Meningitis Complete Guide |
Causes, Symptoms, Diagnosis, Treatment, Prevention, and Complications
1. What is Meningitis?
Meningitis is an inflammation of the protective membranes (meninges) covering the brain and spinal cord. It can be caused by viruses, bacteria, fungi, and non-infectious conditions. Meningitis is a medical emergency requiring rapid treatment.
2. Causes and Transmission
1) Infectious Causes
Viral meningitis is most often caused by enteroviruses, though herpes simplex virus (HSV), measles, varicella, and influenza can also trigger it. Bacterial meningitis is typically caused by Neisseria meningitidis (meningococcus), Streptococcus pneumoniae, or Group B Streptococcus.
2) Non-Infectious Causes
Drug reactions, autoimmune disorders, cancers, or post-traumatic hemorrhage may also lead to meningitis.
3. Symptoms and Clinical Presentation
The classic triad of meningitis includes high fever, severe headache, and neck stiffness (sometimes with photophobia or altered mental status). Children and infants may present with nonspecific symptoms such as irritability, drowsiness, or poor feeding.
1) Risk of Complications
If treatment is delayed, serious complications such as hearing loss, epilepsy, hydrocephalus, and cognitive impairment may occur. In bacterial meningitis, 5~15% of patients may die or suffer permanent disability.
4. Diagnosis and Treatment
1) WHO Global Guidelines 2025
The 2025 WHO guideline emphasizes early diagnosis, immediate treatment, and long-term care. Importantly, antibiotic therapy should not be delayed even before confirmatory testing.
2) Diagnostic Methods
Lumbar puncture for cerebrospinal fluid (CSF) analysis is the gold standard, measuring cell count, protein, glucose, and pathogen testing (PCR, culture). Rapid testing helps improve outcomes.
3) Treatment Approaches
Bacterial meningitis requires immediate intravenous antibiotics and often corticosteroids to reduce neurological complications. Viral meningitis is usually self-limited, but antivirals are indicated in HSV cases. Fungal meningitis requires antifungal therapy.
5. Vaccination and Prevention
Vaccination remains the most effective preventive measure. The MenACWY vaccine is recommended at 11–12 years with a booster at 16 years. Recently approved pentavalent vaccines (Penbraya, Penmenvy) for ages 10–25 broaden protection against multiple meningococcal strains.
6. Global Goals and Policy Directions
The WHO “Defeat Meningitis by 2030” initiative aims to eliminate meningitis epidemics, reduce vaccine-preventable cases by 50%, and lower mortality by 70% worldwide through vaccination programs and rapid access to care.
Meningitis is a life-threatening disease but can be prevented and managed effectively with the latest 2025 guidelines. Early recognition, rapid treatment, vaccination, and global policy cooperation are key strategies to protect individuals and communities.
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