Practice updates

Meningitis

Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges).

Meningitis is usually caused by a viral or bacterial infection. Viral meningitis is the most common and least serious type. Bacterial meningitis is rare but can be very serious if it’s not treated quickly.

Bacterial meningitis can cause life-threatening blood poisoning (septicaemia) and result in permanent damage to the brain or nerves.

Symptoms of meningitis

Symptoms of meningitis develop suddenly and can include:

  • a high temperature (fever) over 38°C (100.4°F)
  • being sick
  • a headache
  • a blotchy rash that doesn’t fade when a glass is rolled over it (this won’t always develop) – use the ‘glass test‘ from Meningitis Now
  • a stiff neck
  • a dislike of bright lights
  • drowsiness or unresponsiveness
  • seizures (fits)

These symptoms can appear in any order and some may not appear.

Meningitis rash

The meningitis rash usually starts as small, red pinpricks before spreading quickly and turning into red or purple blotches. The rash can be harder to see on brown or black skin.

 

Immediate action required: Go to A&E or phone 999 if:

  • you think you or your child have meningitis

Trust your instincts and don’t wait until a rash develops.

Urgent advice: Phone 111 or speak to your GP practice if you:

  • or your child have symptoms that could be meningitis but you’re not sure if it’s anything serious
  • think you’ve been exposed to someone with meningitis

If you’ve had medical advice and are still worried, or any symptoms get worse, get medical help again.

Diagnosing meningitis

People with suspected meningitis will usually need to have tests in hospital. You may need to stay in hospital for treatment.

Tests in hospital

Several tests may be carried out to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection.

These tests may include:

  • a physical examination to look for symptoms of meningitis
  • blood tests that look for signs of infection and check for bacteria or viruses
  • a lumbar puncture – where a sample of fluid is taken from the spine and checked for bacteria or viruses
  • a CT scan to check for any problems with the brain, like swelling

Bacterial meningitis can be very serious. Treatment with antibiotics will usually start before the diagnosis is confirmed. They’ll be stopped later on if tests show the condition is being caused by a virus.

Treatment for meningitis

Bacterial meningitis usually needs to be treated in hospital.

Viral meningitis tends to get better on its own and can often be treated at home.

Treatment in hospital

Bacterial meningitis must be treated in hospital. This is because the condition can cause serious problems and needs to be monitored closely.

Severe viral meningitis may also be treated in hospital.

Treatments include:

  • antibiotics given directly into a vein
  • fluids given directly into a vein to prevent dehydration
  • oxygen through a face mask if there are any breathing difficulties
  • steroid medication to help reduce any swelling around the brain, in some cases

You may need to stay in hospital for a few days if you have meningitis. In certain cases, treatment may last several weeks.

Even after going home, it may be a while before you feel completely back to normal.

You may need more treatment and further support if you have any complications.

Treatment at home

You’ll usually be able to go home from hospital if you or your child have mild meningitis and tests show it’s being caused by a viral infection.

This type of meningitis will normally get better on its own without causing any serious problems. Most people feel better within 7 to 10 days.

In the meantime, it can help to:

  • get plenty of rest
  • take painkillers for a headache or general aches
  • take anti-emetic (anti-sickness) medicine for any vomiting

What causes meningitis?

Meningitis is usually caused by a viral or bacterial infection.

Several different viruses and bacteria can cause meningitis, including:

How meningitis is spread

The viruses and bacteria that cause meningitis can be spread through:

  • sneezing
  • coughing
  • kissing
  • sharing utensils, cutlery and toothbrushes
  • close contact with other people
  • sharing vapes

The infection is usually spread by people who carry these viruses or bacteria in their nose or throat, but aren’t ill themselves.

The infection can also be spread by someone with meningitis, although this is less common.

It’s possible to get meningitis more than once.

Preventing the spread of infection

The risk of someone with meningitis spreading the infection to others is generally low. However, if someone is thought to be at high risk of infection, they may be given a dose of antibiotics as a precautionary measure.

This may include anyone who has been in prolonged close contact with someone who developed meningitis, like:

  • people living in the same house
  • pupils sharing a dormitory
  • university students sharing a hall of residence
  • a boyfriend or girlfriend

People who have only had brief contact with someone who developed meningitis won’t usually need to take antibiotics.

Who’s most at risk of meningitis?

Anyone can potentially get meningitis, but it’s more common in:

  • babies and young children
  • teenagers and young adults
  • older people
  • people with a weak immune system – for example, those with HIV and those having chemotherapy

You can reduce the risk of getting meningitis by ensuring all your vaccinations are up-to-date.

Vaccinations against meningitis

Meningitis can be caused by a number of different infections, so several vaccinations offer some protection against it.

These vaccines are offered to children and young people as part of the NHS vaccination schedule.

The vaccines include:

Complications of meningitis

Most people make a full recovery from meningitis. But, it can sometimes cause serious, long-term problems and can be life-threatening.

This is why it’s important to get medical help as soon as possible if you think you or your child have symptoms of meningitis. It’s also why meningitis vaccinations are offered to certain groups.

Complications are much rarer after viral meningitis.

Some of the most common complications associated with meningitis are:

  • hearing loss, which may be partial or total – people who have had meningitis will usually have a hearing test after a few weeks to check for any problems
  • recurrent seizures (epilepsy)
  • problems with memory and concentration
  • co-ordination, movement and balance problems
  • learning difficulties and behavioural problems
  • vision loss, which may be partial or total
  • loss of limbs – amputation is sometimes necessary to stop the infection spreading through the body and remove damaged tissue
  • bone and joint problems, like arthritis
  • kidney problems

Additional treatment and long-term support may be needed if you or your child experience complications of meningitis.

Further support and information

For further support and information about life after meningitis, you may also find it useful to get in touch with organisations, like:

The images on this page were sourced from dermnetnz.org.