, sneezing, or close contact.

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 in infants may cause:

  • decreased appetite
  • irritability
  • vomiting
  • diarrhea
  • rash
  • respiratory symptoms

In adults, viral meningitis may cause:

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. Your doctor will need 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.

The symptoms of chronic meningitis are similar to other forms of acute meningitis, but can sometimes develop slower.

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One of the later signs that one bacterial cause of meningitis, Neisseria meningitidis, is in your bloodstream is a faint rash on your skin.

The bacteria from a meningococcal meningitis infection reproduce in your blood and target cells around the capillaries. Damage to these cells leads to capillary damage and mild blood leaks. This shows up as a faint pink, red, or purple rash. The spots may resemble tiny pinpricks and are easily mistaken as a bruise.

As the infection worsens and spreads, the rash can become more obvious. The spots will grow darker and larger.

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.

Not every rash looks the same. See photos of meningitis rashes to understand how this symptom might occur.

Viral and bacterial infections are the most common causes of meningitis. There are several other forms of meningitis. Examples include cryptococcal, which is caused by a fungal infection, and carcinomatous, which is cancer-related. These types are less common.

Viral meningitis

Viral meningitis is the most common type of meningitis. Viruses in the Enterovirus category cause about 52 percent of cases in adults and 58 percent of cases in infants. These are more common during the summer and fall, and they include:

Viruses in the Enterovirus category cause about 10 to 15 million infections per year, but only a small percentage of people who get infected will develop meningitis.

Other viruses can cause meningitis. These include:

Viral meningitis typically goes away without treatment. However, some causes do need to be treated.

Bacterial meningitis

Bacterial meningitis is contagious and caused by infection from certain bacteria. It can be fatal if left untreated. About 1 in 10 people who get bacterial meningitis die, and 1 in 5 have serious complications. This can be true even with proper treatment.

The most common types of bacteria that cause bacterial meningitis are:

  • 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”

Fungal meningitis

Fungal meningitis is a rare type of meningitis. It’s caused by a fungus that infects your body and then spreads from your bloodstream to your brain or spinal cord.

People with a weakened immune system are more likely to develop fungal meningitis. This includes people with cancer or HIV.

The most common funguses related to fungal meningitis include:

  • Cryptococcus, which is inhaled from dirt or soil that is contaminated with bird droppings, especially pigeons and chickens, or rotting vegetation.
  • Blastomyces, another type of fungus found in soil, particularly in the Midwestern United States.
  • Histoplasma, which is found in environments that are heavily contaminated with bat and bird droppings, especially in the Midwestern States near the Ohio and Mississippi Rivers.
  • Coccidioides, which is found in soil in specific areas of the U.S. Southwest and South and Central America.

Parasitic meningitis

This type of meningitis is less common than viral or bacterial meningitis, and it’s caused by parasites that are found in dirt, feces, and on some animals and food, like snails, raw fish, poultry, or 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 infect an animal or hide out on food that a human then eats. If the parasite or parasite eggs are infectious when they’re ingested, an infection may occur.

One very rare type of parasitic meningitis, amebic meningitis, is a life-threatening type of infection. This type is caused when one of several types of ameba enters the body through the nose while you swim in contaminated lakes, rivers, or ponds. The parasite can destroy brain tissue and may eventually cause hallucinations, seizures, and other serious symptoms. The most commonly recognized species is Naegleria fowleri.

Non-infectious meningitis

Non-infectious meningitis is not an infection. Instead, it is a type of meningitis that’s caused by other medical conditions or treatments. These include:

  • lupus
  • a head injury
  • brain surgery
  • cancer
  • certain medications

Chronic meningitis

This classification is given to cases of meningitis that last longer than 4 weeks.

The causes of chronic meningitis can be fungi, rheumatological conditions, and cancer, among others. Treatment for chronic meningitis is directed at treating the cause (i.e., managing rheumatoid arthritis).

