Adult Meningitis: Symptoms, Causes, and Further Details
Meningitis is a serious condition that affects the meninges, the protective membranes surrounding the brain and spinal cord. This inflammation can be caused by a variety of pathogens such as viruses, bacteria, fungi, parasites, or noninfectious factors like cancer, autoimmune disorders, reactions to medication, head trauma, and brain surgery.
Viral Meningitis
Viral meningitis is the most common type, often caused by enteroviruses and herpes simplex virus (HSV). Other viruses such as varicella-zoster virus (VZV) can also cause meningitis. Fortunately, viral meningitis usually resolves on its own within a week and leaves no lasting complications. However, herpesvirus infections (e.g., HSV) can be more serious and require prompt antiviral treatment with intravenous acyclovir to prevent serious complications and death.
Bacterial Meningitis
Bacterial meningitis is a medical emergency and requires rapid empiric antibiotic therapy. Common bacterial pathogens include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Group B Streptococcus, and Listeria monocytogenes. The prevalence of these bacteria varies based on age and health status. Bacterial meningitis typically has an acute and severe onset and may rapidly progress to serious complications if left untreated.
In urgent circumstances, a doctor will assume a person has bacterial meningitis and immediately treat them with antibiotics. People over the age of 50 years or those with weakened immune systems will also receive ceftriaxone IV or vancomycin IV, but a doctor may also consider ampicillin IV for bacterial meningitis. To reduce meningeal inflammation, a person may receive steroid therapy for bacterial meningitis, but more research is necessary to determine whether steroids are an effective and safe method to treat bacterial meningitis.
Fungal Meningitis
Fungal meningitis is less common and mainly occurs in immunocompromised adults such as those with HIV/AIDS, cancer, or organ transplants. A typical cause is Cryptococcus species, which can be inhaled from the environment. Fungal meningitis develops more slowly, often presenting as chronic meningitis with symptoms lasting more than four weeks. It requires prolonged, intensive antifungal treatment starting with intravenous amphotericin B followed by oral antifungals such as fluconazole. Treatment duration can extend for weeks or months.
Symptoms
Common symptoms across all types of meningitis include fever, headache, neck stiffness, and neurological changes such as altered mental state or seizures. The classic triad in meningitis is fever, meningismus (neck stiffness and inability to flex the neck), and altered mental status, but this occurs in less than half of adult cases. Symptoms in very young children may differ from adults and can be more severe.
Diagnosis and Complications
Diagnosis requires a lumbar puncture to analyze cerebrospinal fluid (CSF), including PCR, culture, and other microbiological studies. Imaging with CT scan of the head may be recommended before lumbar puncture if increased intracranial pressure is suspected.
Bacterial meningitis can lead to neurological deficits (e.g., hearing loss), organ damage (e.g., Waterhouse-Friderichsen syndrome in meningococcal cases), and death if untreated. Viral meningitis is usually less severe but herpesvirus infections can cause serious outcomes without timely antiviral treatment. Fungal meningitis has a serious prognosis in immunocompromised hosts and requires long-term management.
Vaccination against common bacterial pathogens (e.g., meningococcal, pneumococcal, and Haemophilus influenzae type b vaccines) and prophylaxis for contacts exposed to bacterial meningitis are important prevention measures.
In summary, bacterial meningitis requires urgent antibiotic treatment, viral meningitis mostly needs supportive care except for herpesvirus where antivirals are essential, and fungal meningitis demands prolonged antifungal therapy primarily in patients with weakened immune systems. Diagnosis hinges on CSF analysis from lumbar puncture.
- Meningitis is a serious condition that affects the protective membranes surrounding the brain and spinal cord, often caused by viruses such as enteroviruses and herpes simplex virus (HSV).
- Bacterial meningitis is a medical emergency, typically caused by Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Group B Streptococcus, or Listeria monocytogenes.
- Fungal meningitis, less common, mainly occurs in immunocompromised adults, with Cryptococcus species being a typical cause.
- Viral meningitis usually resolves on its own within a week and leaves no lasting complications, but herpesvirus infections can be more serious and require prompt antiviral treatment.
- In urgent circumstances, a doctor will treat a person with suspected bacterial meningitis with empiric antibiotics, and may also consider ampicillin IV, ceftriaxone IV, or vancomycin IV.
- To reduce meningeal inflammation for bacterial meningitis, a person may receive steroid therapy, but more research is necessary to determine its effectiveness and safety.
- Fungal meningitis develops more slowly, often presenting as chronic meningitis with symptoms lasting more than four weeks, and requires prolonged, intensive antifungal treatment.
- Common symptoms across all types of meningitis include fever, headache, neck stiffness, and neurological changes such as altered mental state or seizures.
- Vaccination against common bacterial pathogens and prophylaxis for contacts exposed to bacterial meningitis are important prevention measures.
- Chronic diseases like cancer and autoimmune disorders can also cause meningitis in noninfectious factors.
- Changes in health and wellness can affect multiple areas of the body, such as respiratory conditions, digestive health, eye health, hearing, skin care, and cardiovascular health.
- In treating meningitis and other medical-conditions, therapies and treatments like CBD and cbd-based products may play a role in maintaining overall health and reducing inflammation in the body.
