Meningitis

The word “meningitis” has been known to strike fear, if not terror, into the hearts of many, especially to the parents of young children. The term actually refers to inflammation of the meninges, which are the tissue-like membranes that cover the outside of the brain and spinal cord. Thankfully, only about 8% of meningitis cases are caused by bacteria. Symptoms of meningitis can include neck pain, stiffness, headache, eye discomfort with bright light (photophobia), confusion, drowsiness, seizures, nausea, and vomiting. Meningitis can be associated with a viral infection like the flu, but viral meningitis is rarely fatal and rarely causes brain injury. On the other hand, bacterial meningitis can be fatal and can cause long-term brain issues and brain damage. Bacterial meningitis typically results from infection that spreads throughout the blood and carries the bacteria to the meninges. Less commonly, direct bacterial invasion of the meninges can occur following an ear or sinus infection or a skull fracture.

About 72% of bacterial meningitis cases are caused by Streptococcus and 11% of cases in those 16 years and older are caused by Neisseria meningitididis (Meningococcal vac­cine protects against N. meningitidis). Newborn infants are most at risk of bacterial meningitis as compared to other age groups. People who are immunocompromised (e.g., HIV positive) or are taking immunosuppressive drugs (i.e., to treat an autoimmune disease or are organ donor recipients), those without a spleen, and those who have recently undergone brain or spinal cord surgery are at increased risk. Outbreaks of meningococcal meningitis can occur in group settings (such as college dormitories) and travelers to certain parts of the world are at risk of acquiring bacterial meningitis.

Some people are carriers and have bacteria in or on their bodies that does not make them ill but can be spread to others and cause meningitis. Others (pregnant women, newborns, those aged 65 and older, and immunocompromised individuals) are at higher risk of developing meningitis from food contaminated with Listeria bacteria, which is sometimes found in unpasteurized dairy products, contaminated produce, or sliced deli meats. Newborns can acquire group B streptococci bacteria during passage through the birth canal. Meningitis is diagnosed by performing a lumbar puncture (spinal tap) to obtain samples of the fluid surrounding the brain and spinal cord (cerebrospinal fluid, or CSF). Patients are usually treated with intravenous antibiotics, which are given as soon as possible, and, in certain cases, intravenous high-potency steroids (dexamethasone) may be given as well.

Prevention of bacterial meningitis can involve vaccination against the most common bacterial agents (Strep, N. meningitidis, H. influenzae), testing and treating pregnant women for group B strep prior to delivery, and avoidance of certain foods (unpasteurized dairy, deli meats) during pregnancy. The CDC recommends that close contacts of those with meningococcal meningitis receive antibiotic prophylaxis, as well as giving prophylaxis to those at risk who may have been exposed to meningitis.

For more information, go to the CDC website at: www.cdc.gov/meningitis/bacterial.html

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