Meningitis is an infection of the tissue around the brain and the spine. It’s typically caused by a virus, but can also be caused by bacteria. Bacterial cases can be very serious, so it’s important to speak to a doctor if you have any symptoms.
- Symptoms include a rash, fever and a stiff neck
- Can be caused by a viral or bacterial infection
- May require hospital treatment in some cases
If you feel seriously ill or suspect you may have meningitis, you should go to hospital as soon as you can. If you have symptoms that you think could be meningitis but are not sure, and are unable to speak to your GP, our doctors are available to help. Video consultation appointments are available for you to book at a convenient time for you.
What is meningitis?
Meningitis is caused by an infection spreading to the tissue which lines the brain and spinal cord, resulting in swelling and inflammation. It’s a condition that can affect anyone; however, young children, teenagers, elderly people and those with a weakened immune system are most at risk of developing it.
What symptoms does meningitis cause?
Symptoms of meningitis can include: headache, fever, feeling nauseous or vomiting, feeling tired or drowsy, an aversion to bright lights, and a stiff neck. A rash may also appear in some cases. Unlike other rashes, a meningitis rash is distinct in that it will still appear on the skin when a glass is rolled over it.
The condition may be caused by a viral, bacterial or fungal infection. Viral incidences are however much more widespread, and tend to be far less serious than bacterial cases, which can be life-threatening. Fungal cases are rare.
In viral meningitis, the infection travels to the lining of the brain (the meninges) and causes inflammation. There are a variety of viral conditions that can potentially lead to meningitis, including gastric flu, chickenpox, mumps and herpes.
Similarly, bacterial meningitis occurs when bacteria enters the bloodstream and travels to the brain. There are several varieties of bacteria that can cause meningitis, such as meningococcal bacteria and pneumococcal bacteria. Pneumococcal bacteria may cause bronchitis and pneumonia. Meningococcal bacteria is categorised into different subtypes, such as meningitis B and C.
It’s thought that around 1 in 10 people carry meningococcal bacteria harmlessly at the back of their throat, and that it plays a helpful role in maintaining immunity. It’s when this bacteria overpowers the immune system that an infection develops.
Treatment for bacterial and viral meningitis is very different, so a doctor will need to determine which strain is present before deciding on a course of action. Testing normally involves a blood test, and a lumbar puncture test may be used in some cases.
Viral incidences don’t require any specific treatment, and can usually be resolved at home with plenty of rest. Bacterial cases, on the contrary, are much more likely to become serious, and will require admission to hospital, so that antibiotics can be given through an IV drip.
Who gets meningitis?
Meningitis can develop at any age, but generally young children and the elderly are particularly at risk. According to Meningitis Now, there are around 3,000 reported cases of bacterial meningitis each year in the UK, and approximately 6,000 cases of viral meningitis. The incidence rate for viral meningitis however is likely to be higher, as many cases may not be reported or they could be mistaken for another condition.
In light of widespread immunisation programmes throughout the world, incidence rates have dropped dramatically in the last two decades. The meningitis B and C vaccines are now offered routinely to infants, as is the MMR vaccine, which can also sometimes lead to meningitis.
If you suspect you may have meningitis, it’s recommended that you go to hospital as soon as possible, particularly if you have developed a characteristic rash or if your symptoms are serious.
You should speak to a GP if your symptoms are milder than those described above, and are unsure as to whether they constitute meningitis or not. Our video doctor service enables you to speak to a clinician online. Book a slot with one of our GMC-registered doctors at a time suitable for you.
What are the causes of meningitis?
Meningitis is caused by an infection, which’s usually viral or bacterial. Viral meningitis is more common than bacterial meningitis, and the less serious condition of the two. Bacterial meningitis can be life-threatening if it isn’t treated.
Some of the more common bacteria responsible for meningitis are pneumococcal and meningococcal bacteria. Enteroviruses, the mumps virus and the herpes simplex virus are often responsible for viral cases.
The bacteria and viruses that cause meningitis can be spread through sharing utensils, coughing and sneezing. In many cases, the people who have these bacteria won’t have meningitis themselves, but carry the pathogens that may cause it. It’s less common to contract the illness from someone who already has meningitis.
The elderly, young children and people with more compromised immune systems are at greater risk of developing meningitis.
How is meningitis diagnosed?
If meningitis is suspected, you should be admitted to hospital urgently. There are some clinical symptoms that most variants of the illness have in common. These can include a fever, headache, an aversion to bright lights, nausea, vomiting, a stiff neck and paresis (muscular weakness).
Meningitis may be indicated by a distinctive rash, although it isn’t present in many cases. The rash first appears as miniscule red spots that resemble a pin prick, before spreading and becoming increasingly blotchy, and does not fade. If the rash does not dissipate when a glass is pressed against it, it's a sign of a blood infection. Urgent medical attention should be sought if you develop this kind of rash.
Will I need tests?
Testing is essential for a diagnosis. A doctor will need to determine what type of meningitis has been contracted so that treatment can be administered accordingly.
The three main tests for meningitis are a blood test, a lumbar puncture test and a CT scan. A lumbar puncture test involves a sample of fluid being taken from the spine, in order to assess the cerebrospinal fluid and whether any viruses or bacteria are present. A CT scan uses imaging to check whether there is any internal swelling around the brain.
How is meningitis managed?
If viral meningitis is diagnosed, antibiotics won’t be required and you should be able to treat it from home. It usually takes about a week for the infection to clear as it is a self-limiting condition, during which time you should rest properly and take painkillers where necessary for headaches. However, you might need to be admitted to hospital if your symptoms are serious or if you’re at increased risk of complications.
In cases of bacterial meningitis, urgent treatment is needed. Someone with bacterial meningitis will need to be admitted to hospital and have antibiotics injected intravenously. Following this, it may be necessary to have fluid injections to prevent dehydration. Oxygen may also be supplied through a mask for potential breathing difficulties, and sometimes a steroid injection to prevent inflammation and swelling around the brain.
Someone with bacterial meningitis may need to be kept in hospital for a few days, and treatment can last for up to several weeks.
How is meningitis treated?
It depends on the cause. Viral cases usually don’t need any specific treatment, and you’ll be able to recover at home in a few days with plenty of rest. Those who are at increased risk of complications may need to be monitored in hospital as a precaution.
Bacterial meningitis requires urgent treatment, and often hospitalisation. Antibiotics will be given for the infection via an intravenous drip, and a doctor may choose to issue steroid medication and fluid injections, depending on the severity of the infection.
How long will it take for me to recover?
In cases of viral meningitis, someone will normally recover in a week or two, although certain symptoms such as a headache may continue for a few weeks.
Prognosis for bacterial meningitis is much more variable, depending on the type of bacteria and the age of the individual. Treatment may last for a few days or for several weeks, but it can take longer for someone to feel as if they have completely recovered. In cases where treatment is delayed, it can be possible to develop lasting complications, such as hearing or sight loss, as well as arthritis and joint problems. Therefore, seeking medical advice right away is vital.
Can I consult a doctor about meningitis online?
If you suspect you may have meningitis, you should go to a hospital as soon as you can.
People who have more general symptoms, and want to speak to a GP, can do so through our online video consultation service. Book an appointment at a convenient time for you.