OVERVIEW

What is bacterial meningitis?

The human brain and spinal cord are covered by three layers of membranes, from outer to inner: the dura mater, arachnoid mater, and pia mater, which protect and support the brain and spinal cord.

When bacteria infect these membranes, causing inflammation, bacterial meningitis occurs. The bacteria responsible are usually Streptococcus pneumoniae and Neisseria meningitidis (also called meningococcus).

Among acute bacterial meningitis, one type is called epidemic cerebrospinal meningitis. What does it refer to?

Bacterial meningitis caused by Neisseria meningitidis is abbreviated as "epidemic cerebrospinal meningitis."

Among acute bacterial meningitis, one type called epidemic cerebrospinal meningitis often occurs in which region?

It is widespread in the "meningitis belt" of sub-Saharan Africa, with about 30,000 cases annually, making it the most common infectious disease causing child mortality in developing countries. Due to widespread vaccination, the incidence in China is relatively low.

What are the characteristics of acute bacterial meningitis?

Bacterial meningitis is an acute disease, most common in infants, young children, and adolescents. It progresses rapidly, often worsening soon after symptoms appear.

What are the typical symptoms of acute bacterial meningitis?

The most typical symptoms include fever, stiff neck, headache, vomiting, and even confusion or coma.

What are the consequences of acute bacterial meningitis?

Due to the severity of the disease, the risk of death is high without prompt treatment. Some survivors may experience long-term complications such as intellectual disability or epilepsy.

SYMPTOMS

What are the symptoms of acute bacterial meningitis?

• Cold-like symptoms: After bacterial infection, many people may experience flu-like symptoms such as fever, chills, and lethargy. As a result, some may mistake the early stage of acute bacterial meningitis for a common cold.

• Meningeal irritation signs: The main manifestation is neck stiffness—when the patient lies on their back, others cannot lift their head. However, this symptom may not be obvious in newborns or the elderly.

• Increased intracranial pressure: Patients may experience severe headaches, vomiting, and even drowsiness, coma, or other consciousness disorders.

• Others: Different bacterial infections may cause varying symptoms. For example, when infected with Neisseria meningitidis, patients may develop patchy red rashes that quickly turn into skin petechiae. Some may also exhibit stroke-like symptoms such as hemiplegia or speech impairment.

CAUSES

How is acute bacterial meningitis caused?

The main cause of bacterial meningitis is bacterial infection. The source of infection may be from infections in the heart, lungs, or other organs spreading to the meninges, or through wound infections during brain trauma or brain surgery. Some newborns may be infected during birth through the birth canal.

Is acute bacterial meningitis hereditary?

No.

Is acute bacterial meningitis contagious? How is it transmitted?

Yes.

Especially meningitis caused by Neisseria meningitidis (meningococcal meningitis) can spread widely among populations, usually through respiratory droplets.

Can family members of acute bacterial meningitis patients be infected? How to handle it?

If someone in the household has bacterial meningitis, family members who have had close contact are at high risk of infection. If necessary, they should receive preventive treatment under medical guidance.

DIAGNOSIS

What tests are needed to diagnose acute bacterial meningitis?

• Complete blood count (CBC): A blood test is required to determine whether there is an infection based on indicators such as white blood cell count.

• Lumbar puncture: A needle is inserted into the lower back to extract cerebrospinal fluid for testing, which can identify the specific bacterial infection and also relieve symptoms like headache and vomiting. This test is crucial for diagnosing bacterial meningitis but is invasive, requiring consent from the patient or their family. The patient must remain still during the procedure, and family members may need to provide comfort if necessary. After the puncture, the patient should lie flat without a pillow for a period of time.

• Brain MRI: This helps determine whether there are any intracranial lesions, providing significant assistance in auxiliary diagnosis and prognosis evaluation.

Which diseases have symptoms similar to acute bacterial meningitis? How are they differentiated?

Viral meningitis, tuberculous meningitis, and fungal meningitis all present similarly to bacterial meningitis. Doctors will take a detailed medical history and make a diagnosis based on test results, primarily those from the lumbar puncture.

TREATMENT

How to treat acute bacterial meningitis?

• The most important treatment for bacterial meningitis is the prompt use of antibiotics. Broad-spectrum antibiotics may be administered initially before the specific bacteria causing the infection are identified. Once the causative bacteria are confirmed, targeted antibiotics should be used. A repeat lumbar puncture may be required 24–36 hours after treatment to assess the effectiveness of the medication.

• Corticosteroids may be considered for patients with severe conditions.

• Symptomatic treatments: Antipyretics for fever, and measures to reduce intracranial pressure for patients with elevated intracranial pressure, etc.

Which department should be consulted for acute bacterial meningitis?

Adults should visit the neurology or infectious disease department, newborns should see a neonatologist, and children should visit the pediatrics department.

Is hospital treatment necessary for acute bacterial meningitis?

Yes.

Without treatment, the risk of death is very high, and even survivors may suffer severe complications.

Does acute bacterial meningitis require hospitalization?

Yes, and severe cases may require admission to the intensive care unit (ICU).

What are the common side effects of medications for acute bacterial meningitis?

Many patients may experience allergic reactions to antibiotics or gastrointestinal symptoms such as diarrhea. Doctors typically adjust medications based on the patient's condition and control the duration and dosage of treatment.

Can medications for acute bacterial meningitis be taken long-term?

Long-term antibiotic use is not recommended. After recovery and discharge, patients should discontinue the medication as directed by the doctor.

Can acute bacterial meningitis be cured?

Yes. However, a small number of patients may experience complications such as intellectual disability or epilepsy.

DIET & LIFESTYLE

What should patients with acute bacterial meningitis pay attention to in daily life?

Wash hands frequently, ventilate rooms regularly, maintain personal hygiene, and avoid cross-infection.

Do not share personal items such as towels or toothbrushes with family members to prevent spreading the disease.

Do patients with acute bacterial meningitis need follow-up examinations?

If discharged after full recovery, follow-up examinations are unnecessary.

If sequelae remain, follow-up examinations should be scheduled according to the doctor's advice based on individual conditions.

Does acute bacterial meningitis affect fertility?

No.

Can patients with acute bacterial meningitis fly, engage in strenuous exercise, or travel to high-altitude areas?

Yes, after full recovery. If epilepsy sequelae remain, refer to epilepsy precautions for details. (Click "epilepsy" for more information.)

PREVENTION

How to prevent acute bacterial meningitis?

• Get vaccinated against meningococcal disease. Click to view "Meningococcal Vaccine" for more details.

• Maintain personal hygiene—wash hands frequently, bathe regularly, and change clothes often.

• Ensure proper ventilation even in cold weather, as enclosed environments promote bacterial growth.

• Maintain a balanced diet, avoid picky eating, exercise regularly, and strengthen immunity.

How to prevent sequelae of acute bacterial meningitis?

Seek early treatment and administer antibiotics promptly.