Meningitis is inflammation of the meninges, which are the membranes that protect the brain and the spinal cord. It can cause various symptoms, including headaches, a rash, and a fever.
Meningitis can cause serious complications and can quickly become life threatening. Anyone can develop meningitis, but young children, older adults, and people with weakened immune systems are most at risk.
The different types of meningitis depend on the cause and include:
How symptoms affect a person may depend on the type.
Viral meningitis is more common and usually less severe than bacterial meningitis. While both types are serious, bacterial meningitis is more likely to be life threatening.
In this article, find out about how to recognize the signs of meningitis.
One of the most common symptoms of meningitis is a severe headache. This is due to inflammation in the meninges, which are the membranes surrounding the brain and the spinal cord. The inflammation can result in significant pain.
The headache tends to start quickly and affect the whole head, rather than focusing on one location.
Some types of meningitis may cause a rash. This is not a skin rash, as it results from bleeding under the skin. If bacteria enter the bloodstream, small blood vessels can break, leading to marks under the skin that healthcare professionals call petechiae.
Not everyone with meningitis will have a rash. It is most likely to occur with meningococcal meningitis, a type of bacterial meningitis.
On pale skin, petechiae may appear as reddish or purple bruise-like patches or as blotchy or mottled skin.
It may also appear as small pink, brown, or purple pinprick marks under the skin that may resemble fleabites. At first, they are likely to be 1–2 millimeters in diameter and appear where the skin is under pressure, for example, under elastic in clothing.
On dark skin, petechiae can be harder to see but may be visible inside the eyelids and on the palms of the hands, the soles of the feet, the abdomen, and the roof of the mouth.
Skin symptoms that evolve quickly can be a sign of severe and rapidly developing disease.
At first, if a person presses a glass tumbler on the rash, the rash may disappear. In time, however, it will remain visible with the same test.
As the infection develops, it can affect blood clotting, making it harder for oxygen to reach the extremities, usually the hands and feet, but likely also the nose and lips.
These areas, and possibly the arms and legs, may develop large dark bruises, which can eventually become blackened, as tissues die due to a lack of oxygen.
Anyone who has skin changes with a headache and fever should seek immediate medical advice.
A person with meningitis may suddenly develop a high fever of over 99.5°F (37.5°C).
The CDC lists fever as a symptom of all types of meningitis except parasitic meningitis, which is
In some cases, long-term problems can occur after bacterial meningitis,
- difficulty thinking and focusing
- problems with memory
- learning difficulties
These effects are due to long-term neurological damage.
Babies have areas on the head known as a fontanel. This is a gap where the skull’s bones have not yet fused together.
The largest fontanel is on top of the head and should feel firm and slightly indented. If a baby’s fontanel appears to be bulging, this could be a sign of brain swelling or fluid buildup. It could indicate bacterial meningitis.
However, if an infant’s fontanel starts to bulge, someone should seek medical advice as soon as possible, especially if the infant has other symptoms.
Pain and stiffness in the neck, which healthcare professionals call Brudzinski sign, are a common indication of meningitis. They result from inflammation in the spinal cord. Moreover, the pain may worsen when a person bends their neck forward.
A child or baby with a stiff neck from meningitis may hold their head and neck straight and be unwilling or unable to bend the head forward.
A person with meningitis may become sensitive to light. Babies or children may cry or turn away from light.
Other possible causes of photophobia
If a person cannot be woken or seems excessively sleepy, this may be an early symptom of meningitis infection. The illness may affect the brain’s alertness, making it hard for a person to stay awake.
They may also notice:
- rapid breathing
- fever and chills
- vomiting, diarrhea, or both
- cold hands and feet
- aches and pains in the abdomen, chest, joints, and muscles
People who have recovered from meningitis may also experience long-term fatigue, including:
- difficulty focusing and remembering things
- sensitivity to noise and light
- emotional changes
- sensitivity to stress
- sleep disturbances
These symptoms may make it difficult to return to work.
A reduced appetite
A severe headache, brain swelling, and the body’s defense against the illness can cause stomach upset and vomiting, especially in children.
Meningitis can lead to changes in mental status and a loss of consciousness. In some cases, coma can occur.
The authors of a 2014 study note that doctors do not always know exactly why this happens. Contributing factors may include:
- severe inflammation
- increased pressure on the brain
- other complications, such as a seizure
- the use of sedative medication
The researchers conclude that people with reduced levels of consciousness due to bacterial meningitis may have a poorer outlook than those whose consciousness levels are not affected.
However, they note that a score of 3 — the lowest score on the
When meningitis causes brain swelling or pressure, it can disrupt the brain’s normal function, resulting in a seizure.
Having seizures during an episode of meningitis does not mean that a person has or will develop epilepsy.
However, because this pressure and inflammation can permanently damage the brain, individuals occasionally develop epilepsy after recovering from meningitis.
In severe cases of meningitis, a person may experience enough brain damage to cause a coma. This is rare with bacterial or viral meningitis.
