Symptoms of Meningitis

Stiff neck
JGI/Tom Grill/Blend Images/Getty Images

Meningitis causes symptoms that often seem similar to those of a flu. Symptoms that are highly suggestive of meningitis include a fever, accompanied by stiff neck and headaches with sensitivity to sounds and light. When meningitis is severe, or if it becomes advanced, it is more likely to cause symptoms that correspond with the inflammation surrounding the brain, such as confusion or seizures.

 

Frequent Symptoms

Meningitis is associated with a classic triad of symptoms that consists of fever, headache​s, and a stiff neck. Other symptoms commonly occur with meningitis as well. But, the most common symptoms of meningitis are generally also the most vague, as they also occur with many other bacterial or viral infections, even those that do not involve the lining brain. 

The following symptoms are very common with meningitis, and they tend to be the earliest symptoms of the illness. You may experience any combination of these symptoms if you have meningitis. 

  • Low grade fever: If you or your child has meningitis, the fever can be below 100 degrees fahrenheit. A low grade fever may make it less likely for you to notice the illness. 
  • Headaches: Headaches may be severe, but they can cause a mild to moderate pain all over the head, and may be associated with sensitivity to sound and light.
  • Stiff neck: Upper neck pain and stiffness when you move your neck is usually present with meningitis, and 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 if you have meningitis, and this is similar to the muscle aches and pains of other infections. 
  • Fatigue: A sense of feeling worn out and exhausted, even with minimal effort, is typical of meningitis.
  • Sleepiness: If you have meningitis, you are likely to feel sleepy and you 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: With the headache, light and sound sensitivity, stiff neck and fatigue, you or your child may become irritable when sick with meningitis. 

Less Common Symptoms

There are many other symptoms of meningitis that are less common than the general flu-like symptoms that occur very early in the course of the illness. These more specific symptoms of meningitis are also more noticeable. 

  • High fever: Meningitis can cause high fevers above 100 degrees fahrenheit, or even above 103 degrees. 
  • Back pain: Back pain caused by meningitis is typically made worse when you bend your legs close to your chest in a fetal position. But back the back pain that you may experience if you have meningitis can be exacerbated by any change in position, and it may be present all the time. 
  • Rash: Bacterial infections that cause meningitis can also cause a rash. This is particularly common with meningococcal meningitis, which is associated with a rash that is 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 and obviously confused, with 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 may 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. These 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 completely healthy as well.

A large part of the medical management of meningitis is focused on preventing these complications, and detecting them as early as possible. If you experience any of these complications, you must seek medical help immediately.

  • Hearing loss: Involvement of the nerves that control hearing can occur as a result of meningitis, 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 infection of the brain itself, and it causes a range of symptoms and effects, which 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 sometimes it can happen with meningitis that is not complicated with encephalitis. Irritation of the brain tissue in some areas of the brain can cause the electrical activity in the brain 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 to blood clots, causing a stroke. 

When to See a Doctor

If you have meningitis, you need to be treated for it, and your doctor must be aware of your illness in order to be able to prevent complications if possible.

If you have any of the following signs or symptoms, you should seek medical attention:

  • Headaches: If you experience new headaches or a different type of headache than headaches that you have experienced before, you should seek medical attention promptly. 
  • Fevers: High fevers above 100 degrees fahrenheit, or fevers accompanied by other symptoms of meningitis could mean that you have meningitis, encephalitis, or another serious illness. 
  • Stiff neck: A stiff neck or painful neck is not usual for healthy children, or for adults who do not normally experience pain of the neck muscles. If you or your child experiences any new symptoms of stiffness or pain in your neck, you should seek prompt medical attention. 
  • Seizures: If you experience involuntary movements of your body, convulsions, spacing out, or episodes during 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, headaches 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.  
  • Back pain: Back pain, particularly with bending your legs, is one of the signs of meningitis, and could also indicate another serious problem, so you should get medical attention without delay. 
  • Passing out: If you or your child loses consciousness, this may be meningitis or another illness that requires urgent medical care

Sources:

Dougherty MJ, Smith AT. Acute streptococcal meningitis presenting as bilateral conductive hearing loss. Am J Emerg Med. 2018 Apr 5. pii: S0735-6757(18)30284-5. doi: 10.1016/j.ajem.2018.04.009. [Epub ahead of print]

Lee JJ, Lien CY, Chien CC, et al. Anaerobic bacterial meningitis in adults. J Clin Neurosci. 2018 Apr;50:45-50. doi: 10.1016/j.jocn.2018.01.014. Epub 2018 Feb 1.

Misra UK, Kalita J, Kumar M, Neyaz Z. Hypovolemia due to cerebral salt wasting may contribute to stroke in tuberculous meningitis. QJM. 2018 Apr 9. doi: 10.1093/qjmed/hcy072. [Epub ahead of print]