Bacterial meningitis is a severe, life threatening form of meningitis that occurs due to a bacterial infection. Meningitis affects the membranes that cover a person’s brain and spinal cord.

Meningitis affects the meninges, which are membranes that surround the brain and spinal cord. The meninges work with the cerebrospinal fluid to protect the central nervous system (CNS).

According to the World Health Organization (WHO), bacterial meningitis has a mortality rate of around 10%. Additionally, 20% of people who have bacterial meningitis end up with severe complications.

The Centers for Disease Control and Prevention (CDC) notes that vaccination is the most effective way to prevent bacterial meningitis.

Due to the severity of bacterial meningitis, treatment should begin as soon as possible. Death from bacterial meningitis can occur in just a few hours.

Read on to learn more about bacterial meningitis, including its symptoms and possible complications.

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The meningococcus bacterium causes meningococcal meningitis.

According to the CDC, symptoms of meningitis usually emerge 3⁠–7 days after infection. The WHO suggests that symptoms can develop over 2⁠–10 days.

Symptoms of meningitis include:

In infants

Infants may exhibit different symptoms to adults. Symptoms of bacterial meningitis in infants include:

  • poor feeding
  • being difficult to wake
  • sleepiness
  • crying when handled
  • irritability
  • grunting or difficulty breathing
  • fever
  • stiff neck
  • bulging soft spot on top of the head
  • high-pitched crying
  • convulsions
  • vomiting
  • pale or blotchy skin
  • abnormal reflexes
  • coma

Meningitis rash glass test

Meningococcal meningitis is a form of bacterial meningitis caused by the Neisseria meningitidis (N. meningitidis) bacterium. Meningococcal meningitis can cause a person to develop septicemia, which is an infection of the blood. This form of septicemia is known as meningococcal septicemia, or meningococcemia.

Meningococcal meningitis can cause a rash in about 50% of people with the condition. Meningococcemia can result in a person bleeding into their skin. This causes a certain type of rash to develop within a person’s skin, characterized by small, non-raised, purple-reddish lesions. The rash occurs due to bleeding outside the capillaries due to meningococcemia.

A person can test if a rash is from meningococcemia by pressing a glass tumbler against it. If the rash does not disappear, it means a person may have meningococcemia. However, a person should not take the glass test as a diagnosis of meningococcemia, as this form of rash can also result from other conditions.

If a person has a rash that does not disappear when pressed by a glass, they should contact their doctor immediately.

The WHO notes that 1 in 5 people who have bacterial meningitis may develop long-term complications, such as:

  • hearing loss
  • seizures
  • limb weakness
  • vision difficulties
  • speech, language, memory, or communication problems
  • severe brain damage
  • scarring or limb amputation due to sepsis

Sepsis

The WHO also states that sepsis often accompanies bacterial meningitis. Sepsis is the body’s extreme response to an infection. Sepsis can quickly lead to organ failure and eventually death.

If a person has an infection that is not getting better, they should seek urgent medical attention. Sepsis is a medical emergency.

Symptoms of sepsis include:

Meningitis is an inflammation of the meninges that cover the brain. There are three membranes that make up the meninges:

  • the dura mater, which is the dense outer layer
  • the arachnoid mater, which is the thin middle layer
  • the pia mater, which is a very thin membrane that lies directly on the brain and spinal cord

There is a space between the arachnoid mater and pia mater, called the subarachnoid space.

Bacteria can access a person’s meninges in various ways, such as:

  • via the bloodstream
  • a result of ear or sinus infections
  • a defect in the dura mater
  • via surgical neurological procedures

Bacterial meningitis can occur due to contact with a range of bacteria, including:

Pneumococcal meningitis is the most common form of bacterial meningitis. It is caused by the bacterium S. pneumoniae.

Bacterial meningitis can spread via certain foods, such as unpasteurized dairy or deli meats. However, the CDC notes that bacterial meningitis usually spreads from person to person.

The spread of bacterial meningitis generally depends on the type of bacteria that causes it. Additionally, a person can have the bacteria that causes bacterial meningitis but not get sick themselves. These people are known as carriers. Someone who is a carrier for bacterial meningitis can still pass it on to other people.

Common ways that bacterial meningitis can spread include:

  • Group B Streptococcus and E. coli: These bacteria can transfer to a baby during birth.
  • H. influenzae, M. tuberculosis, and S. pneumoniae: These bacteria can spread via coughs and sneezes when a person is in close contact with other people.
  • N. meningitides: This bacterium spreads through spit or saliva. A person can spread N. meningitides via coughing, kissing, or living in the same house as someone.
  • E. coli: This bacterium spreads via food prepared by someone who did not wash their hands correctly after using the toilet.