In one study, 30 out of 1,083 people with bacterial meningitis, or 3%, scored 3 on the Glasgow Coma Scale, which indicates a coma.
According to the
- a loss of coordination and muscle control
- weakness or paralysis
A person with meningitis may find it hard to think, focus, and remember things.
After recovering from meningitis, some people continue to experience problems with memory. This can be a result of neurological damage during the illness.
Confusion and altered mental status are symptoms of various types of meningitis.
Neurological damage that occurs during the illness can also affect thinking and concentration in the long term.
Depending on the area of the brain affected, children who have had meningitis may find it harder to carry out various functions, including:
- remembering things
- making decisions and solving problems
The brain takes over 20 years to develop, which means the risk is higher among younger children. Older children and adults, who have already developed certain thinking and reasoning skills before having meningitis, may retain those skills.
Younger children, however, may need additional help at school with tasks such as planning and working independently.
Hearing changes can be a complication of meningitis. Bacterial meningitis can affect the inner ear or the auditory nerve, which carries sound to the brain. This can result in hearing loss, which may be permanent.
Damage can happen if the infection spreads to the hair cells in the cochlea, a bone that plays a crucial role in hearing. It may also occur if inflammation puts pressure on the auditory nerve.
Hearing loss can affect both children and adults. After recovering from meningitis, people should have a hearing test to check for potential hearing problems.
Ringing in the ears, or tinnitus, can also develop after meningitis.
Various types of meningitis can also have a long-term impact on vision if the infection affects the optic nerve.
After recovery, a person may experience:
- partial vision loss
- total vision loss
Vision changes can develop in one or both eyes. In some cases, they can be permanent.
A person who has meningitis
Speech loss or changes in speech
If a child has meningitis before they learn to talk, damage may occur that affects their ability to learn to speak and to use speech and language.
A speech and language therapist can sometimes help a child learn to speak, or help people regain their ability to speak after recovering from the illness.
The brain and the ears interact to help a person keep their balance and their awareness of space around them. Meningitis can cause problems with the inner ear, leading to:
- loss of coordination
This may occur while a person has meningitis, but it often resolves after they recover. If damage has affected the inner ear, however, it may persist.
A child who was previously walking or sitting up, for example, may appear to lose that ability. Up to 10% of children who have bacterial meningitis may have ongoing dizziness or balance problems.
Individuals who continue to experience dizziness should seek medical advice, as they may have a longer-term problem that needs addressing.
- kidney injury
- oliguria, or low urine output
- rhabdomyolysis, which involves a breakdown of muscle tissue
Some medications for meningitis can also damage the kidneys.
A rare but severe complication of bacterial meningitis — usually meningococcal meningitis — is known as Waterhouse-Friderichsen syndrome (WFS). This
- a petechial rash
- weakness and fatigue
- pain in the side or abdomen
- nausea and vomiting
- lack of appetite
- confusion and disorientation
- low blood pressure in around 50% of cases
Experts note that it can be difficult to diagnose adrenal gland failure if a person may have sepsis, because the two produce similar symptoms.
If a person has a diagnosis of suspected sepsis, and their symptoms are not responding to fluids, a doctor may suspect WFS, or adrenal gland failure.
Common symptoms of meningitis to look out for are:
- stiff neck
- cold hands and feet
- rapid breathing
- muscle and joint pain
- pale, mottled, or blotchy skin
- spots or a rash
- sensitivity to bright lights
- sleepiness or difficulty waking
Other symptoms may be less common or develop as a long-term complication.
In addition to other symptoms, an infant or a newborn may:
- refuse to feed
- be irritable
- give a high-pitched cry
- have a stiff body or be floppy or unresponsive
- have a bulging, soft spot on the top of their head
Anyone who shows signs and symptoms of meningitis needs urgent medical attention, as the condition can progress rapidly and lead to severe and potentially fatal complications.
If a person recovers from meningitis and continues to experience problems, they should seek guidance from a doctor, as they may need additional help.
Although the outlook for meningitis partly depends on the cause and type, all types of meningitis are serious and need immediate medical attention.
Without treatment, bacterial meningitis can continue to worsen and cause damage throughout the body. It is fatal in around
Viral meningitis, while serious, is usually self-limiting and goes away with supportive treatment. It can have long-term implications, but
Treatment for bacterial meningitis is with antibiotics. A doctor may not wait for the results of blood tests to start this treatment, as delaying increases the risk of severe illness.
Meningitis is a severe and potentially life threatening condition that involves inflammation of the meninges, which are tissues that surround the brain.
Common symptoms include a headache, fever, stiff neck, and purple rash that healthcare professionals refer to as petechiae. Without prompt treatment, a person with bacterial meningitis may develop sepsis.
Those particularly susceptible to severe illness include young children and people with a weakened immune system.
Anyone with symptoms of meningitis needs prompt medical attention to prevent severe illness and complications.