Causes and Treatment of Spinal Meningitis

Medically reviewed by Smita Patel, DO

Spinal meningitis is the inflammation of tissues, called the meninges, that surround and protect the brain and spinal cord. It usually stems from an infection, leading to symptoms such as a stiff neck, fever, and severe headache. There are vaccines to prevent some types of spinal meningitis.

In some cases, spinal meningitis will resolve on its own. Others may be life-threatening and require antibiotics, hospitalization, and other medical treatments to prevent death or permanent disability.

This article explains what spinal meningitis is, including the symptoms, causes, diagnoses, and treatments.

How Do You Get Spinal Meningitis?

The most common type of spinal meningitis is viral meningitis. Other types are bacterial, parasitic, fungal, amoebic, and noninfectious.

Viral Meningitis

A virus causes the most common type of meningitis. Most people who get viral meningitis recover on their own without treatment within seven to 10 days. Non-polio enteroviruses are the most common causes of viral meningitis.

Enteroviruses can be passed through coughing, sneezing, or coming into contact with surfaces or objects contaminated with respiratory secretions.

Bacterial Meningitis

Bacterial meningitis is the most deadly form of spinal meningitis, caused by many different types of bacteria, such as:

• Neisseria meningitidis

• Streptococcus pneumoniae

• Haemophilus influenzae

• Streptococcus agalactiae

The bacteria that cause meningitis are transmitted from person to person through droplets of respiratory secretions from carriers.

After infection, death can occur rapidly, sometimes as quickly as just a few hours. Those who recover may have residual disabilities, including brain damage, learning disabilities, or hearing loss.

Parasitic Meningitis

Parasitic meningitis is much less common than viral or bacterial meningitis. It more commonly affects animals than people. In humans, it usually is caused by eating contaminated food or an infected animal.

The most common cause is an amoeba, known as Naegleria fowleri, which usually enters the body through tissues in the nose. Spinal meningitis caused by this can lead to primary amoebic meningoencephalitis (PAM) which is fatal in nearly all cases.

There are usually fewer than eight cases of amoebic meningitis per year in the United States.

Fungal Meningitis

Fungal meningitis is rare and usually affects people with compromised immune systems. In these people, a local fungal infection can disseminate (spread throughout the body) and quickly cause infection of the meninges.

Possible causes of fungal meningitis include:

• Cryptococcus

• Histoplasma

• Blastomyces

• Coccidioides

• Candida

Fungal meningitis can't be "passed" or "caught" like viral or bacterial meningitis but is rather a condition spurred by a severely weakened immune system.

Noninfectious Meningitis

Noninfectious meningitis causes inflammation in the absence of an infection. Common causes include brain cancer, autoimmune diseases like lupus or rheumatoid arthritis, and traumatic brain injury.

Symptoms of Spinal Meningitis in Adults and Children

Spinal meningitis can be hard to recognize in the early stages and quickly become serious if left untreated. This is especially concerning in young children who may be unable to describe what they are feeling. Knowing the signs can help you seek treatment before the symptoms become severe.

Symptoms of spinal meningitis may include:

• Fever

• Headaches

• Neck stiffness

• Sensitivity to light

• Vomiting

• Confusion or irritability

• Back pain

• Rashes

Additional symptoms that may be seen in babies and small children include:

• Head swelling from fluid buildup

• Irritability and crying

• Refusing to eat

• Rapid grunting

• Unresponsiveness

• Floppy arms

• Bulging fontanelle (soft spot on the top of the head)

Complications of Spinal Meningitis

Some causes of spinal meningitis carry a high risk of mortality death, including bacterial, fungal, and amoebic meningitis.

When left untreated, severe meningitis can cause:

• Hearing loss

• Vision problems

• Seizures

• Limb weakness

• Problems with speech and language

• Confusion and disorientation

• Sepsis

• Coma

Shock, brain damage, and respiratory failure are among the main causes of death in cases like this.

How Spinal Meningitis Is Diagnosed

Diagnosing spinal meningitis usually starts with a physical exam in which your healthcare provider will collect a medical history and ask about your symptoms.

Other diagnostic tests may include:

• Blood tests: Including those that can detect generalized inflammation and infection

• Lumbar puncture: Also known as a "spinal tap," used to evaluate cerebrospinal fluid

• Electroencephalogram (EEG): A noninvasive test that records electrical activity of the brain

• Computed tomography (CT): A type of imaging study that composites multiple X-ray images

• Magnetic resonance imaging (MRI): An imaging study that creates highly detailed images without radiation
  

How Spinal Meningitis Is Treated

Treatment options depend on the type of meningitis. When someone with meningitis becomes severely ill or is at risk for developing severe illness, a hospital stay is essential to preventing complications.

Treatment options include:

• Bacterial meningitis requires starting antibiotics like penicillin, ampicillin, or rifampin as soon as possible. There are also vaccines available to prevent you from getting bacterial meningitis.

• Viral meningitis usually resolves without treatment within one to two weeks. Pain management therapies are often used to manage headache symptoms. Antibiotics do not help.

• Fungal meningitis requires antifungal medications like Diflucan (fluconazole), Sporanox (itraconazole), and amphotericin B.

• Parasitic meningitis has no specific antiparasitic treatment. In cases of amoebic meningitis, a combination of antiviral, antifungals, and antibiotics may be used.

What Is the Survival Rate for Spinal Meningitis?

The prognosis for most people who get meningitis is positive. However, it is very dependent on the type of meningitis someone has. Early treatment is the best way to ensure a good prognosis.

For example, bacterial meningitis can be deadly within days after the onset of symptoms. Without antibiotic treatment, the prognosis is fatal. In addition, delayed treatment increases the risk of permanent brain damage, hearing loss, and learning disabilities.

The rarest type, amoebic meningitis, is usually fatal even with treatment.

Summary

Spinal meningitis is inflammation of the brain and spinal cord due to an infection. Types of meningitis include viral, bacterial, fungal, parasitic, and noninfectious. Symptoms typically include headache, fever, and neck stiffness. Some cases can be fatal, while others resolve on their own.

Treatment depends on the type of meningitis you get but may include antibiotics, antifungals, pain relievers, or hospitalization.

Read the original article on Verywell Health.