Recurrent meningitis is when someone’s meningitis returns after an initial case. It is relatively uncommon and tends to be less severe than the initial meningitis. However, its symptoms and diagnosis are the same as for regular meningitis.

Meningitis is a life threatening condition affecting millions of people every year. This article will look at what happens in recurrent meningitis.

After defining this condition and detailing its prevalence, this article lists the symptoms of recurrent meningitis. It also summarizes its risk factors, diagnosis, outlook, and treatments.

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The Centers for Disease Control and Prevention (CDC) defines meningitis as an inflammatory condition. It affects the membranes that protect the spinal cord and brain, causing them to swell.

Recurrent meningitis is when someone’s meningitis comes back after treatment.

More precisely, a 2021 study defines recurrent meningitis as meningitis that comes back more than 3 weeks after someone finishes a meningitis treatment. Recurring meningitis can have the same or different cause as the initial case.

Scientists do not know the prevalence of recurrent meningitis.

The same 2021 study looked at the prevalence of recurrent meningitis amongst people with community-acquired bacterial meningitis.

This is when someone develops meningitis after a bacterial infection, such as when the infection arises within the general population rather than in a hospital. The study found a prevalence of about 5%.

The symptoms of recurrent meningitis are the same as those of regular meningitis and can include:

For some people, meningitis can increase pressure within their skulls. This may cause the following:

  • Changes in mental status: This may include lethargy, decreased responsiveness, or confusion.
  • Neurologic problems: These may present as decreased strength, decreased sensation, a facial droop, unequal eye movements, or abnormal reflexes.

The pressure can also cause seizures. These symptoms indicate the meningitis is more severe.

As the CDC explains, meningitis most commonly results from infections. These could be viral, bacterial, or fungal in origin.

Non-infectious causes of meningitis include:

  • Medications: Some anti-inflammatory (ibuprofen), antibiotic (trimethoprim-sulfamethoxazole), chemotherapy, and anti-seizure (lamotrigine, carbamazepine) medications have the potential to cause meningitis.
  • Autoimmune conditions: Experts have linked some autoimmune conditions, such as rheumatoid arthritis, lupus, Sjögren’s, and sarcoidosis, to meningitis.
  • Cancer: Cancer that spreads to the meninges can cause meningitis.

In theory, anyone who develops meningitis could experience a recurrence. However, some groups of people are more prone to this than others.

For instance, a 2021 study found that people with HIV have an increased risk of recurrent fungal meningitis.

According to a 2018 study, immunocompromised people are also at risk. Finally, the 2021 study from Clinical Infectious Disease lists brain injury and cerebrospinal fluid (CSF) leakage as risk factors for recurrent meningitis.

There are no specific diagnostic criteria for recurrent meningitis. Doctors diagnose this condition with the same methods used for diagnosing the initial meningitis.

Laboratory analysis of CSF is the primary technique for diagnosing meningitis.

These analyses will measure levels of white blood cells, glucose, and proteins. They will also aim to detect any bacteria, viruses, or fungi.

Doctors also recommend blood tests, and sometimes, CT scans.

Treatments for recurrent meningitis will depend on the cause.

Depending on whether the current case of meningitis results from a viral, bacterial, or fungal infection, doctors may prescribe:

  • antibiotics
  • antiviral medications
  • antifungal medications

If the current episode of meningitis was from a non-infectious cause, the treatment may be different.

When a doctor has treated the current case of meningitis, they will need to treat the underlying cause of recurrent meningitis. This might include any number of different therapies, such as:

  • surgery
  • medications
  • long-term condition management

Meningitis is a serious condition which can sometimes be life threatening. For instance, the 2021 Clinical Infectious Diseases study notes that community-acquired bacterial meningitis has a mortality rate of roughly 20%.

However, recurrent meningitis is often less serious than the initial meningitis. The mortality rate for community-acquired bacterial meningitis is roughly 4%.

Scientists do not know exactly why this is. However, recurrent meningitis more commonly results from less serious causes.

There is little scientific research on what an individual might do to prevent meningitis from coming back.

The 2018 study suggests that if someone develops meningitis multiple times, investigating the individual’s environment could help determine if there is a repeating cause of meningitis. Avoiding those causes could prevent disease recurrence.

The 2021 study recommends identifying and addressing any risk factors for recurrent meningitis. However, doctors did not find such factors in 28% of patients with recurrent meningitis.

This section answers some frequently asked questions about recurrent meningitis.

Can meningitis come back years later?

Meningitis can recur weeks, months, or years after the initial disease.

What happens if you get meningitis twice?

The outlook for people with some forms of recurrent meningitis is often better than that of the initial disease.

Meningitis is an inflammatory condition that affects the membranes protecting the central nervous system. When someone develops meningitis at least 3 weeks after completing an initial meningitis treatment, doctors call it “recurrent meningitis.”

Scientists do not know the exact prevalence of recurrent meningitis. However, the condition seems to be somewhat uncommon. Moreover, recurrent meningitis has a much lower mortality rate than an initial infection.

The risk of developing recurrent meningitis is higher for people with HIV, brain injuries, or cerebrospinal fluid leakage.

Immunocompromised individuals also form an at-risk group. There is little scientific research on how to prevent meningitis from recurring. However, identifying risk factors and environmental causes could help.