Meningitis – Diagnosis and Treatment
Diagnosis
Recognizing meningitis often starts with looking for symptoms such as high fever, severe headache, stiff neck, and nausea. These signs, along with findings from a physical check, guide healthcare providers to decide on further testing.
Doctors use several key steps to find out if a person has meningitis:
- Blood Tests: Doctors collect blood samples to check for bacteria or viruses. Blood cultures help germs grow so doctors can study them.
Some tests also look for higher levels of substances, like procalcitonin, which suggests infection.
Imaging: Doctors use scans such as CT or MRI to spot swelling in the brain or other areas. These images help support a diagnosis or rule out other causes.
Spinal Tap (Lumbar Puncture): Doctors use a needle to draw a small amount of cerebrospinal fluid (CSF) from the spine. In meningitis, this fluid often has more white blood cells and protein, and less sugar.
| Symptom | Children | Adults |
|---|---|---|
| High fever | Common | Common |
| Stiff neck | Sometimes | Often |
| Severe headache | Sometimes | Often |
| Nausea/vomiting | Sometimes | Sometimes |
Doctors may use special tests on the spinal fluid to find out which germ is causing the problem. They combine test results with a patient’s symptoms to make a clear diagnosis.
Treatment
Treatment for Bacteria-caused Meningitis
Bacterial meningitis, including types from Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae, needs urgent care. Doctors often start intravenous antibiotics or other broad-spectrum drugs to fight many bacteria.
Once doctors find the specific germ, they may change the antibiotic to target it better. A doctor may also give dexamethasone or other corticosteroids to reduce brain swelling and lower the chance of complications like seizures.
Doctors sometimes give preventive antibiotics to close contacts of patients with meningococcal disease or other dangerous infections.
Therapy for Viruses That Cause Meningitis
Viral meningitis, sometimes called aseptic meningitis, usually heals without specific medicine. People often need rest, fluids, and pain relievers to manage fever and aches.
Most cases come from enteroviruses, but other viruses like herpes simplex can also cause it. Doctors may use antiviral drugs if herpes viruses are the cause.
At-Home Care Options
- Bed rest
- Drink plenty of fluids
- Use over-the-counter medicine for pain and fever
Approaches for Other Meningitis Types
Fungal meningitis, like cryptococcal meningitis, needs special antifungal drugs. If Mycobacterium tuberculosis causes meningitis, doctors use a mix of antibiotics for several months.
Parasitic meningitis is rare and needs different treatment. Sometimes, meningitis links to cancer, allergies, or autoimmune diseases. In these cases, doctors focus treatment on the underlying problem and may use steroids or other medicines.
For some rare cases, doctors wait for lab results before starting medicine to avoid side effects from strong drugs. In certain mild cases, the illness may get better without any medication.
Getting Ready for Your Medical Visit
Steps You Can Take Before Your Appointment
Preparing well for a visit about possible meningitis helps the process go smoothly. Here are some helpful steps:
Record Your Symptoms: List all your symptoms and when they started. Include fever, headache, neck stiffness, or other changes like trouble thinking, mood changes, or hearing loss.
Track Your Health and Exposure: Write down places you have been recently, especially if you traveled or moved. List any recent contact with sick people, especially in close spaces like dorms.
Note if you have been around anyone diagnosed with meningitis.
Vaccination Records: Check your vaccination history. List vaccines you have had for diseases like meningitis, including meningococcal, Hib, and pneumococcal vaccines. Bring your records with you.
List of Medicines and Supplements: Write down all medicines, vitamins, or supplements you take. Include the name, dose, and how often you take them.
Take Someone With You: Bring a family member or friend to your appointment. They can take notes or remember details if you feel unwell.
Questions to Ask the Healthcare Team: Prepare your questions. Here are some examples:
| Question | Purpose |
| What tests will I need? | To know what will happen next |
| What treatments are available? | To understand your options |
| Can I pass this illness to others? | To prevent spreading it |
| Am I at risk for long-term problems? | To know what to watch for |
| Should family be protected or get vaccines? | To keep others safe |
- Other Requests: Ask if you need to fast before the appointment or stay afterward for monitoring.
What Your Healthcare Professional Will Likely Ask
Your provider needs detailed information to diagnose and treat you.
Expect questions such as:
- What are your main symptoms, and have they changed?
- Have your symptoms gotten worse or better with time?
Your provider may ask if you were exposed to anyone with meningitis or a similar illness. They may also ask if anyone at home or in your dorm has these symptoms.
You may need to share if you use any medicines that affect your immune system. Your provider might ask about other health issues or allergies to medications.
You may be asked when you last received a meningococcal, Hib, or other vaccine. Your provider may also ask about your family health, travel, and recent group activities.
Be prepared to discuss these topics. This information helps your provider decide on the best care and prevention.
