Meningitis

Diagnosis

A healthcare professional can diagnose meningitis based on a medical history, a physical exam and certain tests.

Common tests to diagnose meningitis include:

• Blood cultures. A blood sample goes into a special dish to see if it grows germs such as bacteria. This is called a blood culture. A sample also can go on a slide that's stained. Study under a microscope can show whether there are germs.
• Imaging. CT or MRI scans of the head may show swelling or irritation. X-rays or CT scans of the chest or sinuses may show an infection that may be linked to meningitis.

• Spinal tap. This procedure collects fluid from around the spine. In people with meningitis, the fluid often shows a low sugar level along with a higher white blood cell count and more protein.

  Studying the fluid also may help show which germ caused the meningitis. For viral meningitis, you may need a DNA-based test known as a polymerase chain reaction amplification. You also may have other tests.

Treatment

Treatment depends on the type of meningitis.

Bacterial meningitis

New-onset bacterial meningitis needs treatment right away with antibiotics given through a vein, called intravenous antibiotics. Sometimes corticosteroids are part of the treatment. This helps you recover and cuts the risk of complications, such as brain swelling and seizures.

The antibiotic or mix of antibiotics depends on the type of germ causing the infection. Until your healthcare professional knows the exact cause of the meningitis, you may get a broad-spectrum antibiotic that fights a range of germs.

Your healthcare professional may prescribe corticosteroids to reduce swelling in the brain and a medicine to control seizures. If a herpes virus caused your meningitis, you may get an antiviral medicine.

Viral meningitis

Antibiotics can't cure viral meningitis. Viral meningitis tends to get better in a few weeks. Treatment of mild viral meningitis includes:

• Bed rest.
• Plenty of fluids.
• Pain medicine to help reduce fever and relieve body aches.

Other types of meningitis

If the cause of your meningitis is not known, you may need to wait to start antibiotic treatment until your healthcare professional finds the cause.

Treatment for ongoing meningitis, called chronic meningitis, depends on the cause.

Antifungal medicines treat fungal meningitis. A mix of antibiotics can treat tuberculous meningitis. But these medicines can have serious side effects. So you might wait for treatment until a lab confirms that the cause is fungal or tuberculous.

Corticosteroids may treat meningitis due to allergic reaction or autoimmune disease. Sometimes, you don't need treatment because the condition clears up on its own. Cancer-related meningitis needs treatment for the cancer.

Preparing for your appointment

Some types of meningitis can lead to death. If you've been around bacterial meningitis and you get symptoms, go to an emergency room. Tell the healthcare team that you may have meningitis.

If you're not sure what you have and you call your healthcare professional for an appointment, here's how to prepare for your visit.

What you can do

• Find out what to do before or after your appointment. Ask if you need to do anything before your appointment, such as restrict your diet. Also ask if you may need to stay at the office to be watched after certain tests.
• Write down your symptoms. Include changes in your mood, thinking or behavior. Note when you got each symptom. Note whether you had symptoms that felt like a cold or a flu.
• Write down key personal facts. Include recent moves, travel or being around animals. If you're a college student, include information about any roommates and dorm mates who have been sick with symptoms like yours. Also tell your vaccination history.
• Make a list of all medicines, vitamins or supplements you take. Include doses.
• Take a family member or friend with you. Meningitis can be a medical emergency. Take someone who can help remember all the facts you might get and who can stay with you if needed.
• Write down questions to ask your healthcare professional.

For meningitis, some basic questions to ask include:

• What tests do I need?
• What treatment do you suggest?
• Am I at risk of long-term complications?
• If antibiotics won't treat my condition, what can I do to get better?
• Can I pass this condition to others? Do I need to be alone?
• What is the risk to my family members? Should they take something to prevent them from getting this condition?
• Do you have any printed information I can have? What websites do you suggest?

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• How bad are your symptoms? Do they seem to be getting worse?
• Does anything seem to make your symptoms better?
• Have you been around anyone with meningitis?
• Does anyone in your household have symptoms like yours?
• Do you take medicines that suppress your immune system?
• Do you have other health concerns? Are you allergic to any medicines?