In an age of antibiotics and immunizations, most doctors are fairly confident about their ability to prevent and treat many infectious diseases. But one particular infection that is both preventable and treatable--meningitis--still strikes fear in the minds of doctors.
This infection is especially worrisome largely because of its location. Meningitis is an infection of the membranes (called meninges) that surround the brain and spinal cord. The infection can start innocuously but very quickly turn into a life-threatening illness.
The illness typically starts with what appears to be a common and simple bacterial or viral infection of the nose or throat. Like almost all such infections, there may be cold-like symptoms, a mild sore throat or a cough--or there may be no symptoms at all. The problem begins when the bacterium or virus responsible for the illness enters the bloodstream and spreads to the meninges. Then the picture changes dramatically.
In adults, the most common signs of an infection involving the meninges are fever, headache, neck stiffness, nausea and vomiting. Confusion and drowsiness may also occur, and bright lights may hurt the eyes. In infants and small children, however, these classic signs of meningitis may be absent or difficult to detect. The only early signals that a serious infection is developing may be nonspecific ones like irritability, tiredness or poor feeding.
Although the symptoms of bacterial and viral meningitis are similar, their treatment and prognosis are quite different. Bacterial meningitis--the more serious of the two--requires treatment with antibiotics, usually administered intravenously in a hospital.
Bacterial meningitis is also associated with a significant risk of serious complications; about 10% of people who develop meningococcal meningitis die, and another 10% suffer severe complications including hearing loss and mental retardation.
Viral meningitis, however, usually improves with remedies such as acetaminophen or ibuprofen, used to reduce fever and relieve headache. It is rarely fatal in healthy individuals, and the vast majority of patients will recover completely.
Although meningitis is much less contagious than the common cold or flu, it can be spread from one person to another, typically through contact with infected oral secretions such as saliva or sputum (because the infection actually begins in the nose and throat). That's why people living in crowded conditions like college dormitories and military barracks have an increased risk of contracting meningitis. Some forms of viral meningitis are spread through contact with infected fecal material.
