Bacterial Meningitis Can Be Life-Threatening—What to Know About Causes, Symptoms, and Treatment

Vaccination protects against certain bacteria that can cause these infections.

Most people are somewhat familiar with meningitis, a rare but serious condition in which the membranes surrounding the brain and spinal cord, called "meninges," become inflamed from a virus, bacteria, fungus, or other trigger.

But what people may not know is that meningitis is a broad term that covers a variety of illnesses, each with its own set of implications and treatments. And one type—bacterial meningitis—has become a major focus of the World Health Organization (WHO), which has set a goal to eliminate epidemics of this deadly disease by 2030. If successful, the WHO says it could prevent more than 200,000 deaths every year and significantly reduce permanent disabilities from bacterial meningitis.

Here's a breakdown of everything you need to know about bacterial meningitis and what to do if you experience symptoms of this life-threatening illness.

What is bacterial meningitis?

Like all types of meningitis, bacterial meningitis is an inflammation of the meninges, the membranes surrounding the brain and spinal cord, says the National Institute of Neurological Disorders and Stroke. It happens when bacteria enter the bloodstream and travel to the brain and spinal cord. Bacterial meningitis can also be caused by bacteria that directly infect the meninges through an ear, skull fracture, sinus infection, or (in rare cases) surgery, per the Mayo Clinic.

When bacterial meningitis causes the meninges to swell, it can put pressure on the spinal cord and brain, according to Johns Hopkins Medicine. And that can turn into a life-threatening situation—fast.

"In the case of bacterial meningitis, getting evaluated promptly and getting proper treatment initiated right away is really critical," Marie Grill, MD, specialist in neuroinfectious diseases at the Mayo Clinic, tells Health. "It should be considered an emergency because it can actually progress over hours."

There are many types of bacteria that can cause meningitis, but three types are responsible for 80% of all cases, according to the National Organization for Rare Disorders (NORD). They are:

  • Haemophilus influenzae (type b)
  • Streptococcus pneumoniae (Pneumococcus)
  • Neisseria meningitidis (Meningococcus)

The NORD also notes that these three types of bacterial meningitis peak in the wintertime.

How do you get bacterial meningitis?

Bacterial meningitis spreads through close and prolonged contact with someone carrying the bacteria, according to the WHO. More specifically, the disease is transmitted through respiratory droplets and throat secretions from carriers. That can happen through:

  • living in close quarters
  • kissing
  • sneezing
  • coughing

Carriers of the types of bacteria that cause meningitis can be asymptomatic but still excrete droplets, says Dr. Grill, adding: "If you're going to be in close contact with people, then you could potentially have an exposure."

While anyone can get bacterial meningitis, certain people can be at greater risk of contracting the illness. The CDC notes that babies and people living in group settings (like college dorms) face a higher risk of bacterial meningitis. Certain medical conditions, such as being HIV-positive or not having a spleen, can also make a person more likely to contract this disease.

You may also be at increased risk of meningococcal disease (which includes bacterial meningitis) if you travel to certain places, such as parts of sub-Saharan Africa during the dry season or Mecca during the Hajj and Umrah pilgrimage, per the CDC.

Certain germs that can cause bacterial meningitis, including Listeria monocytogenes and E. coli, can be spread through contaminated food, while others (such as Group B Streptococcus) can be passed from mothers to newborns during childbirth, the CDC notes.

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What are the symptoms of bacterial meningitis?

Bacterial meningitis symptoms typically come on suddenly, according to the CDC, and may include:

  • Fever
  • Headache
  • Stiff neck
  • Nausea
  • Vomiting
  • Confusion
  • Light sensitivity (photophobia)

"People with meningitis all come with very similar symptoms. When your brain is affected, you don't think very well. You have a tremendous headache. The light bothers your eyes, sounds bother your ears, your neck becomes stiff, in some circumstances, you just can't turn your head," Frank Esper, MD, pediatric infectious disease specialist at Cleveland Clinic Children's, tells Health.

Though early bacterial meningitis symptoms may appear flu-like, people tend to deteriorate very quickly (sometimes within hours) and may become extremely sick. "Bacterial [meningitis] often sets itself apart just because it's so rapid, acute, and intense," says Dr. Grill.

Bacterial meningitis symptoms can show up a little differently in newborns and babies, according to the CDC. They may:

  • Vomit
  • Move slowly or be inactive
  • Feed poorly
  • Be irritable
  • Experience abnormal reflexes
  • Have a bulging "soft spot" (fontanelle) on their head

"We're worried about any child under the age of 28 days," adds Dr. Esper. "In the first month of life, if they have a fever, they're being treated for meningitis."