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 sets up in the lining or fluids around these vital body parts and starts developing into a more advanced infection.

Non-infectious meningitis is the result of a physical injury or other condition; it doesn’t involve an infection.

Yes, there is a vaccine for several types of bacterial meningitis. Meningococcal meningitis, caused by Neisseria meningitidis, is one version for which vaccines are available. While viral meningitis is more common, bacterial meningitis can be more dangerous if it’s not diagnosed and treated quickly.

For that reason, the two primary vaccines for meningitis are for bacterial causes:

  • 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 Serogroup B meningococcal, or MenB, vaccine targets one specific strain, and its protection window is much shorter. Only certain populations are recommended to get this vaccine.

Side effects of a meningitis vaccine can include:

  • soreness, redness, and burning at the injection site.
  • a low-grade fever for a day or two following the injection
  • chills
  • headache
  • joint pain
  • fatigue

These side effects should subside in 3-7 days.

Who should get the MenACWY vaccine?

The CDC recommends the MenACWY vaccine for:

  • Children ages 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

Who should get the MenB vaccine?

The CDC recommends that anyone 10 years old or older who is at an increased risk for meningococcal disease get the MenB vaccine.

Special conditions

While most younger children and adults do not need a meningitis vaccine, the CDC recommends it for the following conditions:

  • 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

Talk to your doctor about the proper time to have your child vaccinated for meningitis, as well as yourself, if you fall into any of the categories above.

Your treatment is determined by the cause of your meningitis.

  • Bacterial meningitis requires immediate hospitalization. Early diagnosis and treatment will prevent brain damage and death. Bacterial meningitis is treated with intravenous antibiotics and steroids. There’s no specific antibiotic for bacterial meningitis. It depends on the bacteria involved.
  • Fungal meningitis is treated with antifungal agents.
  • Parasitic meningitis may either involve treating just the symptoms or attempting to treat the infection directly. Depending on the cause, this type may get better without antibiotic treatment. If it worsens, however, your doctor may try to treat the infection itself.
  • Viral meningitis may resolve on its own, but some causes of viral meningitis will be treated with intravenous antiviral medications.
  • Chronic meningitis is treated by treating the underlying cause first, such as a fungal infection or an autoimmune issue such as rheumatoid arthritis.

Several types of meningitis are not 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 be spread and shared with sneezing and coughing. You do not have to come into direct contact with an infected person to pick up this infection.

Bacterial meningitis, the most serious form of meningitis, can also be contagious, especially if it’s meningococcal meningitis. It’s spread through extended contact with an infected person. Schools, daycare centers, military barracks, hospitals, and college dorms are prime locations for sharing this infection.

Some types of meningitis are spread through person-to-person contact, but not all. Learn more about the types that are contagious and how you can avoid them.

Babies who develop meningitis may show different signs and symptoms of an infection than adults. These symptoms 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 breastfeeding

Viral meningitis can be common in infants. It can develop as a result of unmanaged colds, cold sores, flu, and diarrhea. The viruses that cause these common conditions also cause viral meningitis.

Bacterial meningitis, which is common but life threatening, most likely spreads from a serious infection in a nearby area of the body. For example, the bacteria from a severe ear infection or sinus infection can enter the bloodstream and find their way to the brain or spinal cord and cause a bigger infection.

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

The risk for several forms of meningitis decreases after young adulthood. That’s in large part due to changing circumstances. Schools and college dorms are common sites where some forms of meningitis can be easily shared. Once a young adult ages out of these settings, the likelihood of an infection begins to fall.

However, older individuals who are living with underlying diseases or health conditions that weaken the immune systems can be at a greater risk — especially older adults who reside in assisted living facilities, where infections can spread quickly.

Teachers, healthcare professionals, and daycare staffers are also at an elevated risk.

