Frequent Symptoms
Fever, a stiff neck, and a change in mental status make up the classic triad of meningitis symptoms, though there are others that often occur.
The following symptoms are very common with meningitis, and they tend to be the earliest symptoms of the illness. Some of these are also common with other bacterial and viral infections. You may experience any combination of these symptoms:
Low-grade fever: Fever can be low grade or high grade. Headaches: Headaches may be severe, but they can also cause mild to moderate pain all over the head; they may be paired with sensitivity to sound and light. Stiff neck: Upper neck pain and stiffness when you move your neck are usually present; it typically does not improve when you change the position of your neck. Muscle aches: You may experience soreness and tenderness all over the body that is similar to that of other infections. Fatigue: A sense of feeling worn out and exhausted, even with minimal effort, is typical. Sleepiness: You are likely to feel sleepy and may sleep for hours longer than you normally would if you were not sick. Lack of appetite: Often, meningitis is associated with a disinterest in food. Nausea and vomiting: You may experience nausea or vomiting, even if you have a mild case of meningitis. Irritability: Perhaps not surprisingly, mood can be affected by the presence of the above symptoms. Back pain: Back pain caused by meningitis is typically made worse when you bend your legs close to your chest in a fetal position, though it can also be exacerbated by any change in position and it may be present all the time.
Young Infants
In newborns and small infants, the symptoms of meningitis may come on rapidly, within a matter of hours. The classic meningitis symptoms of fever, headache, and neck stiffness may be absent or difficult to detect in very young babies.
Symptoms of meningitis in infants can include:
FussinessExcessive tirednessDiminished eating and drinkingVomiting. A bulging fontanel, the soft spot on a baby’s skull where the bones have not closed yet, due to an increase in pressure inside of the head.
Less Common Symptoms
There are many other symptoms of meningitis beyond the general flu-like ones that occur very early in the course of the illness. These more specific symptoms of meningitis are also more noticeable and are more common with the bacterial, rather than viral, type of the infection.
Rash: Bacterial infections that cause meningitis can also cause a rash. This is particularly common with meningococcal meningitis, which is associated with a rash characterized by tiny, flat, red dots on the skin. These red dots are actually caused by bleeding of tiny blood vessels (capillaries) that result from the spread of the infection outside the nervous system. Confusion: Because meningitis is an infection near the brain, it can cause neurological symptoms such as intermittent confusion and difficulty concentrating and paying attention. Delirium: When meningitis is severe, or when the infection spreads beyond the meninges to the brain, a person can become suddenly, obviously confused and experience behavioral changes. This may progress to the point of becoming incapable of understanding what is going on. Coma: In rare instances, a person with meningitis may lose consciousness and remain in an unconscious state until high-level medical intervention begins to resolve the infection.
Complications
There are a number of significant complications of meningitis; again, these are more common with bacterial meningitis than viral.
These issues can occur when the infection reaches the nerves, spreads to the brain, or involves other areas of the body. Complications of meningitis are more common in very young babies or in people who do not have a healthy immune system, but they can occur in people who are otherwise completely healthy as well.
Hearing loss: Meningitis can involve the nerves that control hearing, causing permanent hearing impairment. It is very unusual for hearing to be affected as an early symptom of meningitis, but it can happen. However, it is a known complication of the infection. Encephalitis: The infection and inflammation of meningitis can spread to the brain, resulting in a condition called encephalitis. Encephalitis is the infection of the brain itself, and it causes a range of symptoms and effects that may be long-lasting. Examples of long-term changes that can result from encephalitis include fatigue, trouble sleeping, a decline in cognitive function, and vision changes. Seizures: The infection and inflammation of meningitis can reach the brain. This usually occurs when meningitis advances to encephalitis, but it can happen in cases that don’t. Irritation of the tissue in some areas of the brain can cause the electrical activity to become dysfunctional, resulting in seizures. Septicemia: Septicemia is the spread of an infection in the blood. It is a serious complication that may be accompanied by rapid circulatory collapse, which means that the body does not receive enough blood and oxygen. This is often accompanied by organ failure. Meningococcal meningitis, in particular, is associated with septicemia, which can be fatal. Stroke: While it is not common, the inflammatory reaction of meningitis can predispose individuals to blood clots, causing a stroke. Death: Meningitis can progress, causing an especially aggressive infection with signs that may appear gradually or rapidly. For example, meningitis can result in a slow development of excessive swelling in and around the brain. This may cause a dangerous condition called brain herniation, in which the brainstem (the lower part of the brain) becomes squeezed into the spinal canal. When this happens, respiratory arrest can occur and may result in death if emergency medical care is not available—sometimes even when it is.
When to See a Healthcare Provider
If you have meningitis, you need to be treated for it. Your healthcare provider must follow your illness in order to help prevent complications, if possible.
If you have any of the following signs or symptoms, you should seek medical attention:
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Headaches: If you experience new headaches or a different type of a headache than headaches that you have experienced before, you should seek medical attention promptly. Fevers: High fevers that persist or are accompanied by other symptoms of meningitis could mean that you have meningitis, encephalitis, or another serious illness. Stiff neck: This symptom is typical of meningitis and is not otherwise common for children. If you or your child experience any new symptoms of stiffness or pain in your neck, seek prompt medical attention. Seizures: If you experience involuntary movements of your body, convulsions, “spacing out,” or episodes of which you are unaware of your surroundings, this could be a seizure. Any new seizure requires urgent medical care, even if you feel better after the episode. Rash with fever: A rash with a fever, headache, and stiff neck is the trademark of meningococcal meningitis, a bacterial infection that can progress rapidly. Confusion: If you become confused, have trouble concentrating, or cannot pay attention, you must get medical assistance promptly. Passing out: If you or your child loses consciousness, this may be meningitis or another illness that requires urgent medical care.