Another possible bacterial meningitis symptom in people of all ages is a rash. According to the UK's Meningitis Research Foundation, the appearance of a meningitis rash can vary from person to person, but typically appears as red or purple pinpricks on the skin, or reddish-purple areas of bruising caused by blood escaping from bacteria-damaged blood vessels.

The meningitis rash is most commonly found in tandem with meningococcal meningitis and indicates a significant medical emergency, per the Meningitis Research Foundation. However, not everyone with bacterial meningitis gets a rash, so it's important to seek immediate care for any meningitis symptoms you experience.

Viral vs. bacterial meningitis: Which is worse?

Between viral and bacterial meningitis, viral tends to be less severe and is rarely life-threatening. But both types are still serious and require medical attention, says Dr. Esper.

"With viral meningitis, [people] show up to the hospital, or the emergency department, or to their primary care doctors because the body says to you, 'This is not your normal flu. This is something that's bad.' It's in your head and you usually go seek care," says Dr. Esper

Like the name implies, viral meningitis is caused by a virus. According to the Meningitis Research Foundation, the viruses typically responsible for most cases of viral meningitis are enteroviruses (a group of viruses typically associated with the common cold), herpes simplex (often the same type that causes genital herpes), and varicella zoster (the same one that causes chickenpox and shingles).

Antiviral medications can be used to treat specific kinds of viral meningitis. But for the most part, like other viruses, the treatment for viral meningitis largely involves addressing any symptoms or discomfort caused by the illness and time to recover from it.

Most people recover from viral meningitis with no long-term issues (although some survivors may have short-term memory loss and attention problems), according to the Meningitis Research Foundation. Bacterial meningitis, on the other hand, leaves around 20% of survivors with permanent disabilities, such as deafness or loss of a limb, according to the CDC. And around 10% of cases are deadly, per the Cleveland Clinic, hence why bacterial meningitis is considered worse than viral meningitis.

How is bacterial meningitis treated?

Early intervention is key to treating bacterial meningitis, Dr. Grill says. "Getting evaluated promptly and getting proper treatment initiated right away is really critical."

A patient suspected of having any type of meningitis will often be started on a course of intravenous antibiotics, per the Mayo Clinic. Doctors may then order a series of tests, including blood cultures to look for pathogens, CT or MRI scans to check for swelling in the head, and a lumbar puncture (also known as a spinal tap) for a definitive diagnosis.

"The spinal fluid is our main diagnostic test for being able to discern between bacterial and viral meningitis," says Dr. Grill. She adds that studying the spinal fluid can also pinpoint the specific type or cause of the meningitis the patient has in order to determine which course of antibiotics or additional care is required.

Depending on what the lab results reveal, a doctor may then switch a patient's antibiotics to ones that specifically target the bacteria causing the meningitis. Bacterial meningitis treatment sometimes also involves corticosteroid injections to reduce inflammation and fluid replenishment, per the Cleveland Clinic. The Mayo Clinic notes that anticonvulsant medication may be given to control seizures from bacterial meningitis.

Even though bacterial meningitis can become deadly, most people recover when the disease is detected and treated early enough, according to the Cleveland Clinic. Early treatment is also key to reducing the risk of seizures, mental impairment, and paralysis from the disease.

Can you prevent bacterial meningitis?

Vaccinations are one of the best ways to prevent certain types of bacterial meningitis, per the CDC. While there aren't immunizations for every type of bacteria that can cause meningitis, there are vaccines available to help protect against some of the more predominant types, including:

  • Meningococcal
  • Pneumococcal
  • Hib (a disease caused by the Haemophilus influenzae bacteria)

Most people receive these vaccines as part of routine doctor visits, beginning in infancy and continuing into young adulthood, according to the CDC. In some cases, older adults may receive booster shots if initial protection has waned, or they are at high risk.

No vaccine is 100% effective though, and anyone experiencing bacterial meningitis symptoms should seek medical attention right away—even if they've been vaccinated.

Otherwise, to help prevent bacterial meningitis, the Mayo Clinic recommends keeping the immune system strong through healthy habits like diet and exercise, maintaining good hygiene practices including thorough handwashing, covering your mouth during a cough or sneeze, and avoiding sharing items like food, straws, utensils, and toothbrushes with other people.

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