A person can develop bacterial meningitis at any age. However, infants are at a higher risk of developing bacterial meningitis. People of different ages are likely to be affected by different forms of bacterial meningitis.

Children ages 2 years and under and people with weakened immune systems have a greater risk of developing pneumococcal meningitis.

Meningococcal meningitis is more likely to affect:

  • infants under 1 year old
  • people with weakened immune systems
  • travelers to countries where it is common
  • college students
  • military recruits
  • people who live in dormitories

Other factors that increase the risk include:

  • not having bacterial meningitis vaccinations
  • neurosurgery
  • abnormality or trauma between the throat and the subarachnoid layer of the meninges
  • skull fractures
  • cochlear implants

Recurrent bacterial meningitis is possible. However, studies show that 59% of recurrent cases are due to anatomical problems, and 36% occur in people with a severely weakened immune system.

Bacterial meningitis is a serious condition that can lead to seizures, coma, or death. Bacterial meningitis can progress quickly and requires immediate treatment.

If a person, or their child, has any signs of bacterial meningitis, they should seek urgent medical attention.

According to the WHO, admission to a hospital or healthcare facility is necessary for the treatment of bacterial meningitis.

Treatment should begin as soon as possible.

Antibiotics

Early treatment for bacterial meningitis involves antibiotics that can cross the blood-brain barrier. The blood-brain barrier is a wall of cells that prevents harmful micro-organisms from entering the brain.

Antibiotics that can help treat bacterial meningitis include:

Doctors may recommend corticosteroids to reduce swelling in a person’s brain. A person may also require drainage of infected sinuses. If a person develops seizures due to bacterial meningitis, they may also receive anticonvulsants.

Several forms of bacteria can cause a person to develop bacterial meningitis. This means that various vaccines are required to prevent it. Currently, vaccines are available to prevent meningococcal, pneumococcal, and H. influenzae meningitis.

Meningococcal meningitis vaccine

Currently, the CDC recommends that children ages 11–12 years receive a meningococcal vaccine. The vaccine available for preteens also requires a booster shot at age 16.

Teenagers ages 16–18 years may receive an additional meningococcal shot. Although this shot is voluntary, the CDC recommends it for teenagers who:

  • have complement component deficiency, a rare immune disorder
  • are taking medications called complement inhibitors
  • have a damaged or removed spleen
  • have sickle cell disease
  • are at risk of a serogroup B meningococcal disease due to an outbreak

Pneumococcal meningitis vaccine

There are currently two vaccines available for pneumococcal meningitis. The pneumococcal conjugate vaccine (PCV13) is recommended for children ages 2 years and under and people who have certain medical conditions.

The second pneumococcal meningitis vaccine is called pneumococcal polysaccharide vaccine (PPSV23). The CDC recommends this vaccine for:

  • all adults over 65
  • people ages 2–64 years with certain medical conditions
  • adults ages 19–64 years who smoke cigarettes

H. influenzae meningitis vaccine

Infants usually receive the Hib vaccine in three or four shots. They generally get their first Hib shot around 2 months old, and should have all their doses by 12⁠–15 months old.

Children ages 1⁠–5 years and not previously vaccinated for Hib may require one or more additional doses.

Anyone ages 5 years and over may require a Hib vaccine:

  • if they have a damaged or removed spleen
  • if they have sickle cell disease
  • before spleen removal surgery
  • following a bone marrow transplant

Healthcare professionals may also recommend the Hib vaccine for people ages 5⁠–18 years with HIV.

Additional ways to prevent bacterial meningitis include:

  • frequent washing of hands
  • avoiding sharing utensils, food, and glasses with people who have the infection
  • taking prescribed antibiotics if exposed to someone with the condition
  • avoiding smoking and cigarette smoke
  • being well rested
  • covering the nose when sneezing
  • covering the mouth when coughing
  • avoiding being bitten by insects, as they can carry bacteria that cause bacterial meningitis

Bacterial meningitis affects the membranes that cover the brain and spinal cord. It is a medical emergency. People who experience symptoms of this condition should seek urgent medical care.

Symptoms include nausea and vomiting, fever, confusion, and a stiff neck. Some people experience a rash.

Treatment may include medication to reduce the inflammation and swelling bacterial meningitis causes.