Diagnosing meningitis starts with a health history and physical exam. Age, dorm residence, and daycare center attendance can be important clues. During the physical exam, your doctor will look for:

Your doctor will also order a lumbar puncture. This test is also called a spinal tap. It allows your doctor to analyze the cerebral spinal fluid, which contains a number of clues regarding an infection. Some of the clues in the cerebral spinal fluid can be glucose, white blood cell count, and red blood cell count. This test can also determine the best antibiotic for treatment.

Other tests may also be ordered to diagnose meningitis. Common tests include the following:

  • 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 and meningitis.
  • A complete blood count with differential is a general index of health. It checks the number of red and white blood cells in your blood. White blood cells fight infection. The count is usually elevated in meningitis.
  • Chest X-rays can reveal the presence of pneumonia, tuberculosis, or fungal infections. Meningitis can occur after pneumonia.
  • A CT scan of the head may show problems like a brain abscess or or intercranial pressure. Bacteria can spread from the sinuses to the meninges.

Maintaining a healthy lifestyle, especially if you’re at increased risk, is important. This includes:

  • getting adequate amounts of rest
  • not smoking
  • avoiding contact with sick people
  • washing your hands often, especially if you work in a daycare or healthcare setting

If you’ve been in close contact with one or more people who have a bacterial meningococcal infection, your doctor can give you preventive antibiotics. This will decrease your chances of developing the disease.

Vaccinations can also protect against certain types of meningitis. Vaccines that can prevent meningitis include the following:

Practicing good personal hygiene may also help you prevent meningitis. Some types of meningitis are spread through close contact with an infected person’s body fluid, such as saliva and nasal secretions. Avoid sharing drinks, utensils, and personal items that may carry saliva or other fluids.

Pregnancy and listeria

A listeria infection (L. monocytogenes) can lead to a bacterial meningitis infection if not treated quickly, and this type of infection can be very dangerous to a developing baby.

Certain types of food, such as soft cheeses, celery, sprouts, cantaloupe, and ice cream, have recently been connected to listeria outbreaks, but this doesn’t mean eating these foods while pregnant guarantees an infection.

If you’re pregnant, it’s a good idea to talk to your doctor about listeria risks and foods.

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. That can cause blood vessel damage and leaking of 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 are not treated properly.

Pneumococcal meningitis is a rare but serious and life-threatening form of bacterial meningitis. Even with treatment, about 1 in 20 people with this type of infection die.

About 40 percent 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.

From time to time, however, those bacteria manage to cross the blood-brain barrier and cause inflammation and infection in the brain, spinal cord, or fluids immediately surrounding them.

Symptoms of this serious form of meningitis include:

  • chills
  • high fever
  • vomiting
  • light sensitivity
  • headache
  • stiff neck
  • confusion
  • weakness
  • disorientation

Fortunately, two vaccines are available to prevent pneumococcal meningitis. Learn more about them and other ways to prevent this deadly form of infection.

The following are some of the risk factors for meningitis:

Compromised immunity

People with an immune deficiency are more vulnerable to infections. This includes the infections that cause meningitis. Certain disorders and treatments can weaken your immune system. These include:

Cryptococcal meningitis, which is caused by a fungus, is the most common form of meningitis in people with HIV.

Community living

Meningitis is easily spread when people live in close quarters. Being in small spaces increases the chance of exposure. Examples include:

  • college dormitories
  • barracks
  • boarding schools
  • daycare centers
  • assisted living facilities

Pregnancy

Pregnant women have an increased risk of listeriosis, which is an infection caused by the Listeria bacteria. Infection can spread to the unborn child.

Age

All ages are at risk for meningitis. However, certain age groups have a higher risk. Children under the age of 5 are at increased risk of viral meningitis. Infants are at higher risk of bacterial meningitis. Older adults can also be at risk for certain infections that can lead to meningitis.

Working with animals

Farm workers and others who work with animals have an increased risk of infection with Listeria.

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.

There are a few different types of meningitis, including viral, bacterial, and fungal meningitis.

Meningitis can be quite dangerous if not treated quickly, and can cause death.

On a positive note, vaccines, mostly 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.