Bacterial Meningitis

affects the meninges, the membranes that surround the brain and spinal cord and protect the central nervous system (CNS), together with the cerebrospinal fluid

the most serious type of meningitis. It can lead to death or permanent disability. It is a medical emergency

Causes

Bacterial meningitis can be caused by a range of bacteria, including:

Haemophilus influenzae (H. influenzae) type B (Hib)
Neisseria meningitides (N. meningitides)
Streptococcus pneumoniae (S. pneumonia)
Listeria monocytogenes (L. monocytogenes
Group B Streptococcus

At different ages, people are more likely to be affected by different strains.

The bacteria that cause meningitis usually pass from one person to another, for example, through droplets in coughs and sneezes or through saliva or spit. Some types can spread through food.

Group B streptococcus can pass from mothers to newborns during delivery.

Some people are carriers. They have the bacteria, but they do not develop symptoms. Living in a house with either a carrier or someone who has meningitis increases the risk.

It is important to follow the recommended vaccination schedule to prevent meningitis. H. influenza is the main cause of bacterial meningitis in children under 5 in countries that do not offer the Hib vaccine.

Prevention

The most effective way to protect you and your child against certain types of bacterial meningitis is to get vaccinated. There are vaccines for three types of bacteria that can cause meningitis:

Neisseria meningitidis
Streptococcus pneumoniae
Hib

Make sure you and your child are vaccinated on schedule.

Like with any vaccine, the vaccines that protect against these bacteria are not 100% effective. The vaccines also do not protect against all the types (strains) of each bacteria. For these reasons, there is still a chance you can develop bacterial meningitis even if you were vaccinated.

Pregnant women should talk to their doctor or midwife about getting tested for group B Streptococcus. Women receive the test when they are 35 to 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent passing group B Strep to their newborns.

Pregnant women can also reduce their risk of meningitis caused by Listeria monocytogenes. Women should avoid certain foods during pregnancy and safely prepare others.

If someone has bacterial meningitis, a doctor may recommend antibiotics to help prevent other people from getting sick. Doctors call this prophylaxis. CDC recommends prophylaxis for:

Close contacts of someone with meningitis caused by Neisseria meningitidis
Family members, especially if they are at increased risk, of someone with a serious Hib infection

Your doctor or local health department will tell you if you or someone in your house needs prophylaxis.

You can also help protect yourself and others from bacterial meningitis by maintaining healthy habits:

Don’t smoke and avoid cigarette smoke
Get plenty of rest
Avoid close contact with people who are sick

This is especially important for people at increased risk for disease, including:

Young babies
Older adults
People with weak immune systems
People without a spleen or a spleen that doesn’t work the way it should (functional asplenia)

Symptoms

According to the Centers for Disease Control and Prevention (CDC), the symptoms of meningitis can appear either suddenly or over a few days. They normally emerge in 3 to 7 days after infection.

Early symptoms of meningitis include:

nausea and vomiting
fever
headache and a stiff neck
muscle pain
sensitivity to light
confusion
cold hands or feet and mottled skin
in some cases, a rash that does not fade under pressure

Later symptoms include seizures and coma.

Infants may:

breathe quickly
refuse feeds and be irritable
cry excessively, or give a high-pitched moan
be stiff, with jerky movements, or listless and floppy

The fontanelle may be bulging.

Meningitis rash glass test

A meningitis rash occurs if blood leaks into the tissue under the skin.

It may start as a few small spots in any part of the body, then spread rapidly and look like fresh bruises.

The glass test can assist in identifying a meningeal rash.

Press the side of a drinking glass firmly against the rash.
If the rash fades and loses color under pressure, it is not a meningitis rash.
If it does not change color, you should contact a doctor immediately.

The rash or spots may fade and then come back.

Treatment

Treatment for bacterial meningitis normally involves admission to the hospital, and possibly an intensive care unit.

Antibiotics are essential, and these may be started before the results of tests come back, possibly before arrival at the hospital.

Treatment includes:

Antibiotics: These are usually given intravenously.
Corticosteroids: These may be given if inflammation is causing pressure in the brain, but studies show conflicting results.
Acetaminophen, or paracetamol: Together with cool sponge baths, cooling pads, fluids, and room ventilation, these reduce fever.
Anticonvulsants: If the patient has seizures, an anticonvulsant, such as phenobarbital or Dilantin, may be used.
Oxygen therapy: Oxygen will be administered to assist with breathing.
Fluids: Intravenous fluids can prevent dehydration, especially if the patient is vomiting or cannot drink.
Sedatives: These will calm the patient if they are irritable or restless.

Blood tests may be used to monitor the patient's levels of blood sugar, sodium, and other vital chemicals.