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</div><div><span>Meningitis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Meningitis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The most common causes of meningitis are viral infections. These infections usually get better without treatment. But, bacterial meningitis infections are very serious. They may result in death or brain damage, even if treated. A lumbar puncture (or spinal tap) is required to determine the specific cause.</p><p>Meningitis may also be caused by:</p><ul><li>Chemical irritation</li><li>Drug allergies</li><li>Fungi</li><li>Parasites</li><li>Tumors </li></ul><p>Many types of viruses can cause meningitis:</p><ul><li>Enteroviruses: These are viruses that also can cause intestinal illness.</li><li>Herpes viruses: These are the same viruses that can cause <a test="test" href="./000606.htm">cold sores</a> and <a test="test" href="./000857.htm">genital herpes</a>. However, people with cold sores or genital herpes do not have a higher chance of developing herpes meningitis.</li><li>HIV.</li><li>Mumps virus.</li><li><a test="test" href="./007186.htm">West Nile virus</a>: This virus is spread by mosquito bites and is an important cause of viral meningitis in most of the United States. </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Enteroviral meningitis occurs more often than bacterial meningitis and is milder. It usually occurs in the late summer and early fall. It most often affects children and adults under age 30. Symptoms may include:</p><ul><li>Headache</li><li>Sensitivity to light (<a test="test" href="./003041.htm">photophobia</a>)</li><li>Slight fever</li><li>Upset stomach and diarrhea </li><li>Fatigue </li></ul><p>Bacterial meningitis is an emergency. You will need immediate treatment in a hospital. Symptoms usually come on quickly, and may include:</p><ul><li>Fever and chills</li><li><a test="test" href="./003205.htm">Mental status changes</a></li><li>Nausea and vomiting</li><li>Sensitivity to light</li><li>Severe headache</li><li>Stiff neck </li></ul><p>Other symptoms that can occur with this disease:</p><ul><li><a test="test" href="./003212.htm">Agitation</a></li><li><a test="test" href="./003310.htm">Bulging fontanelles</a> in babies</li><li><a test="test" href="./003202.htm">Decreased alertness</a></li><li>Poor feeding or irritability in children</li><li>Rapid breathing</li><li>Unusual posture, with the head and neck arched backward (<a test="test" href="./003195.htm">opisthotonos</a>) </li></ul><p>You cannot tell if you have bacterial or viral meningitis by how you feel. Your health care provider must find out the cause. Go to a hospital emergency department right away if you think you have symptoms of meningitis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your provider will examine you. This may show:</p><ul><li>Fast heart rate</li><li>Fever</li><li>Mental status changes</li><li>Stiff neck </li></ul><p>If the provider thinks you have meningitis, a lumbar puncture (<a test="test" href="./003428.htm">spinal tap</a>) should be done to remove a sample of spinal fluid (cerebrospinal fluid, or CSF) for testing.</p><p>Other tests that may be done include:</p><ul><li><a test="test" href="./003744.htm">Blood culture</a></li><li><a test="test" href="./003804.htm">Chest x-ray</a></li><li><a test="test" href="./003786.htm">CT scan of the head</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Antibiotics are used to treat bacterial meningitis. Antibiotics do not treat viral meningitis. But antiviral medicine may be given to those with herpes meningitis.</p><p>Other treatments will include:</p><ul><li>Fluids through a vein (IV)</li><li>Medicines to treat symptoms, such as brain swelling, <a test="test" href="./000039.htm">shock</a>, and <a test="test" href="./003200.htm">seizures</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Without prompt treatment, meningitis may result in the following: </p><ul><li>Brain or neurologic damage</li><li>Buildup of fluid between the skull and brain (<a test="test" href="./001422.htm">subdural effusion</a>)</li><li><a test="test" href="./003044.htm">Hearing loss</a></li><li>Buildup of fluid inside the skull that leads to brain swelling (<a test="test" href="./001571.htm">hydrocephalus</a>)</li><li>Seizures</li><li>Death</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Certain vaccines can help prevent some types of bacterial meningitis: </p><ul><li>Haemophilus vaccine (<a test="test" href="./007597.htm">HiB vaccine</a>) given to children helps.</li><li>Pneumococcal vaccine is given to <a test="test" href="./007605.htm">children</a> and <a test="test" href="./007607.htm">adults</a>.</li><li>Meningococcal vaccine is given to <a test="test" href="./007602.htm">children and adults</a>; some communities hold vaccination campaigns after an outbreak of meningococcal meningitis. </li></ul><p>Household members and others in close contact with people who have meningococcal meningitis should receive antibiotics to prevent becoming infected.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Meningitis - bacterial; Meningitis - viral; Meningitis - fungal; Meningitis - vaccine</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div name="Patient Instructions" class="section-body" id="section-carepnt"><ul class="side-nav"><li><a href="../patientinstructions/000149.htm">Ventriculoperitoneal shunt - discharge</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Hasbun R, Van de Beek D, Brouwer MC, Tunkel AR. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. <em>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</em>. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.</p><p>Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 384.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/4/2022</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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