Health Encyclopedia

Meningitis - meningococcal

Definition

Meningococcal meningitis is an infection that causes swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.

Alternative Names

Meningococcal meningitis

Causes, incidence, and risk factors

Meningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus).

Most cases of meningococcal meningitis occur in children. Meningococcus is the most common cause of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.

The infection occurs more often in winter or spring. It may cause local epidemics at boarding schools, college dormitories, or military bases.

Risk factors include recent exposure to meningococcal meningitis and a recent upper respiratory infection.

Symptoms

The disease may come on quickly, and may start with an upper respiratory infection or sore throat.

Symptoms include:

High fever
Mental status changes
Nausea
Purple, bruise-like areas (purpura)
Rash, pinpoint red spots (petechiae)
Sensitivity to light (photophobia)
Severe headache
Severe general ill feeling (malaise)
Stiff neck
Vomiting

Signs and tests

Physical examination will show:

Fast heart rate
Low blood pressure
Possible rash
Stiff neck

For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.

Tests may include:

Treatment

Antibiotics such as ceftriaxone are prescribed and given through the arm by IV (intravenous line). Other medicines may be used to treat the complications from increased spinal fluid pressure.

Sometimes steroid medication is used, more often in children than adults.

People in close contact with someone with meningococcal meningitis should be given antibiotics to prevent infection. Such people include:

Household members
Roommates in dormitories
Those who come into close contact with an infected person

Expectations (prognosis)

Early diagnosis and treatment is extremely important to prevent serious illness or death. The death rate ranges from 5% - 15%. Young children and adults over 50 have the highest risk of death.

Complications

Brain damage
Deafness
Hydrocephalus
Increased spinal fluid pressure
Mental retardation
Myocarditis
Paralysis of various muscles
Shock

Calling your health care provider

Go to an emergency room or call the local emergency number (such as 911) if:

You notice symptoms of meningitis
Symptoms get worse or do not improve with treatment
You think you have been exposed to someone with meningitis

Meningitis can quickly become life-threatening.

Prevention

All family and close contacts (especially in health care or school settings) of people with this type of meningitis should begin antibiotic treatment as soon as possible to prevent spread of the infection. Ask your health care provider about this during the first visit.

Close contacts in the same household, school, or day care center should be watched for early signs of the disease as soon as the first case is diagnosed. Always use good hygiene habits, such as washing hands before and after changing a diaper, or after using the bathroom.

Vaccines are effective for controlling epidemics. They are currently recommended for:

College students
Military recruits
Travelers to certain parts of the world

References

Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 437.

Review Date:9/28/2008
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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