Meningitis or meningitis is an inflammation of the membranes surrounding the brain and spinal cord; the meninges. Meningitis usually develops acutely, but the symptoms can also develop gradually. If meningitis is suspected, a person must be admitted to hospital immediately. What are the causes and symptoms of meningitis, how is the infection controlled and what is the prognosis after treatment?
- Meninges and meningitis
- Causes of meningitis
- Symptoms of meningitis
- Treatment of meningitis
- Prognosis of meningitis
- Can you prevent meningitis?
Meninges and meningitis
Meninges, also called meninges, are the three membranes that cover the brain. They form one whole with the spinal cord membranes. The three membranes lie over each other and from the outside in: the dura or hard meninges, the arachnoid or spider web membrane and the pia or soft meninges. The membranes continue in a septum between the cerebral hemispheres and in a septum between the cerebrum and cerebellum. Meningitis is an inflammation of the membranes surrounding the brain and spinal cord due to an infection. Other names for meningitis: neck cramp, meningitis, meningoencephalitis.
Causes of meningitis
The cause is often a viral or bacterial infection. In a viral infection, a virus is the culprit, in a bacterial infection the blame lies with a bacterium. A viral infection is more common and less serious, the bacterial variant can have fatal consequences. You can get a viral infection and a bacterial infection at any age, but the bacterial variant is most commonly seen in children.
An infection by bacteria can occur after an injury to the head, or if the immune system is severely weakened. People who consume a lot of alcohol are at greater risk. Very occasionally, meningitis is caused by a fungus, especially if the immune system does not function properly. There are many viruses that can cause inflammation of the meninges, for example the Coxsackie virus, but the virus that causes mumps can also be the culprit.
With bacterial meningitis it is often not clear where it comes from. Sometimes the disease is caused by an infection somewhere else in the body. For example, streptococcus (streptococcus pneumoniae) can move from the lungs to the brain. The meningococcus (neisseria meningitidis) can also cause meningitis. Many people have meningococci in their throats, but very few people get meningitis. The tuberculosis bacteria can also be the causative agent. People whose immune system does not function properly are more likely to develop inflammation of the meninges. The immune system can work less well due to a disease (for example HIV) or a certain treatment (for example chemotherapy).
Symptoms of meningitis
Meningitis can start with symptoms reminiscent of the flu, such as increased body temperature and pain. However, the complaints become worse, especially in the case of a bacterial infection (within a few hours). If a virus is the cause, the symptoms will appear within a few days, if a fungus or tuberculosis is the culprit, it can take weeks.
- Bad headache;
- An increased body temperature;
- General malaise;
- Pain in the throat;
- Stiff neck: bending the chin towards the chest hurts a lot or is even impossible;
- Raising the leg straight is painful, this is called diaper pain in babies;
- Hypersensitivity to light;
- A feeling of nausea, vomiting;
- A person may become confused;
- Sometimes convulsions occur;
- With meningitis caused by meningococci, you often see red-purple spots on the skin (skin hemorrhages). These can be as small as the head of a pin, or larger. If you press on the spots, they don’t disappear . Seek medical attention immediately!
- A newborn with meningitis may exhibit irritable behavior or be very lethargic.
Treatment of meningitis
Many symptoms are reminiscent of flu and therefore meningitis is not always recognized immediately. Rapid treatment is particularly important in the case of meningitis caused by bacteria. Without treatment, seizures or unconsciousness can occur, and in the elderly and children it can even lead to death. A brain abscess can develop due to a bacterial infection, pus collects locally and this puts pressure on the tissue adjacent to it. If it is not treated it can be life-threatening.
If an inflammation of the meninges is suspected, a person must be admitted to hospital immediately. Blood tests will follow and spinal fluid will be taken to test for infections (lumbar puncture). Antibiotics will be administered via an IV. A CT scan or MRI can be done to see if there is an abscess in the brain. With bacterial meningitis, a person is usually admitted to intensive care. Fluids are often given through an IV and a person may need anti-epileptic drugs. There is no special treatment for viral meningitis. The complaints can be reduced by painkillers. If a fungus is the cause of the meningitis, antifungal medication will be given (in the hospital).
Prognosis of meningitis
A viral meningitis usually clears up within a few weeks, while a bacterial infection can take weeks or months to complete recovery. Sometimes there are residual symptoms such as deafness or loss of memory. About ten percent of people with meningitis caused by bacteria die. It happens most often in vulnerable groups such as children and older people.
Can you prevent meningitis?
If someone in a family has meningitis, the other family members can receive antibiotics as a precaution. Children have been vaccinated against Hib since 1993, against meningococcal C since 2002 and against pneumococcal since 2006. If you are traveling to a high-risk area, find out what you need to be vaccinated for.