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Meningitis: Types, Causes, Symptoms, Risk Factors, Complications, Prevention And Treatment

| Reviewed By Alex Maliekal

Various studies based in India have attributed meningitis as one of the leading causes of deaths in children below the age of 5. In 2012, the Government of India introduced the Pentavalent Vaccine in the Universal Immunization Programme (UIP) across the country and covered the nation by 2017.

Although the prevalence of meningitis has decreased, there still needs to be continued monitoring to assess the emerging patterns of antibiotic resistance and distribution in the country. Read on to know about the disease that is affecting the nation, its causes and the ways to prevent it.

What Is Meningitis?

Meningitis is an infection causing the inflammation of membranes surrounding the spinal cord and brain. Infants, children, teens and adults can all develop meningitis, although the type of meningitis tends to vary according to the age group.

The swelling of the meninges (the protectors of the brain and the spinal cord, that is, they prevent the brain and spinal cord from being affected by germs or any trauma) occur when the fluid surrounding the area gets infected [1] .

This, in turn, causes the dysfunction of the meninges, along with cerebrospinal fluid which protects the structures of the central nervous system [2] .

What Are The Types Of Meningitis?

Meningitis is caused by bacteria or viruses and the meningitis types are classified accordingly. The most common types of meningitis are bacterial and viral.

1. Viral meningitis

The most common type of meningitis, viral meningitis is mild and gets cured on its own. It is commonly caused by the viruses in the Enterovirus category, which accords to 85 per cent of the disease [3] .

2. Bacterial meningitis

This type of meningitis is contagious. Bacterial meningitis is caused by specific types of bacteria such as the Streptococcus pneumoniae, Neisseria meningitides, Haemophilus influenza, Listeria monocytogenes and Staphylococcus aureus.

If left untreated, the condition can be fatal. According to reports, 5 to 40 per cent of children and 20 to 50 per cent of adults with bacterial infection die [4] .

3. Fungal meningitis

A rare type of meningitis, fungal meningitis is caused by fungi such as Cryptococcus, Blastomyces, Histoplasma and Coccidioides. The fungus infects the body and spreads to the bloodstream, from where it travels to your brain or spinal cord.

4. Parasitic meningitis

Caused by parasites found in dirt, faeces, food items like raw fish, produce and poultry, parasitic meningitis is caused by parasites such as Angiostrongylus cantonensis, Baylisascaris procyonis and

Gnathostoma spinigerum.

Parasitic meningitis is not directly contagious, that is, it is not passed from one person to other. It is spread when the parasites infect an animal or a food item, which is then consumed by the human [5] .

5. Non-infectious meningitis

Meningitis can also develop as a result of non-infectious reasons and this one falls under that category.

10 Effective Home Remedies & Lifestyle Tips For Meningitis

What Are The Causes Of Meningitis?

Each type of infection has different causes with viral infections being the most common cause. The other prominent cause is bacterial infections and fungal infections occur rarely [6] [7] .

The cause of bacterial meningitis varies according to the age group of the infected individual. In premature babies and newborns up to three months old, common causes are group B streptococci. In older children, it is caused by Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae. Whereas in adults, it is caused by Neisseria meningitidis and Streptococcus pneumoniae.

Viral meningitis is caused by viruses such as the West Nile virus, influenza, mumps, HIV,

measles, herpes viruses and Coltivirus.

Fungal meningitis can be caused by several factors. Some of the causes are the use of immunosuppressants, the loss of immunity with age and HIV/AIDS.

Parasitic meningitis is caused by parasites such as Angiostrongylus cantonensis, Gnathostoma spinigerum and Schistosoma. The condition also develops as a result of conditions such as cysticercosis, toxocariasis, baylisascariasis and paragonimiasis.

Non-infectious meningitis develops as a result of other medical conditions or treatments such as lupus, a head injury, brain surgery, cancer and certain medications.

What Are The Symptoms Of Meningitis?

The early signs associated with the condition are similar to that of the flu and develop over a few days. The meningitis symptoms vary depending on one's age and the type of infection and the symptoms of viral and bacterial meningitis can be similar at the beginning [8] .

Viral meningitis symptoms in infants are as follows:

  • Irritability
  • Lack of appetite
  • Lethargy
  • Fever
  • Sleepiness

The common signs and symptoms of meningitis in adults are as follows:

  • Vomiting
  • Fever
  • Sleepiness
  • Stiff neck
  • Seizures
  • Sensitivity to bright light
  • Decreased appetite
  • Lethargy
  • Nausea
  • Irritability
  • Lethargy
  • Headache
  • Purple skin that resembles bruises
  • Chills
  • Sensitivity to light (photophobia)
  • Confusion
  • Disorientation

In parasitic meningitis, the symptoms are similar to that of fungal meningitis and the individual may develop rashes on the body. Meningococcal meningitis will have rashes over the body and signs of the condition include neck stiffness, Brudzinski's sign ad Kernig's sign on physical examination [9] .

What Are The Risk Factors Of Meningitis?

Meningitis risk factors include the following [10] :

  • Young age
  • Pregnancy
  • A weak or compromised immune system
  • Living in a community setting
  • Avoiding vaccinations

What Are The Complications Of Meningitis?

Every medical condition is prone to developing complications and meningitis complications are severe and can cause seizures and permanent neurological damage if left untreated [11] .

