The symptoms of bacterial and the viral meningitis are often similar, making it challenging to distinguish between the two based solely on symptoms. Common symptoms indicative of meningitis can include:
Fever that is accompanied by seizures
Impaired consciousness
Irritability and lethargy
Nausea and vomiting
Key signs of meningitis are:
Neck stiffness (pain or resistance to neck flexion)
Increased sensitivity to light (photophobia), often with drowsiness or irritability
In infants, a bulging fontanelle (the soft spot on the head) due to increased pressure
Purpuric rash, which may suggest bacterial meningitis
For infants and young children with fever of unknown origin, a high index of suspicion for meningitis is necessary. Diagnosis typically involves a lumbar puncture to obtain cerebrospinal fluid for testing.
What causes it
Meningitis can be caused by various micro-organisms, classified as bacterial (septic meningitis) or viral (aseptic meningitis). There are also rare inflammatory causes of meningitis caused by auto antibodies (eg. MOG antibodies).
About the condition
Meningitis is the inflammation of the membranes covering the brain and spinal cord. Viral meningitis is more common and generally less severe, while bacterial meningitis is less common but more severe.
In viral meningitis, most children recover completely, but some may experience lingering symptoms such as malaise, dizziness and headaches. Rare complications include hearing impairment or long-term seizures, behavioural or learning issues.
Bacterial meningitis can be life-threatening, with potential complications including septic shock or severe brain swelling. Mortality rates vary from 5–10%, depending on the virulence of the bacteria. Acute complications can include fluid and electrolyte imbalances and seizures.
Diagnosis and Treatment Options
The evaluation of meningitis will require assessment of cerebrospinal fluid through lumbar puncture (also known as spinal tap).
Prompt treatment with intravenous antibiotics is crucial for bacterial meningitis. Post-recovery complications of bacterial meningitis may include hydrocephalus, requiring surgical intervention. Long-term sequelae of bacterial meningitis, including physical or mental disabilities, persist in up to 10-15% of survivors due to the brain damage caused by the inflammatory response.
Early administration of antivirals is crucial for particular viral causes, such as Herpes Simplex Virus. In contrast, autoimmune-induced meningitis needs immune therapies like steroids. The majority of cases are monophasic and rarely recur.
