Meningitis is inflammation of the membranes (meninges) covering the brain and the spinal cord. Although the most common causes are infection (bacterial, viral, fungal or parasitic), chemical agents and even tumor cells may cause meningitis. Meningitis can produce a wide range of symptoms including fever, headache or confusion and in extreme cases, deafness, brain damage, stroke, seizures or even death. Encephalitis and brain abscess can complicate infective meningitis.
The classical symptoms of meningitis are headache, neck stiffness and photophobia (intolerance of bright light); the trio is called meningism. Fever and chills are often present, along with myalgia. An altered state of consciousness or other neurological deficits may be present depending on the severity of the disease. In meningococcal meningitis or septicaemia, a petechial rash may appear. A lumbar puncture to obtain cerebrospinal fluid (CSF) is usually indicated to determine the cause and direct appropriate treatment.
Convulsions and hydrocephalus are known complications of meningitis.
Bacterial Meningitis has a high mortality rate if it goes untreated and is thus a severe medical emergency. All suspected cases, however mild, need emergency medical attention. Early treatment of bacterial meningitis is important to its outcome. Strong doses of general antibiotics may be prescribed first, followed by intravenous antibiotics in more severe cases. Broad spectrum antibiotics should be started even before the culture results are available, on the presumption that all cases are bacterial in nature, until otherwise proven. If lumbar puncture can not be performed because of raised intracranial pressure (likely due to edema or concomitant brain abscess), a broad spectrum intravenous antibiotic should be started immediately (this is often a third generation cephalosporin or, in less affluent countries, chloramphenicol). When cerebrospinal fluid gram stain, or blood or CSF culture and sensitivity results, are available and confirm the bacterial nature of the infection, then the empiric treatment can be refined by switching to more specific antibiotics. Appropriate antibiotic treatment for most types of meningitis can reduce the risk of dying from the disease to below 15 percent.