The complications of meningitis are as follows:

  • Kidney failure
  • Shock
  • Learning disabilities
  • Hearing loss
  • Memory problems
  • Arthritis
  • Brain damage
  • Gait problems
  • Hydrocephalus
  • Death

How Is Meningitis Diagnosed?

The doctor will carry out the diagnosis based on a physical exam, diagnostic tests and one's medical history. The doctor will check for infection around the head, ears, throat and the skin along the spine [12] . The most important investigation/test in meningitis is LP (lumbar puncture).

The diagnosis will include the following tests:

  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Blood cultures
  • Chest X-rays

How Is Meningitis Treated?

The medical care for the condition depends on the type of meningitis.

Bacterial meningitis requires immediate treatment with intravenous antibiotics and corticosteroids. Viral meningitis treatment includes bed rest, fluid consumption and over-the-counter pain medications. Antifungal medications are used for treating fungal meningitis [13] .

In the remaining types of meningitis, the doctors prescribe antiviral and antibiotic treatment. Non-infectious meningitis is treated with corticosteroids. In some cases of meningitis, treatment is not required as the condition gets better on its own.

What Are The Steps For Meningitis Prevention?

As the condition is caused by common viruses and bacteria, it can spread through coughing, kissing, by sharing utensils etc. The following steps can help prevent meningitis spread [14] .

  • Wash your hands
  • Stay healthy (get rest, exercise regularly, eat healthily)
  • Practice good hygiene
  • Cover your mouth while coughing or sneezing
  • Pregnant women should be extra cautious of eating habits

Apart from these, meningitis can be prevented by taking immunizations.

Commonly Asked Questions

Q. What is the first sign of meningitis?

Ans: Fever, vomiting, headache, limb pain, pale skin, and cold hands and feet are the first signs of meningitis.

Q. Can a person survive meningitis?

Ans: If left untreated meningitis can be fatal. But, timely medical attention and intervention can help the individual survive the condition.

Q. How quickly can meningitis kill you?

Ans: Meningitis can kill within 4 hours.

Q. What does a meningitis headache feel like?

Ans: Unlike the usual headache, one gets, meningitis headaches affect your whole head and is not localised in any specific part.

View Article References
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  2. [2] Cooper, L. V., Kristiansen, P. A., Christensen, H., Karachaliou, A., & Trotter, C. L. (2019). Meningococcal carriage by age in the African meningitis belt: a systematic review and meta-analysis. Epidemiology & Infection, 147.
  3. [3] van Samkar, A., Brouwer, M. C., Schultsz, C., van der Ende, A., & van de Beek, D. (2015). Streptococcus suis meningitis: a systematic review and meta-analysis. PLoS neglected tropical diseases, 9(10), e0004191.
  4. [4] Hussein, K., Bitterman, R., Shofty, B., Paul, M., & Neuberger, A. (2017). Management of post-neurosurgical meningitis: narrative review. Clinical Microbiology and Infection, 23(9), 621-628.
  5. [5] Ogrodzki, P., & Forsythe, S. (2015). Capsular profiling of the Cronobacter genus and the association of specific Cronobacter sakazakii and C. malonaticus capsule types with neonatal meningitis and necrotizing enterocolitis. BMC genomics, 16(1), 758.
  6. [6] Sinha, M. K., Prasad, M., Haque, S. S., Agrawal, R., & Singh, A. (2016). Clinical Status of Lactate Dehydrogenase Activity in Cerebrospinal Fluid with Age and Sex Distribution in Different Types of Meningitis. MOJ Immunol, 4(5), 00142.
  7. [7] Kakarlapudi, S. R., Chacko, A., Samuel, P., Verghese, V. P., & Rose, W. (2018). Comparison of scrub typhus meningitis with acute bacterial meningitis and tuberculous meningitis. Indian pediatrics, 55(1), 35-37.
  8. [8] Lv, S., Zhou, X. N., & Andrews, J. R. (2017). Eosinophilic meningitis caused by Angiostrongylus cantonensis.
  9. [9] Heemskerk, A. D., Bang, N. D., Mai, N. T., Chau, T. T., Phu, N. H., Loc, P. P., ... & Lan, N. H. (2016). Intensified antituberculosis therapy in adults with tuberculous meningitis. New England Journal of Medicine, 374(2), 124-134.
  10. [10] Wilkinson, R. J., Rohlwink, U., Misra, U. K., Van Crevel, R., Mai, N. T. H., Dooley, K. E., ... & Thwaites, G. E. (2017). Tuberculous meningitis. Nature Reviews Neurology, 13(10), 581.
  11. [11] Carpenter, R. R., & Petersdorf, R. G. (1962). The clinical spectrum of bacterial meningitis. The American journal of medicine, 33(2), 262-275.
  12. [12] Centers for Disease Control and Prevention. (2015). Epidemiology and prevention of vaccine-preventable diseases. Washington DC Public Health Foundation, 2, 20-2.
  13. [13] Mount, H. R., & Boyle, S. D. (2017). Aseptic and bacterial meningitis: evaluation, treatment, and prevention. Am Fam Physician, 96(5), 314-322.
  14. [14] Rajasingham, R., Smith, R. M., Park, B. J., Jarvis, J. N., Govender, N. P., Chiller, T. M., ... & Boulware, D. R. (2017). Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. The Lancet infectious diseases, 17(8), 873-881.
Alex MaliekalGeneral Medicine
Alex Maliekal