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Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Meningitis may develop in response to a number of causes, usually bacteria, viruses and other pathogens, but also physical injury, cancer or certain drugs. While some forms of meningitis are mild and resolve on their own, meningitis is a potentially life-threatening condition due to the proximity of the inflammation to the brain and spinal cord. The potential for serious neurological damage or even death necessitates prompt medical attention and evaluation.

What viruses cause viral meningitis?

Viral meningitis is caused by any of a number of different viruses, many of which are associated with other diseases. About half of the cases in the United States are caused by common intestinal viruses. Occasionally, children with mumps or herpes virus infection develop viral meningitis. Mosquito-borne viruses also cause some cases each year. In many cases, a specific virus cannot be identified.

Many different types of bacteria can cause bacterial meningitis. In newborns, the most common causes are Group B streptococcus, Escherichia coli, and Listeria monocytogenes. In older kids, Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are more often the causes.

What are the symptoms?

About 25% of those who develop meningitis have symptoms that develop over 24 hours. The remainder generally become ill over one to seven days. Occasionally, if someone has been on antibiotics for another infection, the symptoms can take longer to develop or may be less intense. If someone is developing fungal meningitis (most commonly someone who is HIV positive), the symptoms may take weeks to develop.

The most common symptoms among teens and young adults are:

A stiff and painful neck, especially when you try to touch your chin to your chest.

Fever.

Headache.

Vomiting.

Trouble staying awake.

How is viral meningitis diagnosed?

Viral meningitis is usually diagnosed by laboratory tests of spinal fluid obtained with a spinal tap. The specific cause of viral meningitis can be determined by tests that identify the virus in specimens collected from the patient, but these tests are rarely done.All types of meningitis are diagnosed by growing bacteria from a sample of the infected person's spinal fluid, which is collected by performing a lumbar puncture (spinal tap). Results show whether or not the cerebral spinal fluid (CSF) has increased white blood cells. Blood tests are also conducted to determine whether or not there is a significant increase or decrease in the white blood cell count.

Should a person with viral meningitis be isolated?

Strict isolation is not necessary. Since most cases are due to enteroviruses that may be passed in the stool, people diagnosed with viral meningitis should be instructed to thoroughly wash their hands after using the toilet.

Treatment Overview

Most people with viral meningitis usually start getting better within 3 days of feeling sick and recover within 2 weeks. However, it is important to see your health professional if symptoms of meningitis develop so that he or she can rule out bacterial meningitis, which is more serious. With mild cases of viral meningitis, you may only need home treatment, including fluids to prevent dehydration and medicine to control pain and fever.

There is no treatment for viral meningitis. The immune system, however, will produce antibodies to destroy the virus.

Until it is known that a child has viral, not bacterial meningitis, he or she will be admitted to the hospital. But once the diagnosis of viral meningitis is made, antibiotics are stopped, and a child who is recovering satisfactorily will be sent home.