Meningitis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is meningitis?
Meningitis is inflammation of the meninges, the membranes covering the brain and spinal cord. Viral meningitis is usually self limiting, whereas bacterial meningitis is a medical emergency that can kill within hours. Any combination of fever, severe headache, neck stiffness and altered consciousness requires immediate assessment, and a non blanching rash demands emergency care.
Causes
- Bacteria including meningococcus, pneumococcus and Haemophilus influenzae
- Enteroviruses, the commonest viral cause
- Herpes simplex and varicella zoster viruses
- Tuberculosis
- Fungal infection in immunosuppressed people
Symptoms
- Severe headache
- Fever
- Neck stiffness
- Dislike of bright light
- Nausea and vomiting
- Drowsiness or confusion
- A rash that does not fade under pressure in meningococcal disease
- Bulging fontanelle and high pitched cry in infants
Risk factors
- Age under 5 or adolescence and young adulthood
- Being unvaccinated
- Crowded living such as university halls
- Absent or non functioning spleen
- Weakened immune system
- Cochlear implants or skull base fracture
Diagnosis
- Urgent clinical assessment without delaying treatment
- Blood cultures and inflammatory markers
- Lumbar puncture for cerebrospinal fluid analysis
- CT head first if raised intracranial pressure is suspected
- PCR testing for bacterial and viral pathogens
Treatment
- Immediate intravenous antibiotics when bacterial meningitis is suspected
- Dexamethasone in selected bacterial cases
- Aciclovir if herpes encephalitis is possible
- Supportive care with fluids and monitoring
- Vaccination for prevention against several causes
- Antibiotic prophylaxis for close contacts of meningococcal disease
Self care
- Do not manage suspected meningitis at home; seek emergency care
- While waiting for help, keep the person calm in a quiet, dimly lit room
- Use the glass test on any rash, but never wait for a rash to appear
- After viral meningitis, rest and allow several weeks for fatigue to settle
- Complete any prescribed antibiotics for close contacts
When to see a doctor
Book an appointment if:
- Persistent headache and fatigue in the weeks after viral meningitis
- New hearing difficulty following bacterial meningitis
- Concerns about vaccination status for you or your child
- Close contact with a confirmed case, to discuss preventive antibiotics
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Routine childhood immunisation including MenB, MenACWY, Hib and pneumococcal vaccines
- Booster vaccination for adolescents and students entering shared accommodation
- Preventive antibiotics for close contacts of meningococcal cases
- Avoid sharing drinks, cutlery and cigarettes
- Good hand hygiene
Outlook
Viral meningitis usually resolves within one to two weeks with supportive care and rarely causes lasting harm. Bacterial meningitis is far more serious: with prompt antibiotics most people survive, but delays substantially raise the risk of death and of lasting effects such as hearing loss, seizures or cognitive difficulty. This is why treatment is started on suspicion rather than waiting for test results.
Common questions
What is the glass test?
Pressing a clear glass against a rash checks whether it fades. A rash that does not fade under pressure suggests meningococcal septicaemia and needs emergency care. A fading rash does not exclude meningitis.
Should treatment wait for test results?
No. Suspected bacterial meningitis is treated with antibiotics immediately, because delay of even a few hours increases death and disability. Investigations follow rather than precede treatment.
Is viral meningitis serious?
It is usually far less severe and often resolves within one to two weeks with supportive care, but it can still cause significant headache and fatigue, and it must be distinguished from bacterial disease.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.