What is Meningitis?

Meningitis is an infection of the cerebrospinal fluid and the covering around the brain (meninges). Cerebrospinal fluid is the fluid present around the brain and spinal cord that helps to protect your brain and spinal cord.

Most cases of meningitis are caused by viral or bacterial infection. Bacterial meningitis is considered as a medical emergency because it has a fulminate course. It can progress rapidly and lead to septicaemia (blood poisoning), brain damage or even death.  Viral infections are milder and may get better without treatment or with supportive care.

Other causes of meningitis include:

• chemical irritation
• drug allergies
• fungal infections and
• brain tumours.

Signs and symptoms meningitis

Symptoms of viral and bacterial meningitis are almost similar and can be difficult to differentiate clinically. Some symptoms of meningitis include:

• severe throbbing or splitting headache
• high fever
• nausea (feeling sick) and vomiting (may be recurrent)
• drowsiness and confusion
• seizures or fits
• stiff neck (less common in young children) and
• sensitivity to light (being unable to tolerate bright lights i.e. photophobia).

Possible signs and symptoms of meningitis in infants and young children include:

• floppy and unresponsive child
• seizures, stiff with jerky movements
• highly irritable and not wanting to be held
• unusual crying (not becoming comforted on being picked-up or held)
• vomiting and refusal of feeds
• blank or staring expression
• very sleepy or drowsy (with a reluctance to wake up) and
• swelling in the soft part of their head (fontanelle).

Diagnosis and treatment

Meningitis is diagnosed based on medical history and physical exam and tests. Diagnostic tests such as CT scan or MRI scan of the brain, CSF test and blood test may be done if meningitis is suspected. Analysis of cerebrospinal fluid (CSF) is a definitive test to diagnose meningitis. In meningitis, the CSF fluid composition is altered and it often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.

Meningitis is usually treated in a hospital. The person to be treated may be admitted in the intensive care unit if he or she is very sick for appropriate management. Treatment depends on the type of meningitis (cause of infection: bacteria or virus) and presence of other complications (such as brain edema, seizures). People with acute bacterial meningitis are given intravenous antibiotics usually for 10-14 days or longer if response to treatment is not adequate. If viral meningitis is suspected, anti-viral medicines are given. Fungal meningitis requires long-term anti-fungal drugs.

Other medications which may be given include:

• oxygen
• intravenous fluids (through a vein)—to correct dehydration and support fluid and electrolyte requirement of the body till you can take orally
• steroids or other medication— may be given if you develop (swelling) around your brain and
• anti-epileptic medication.