Meningococcal meningitis is an infection that causes swelling and irritation (inflammation) of the membranes covering the brain and spinal cord.

See also:

• Aseptic meningitis
• Meningitis
• Meningitis - cryptococcal
• Meningitis - gram-negative
• Meningitis - H. influenzae
• Meningitis - pneumococcal
• Meningitis - staphylococcal
• Meningitis - tuberculous

Meningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus).

Most cases of meningococcal meningitis occur in children. Meningococcus is the most common cause of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.

The infection occurs more often in winter or spring. It may cause local epidemics at boarding schools, college dormitories, or military bases.

Risk factors include recent exposure to meningococcal meningitis and a recent upper respiratory infection.

The disease may come on quickly, and may start with an upper respiratory infection or sore throat.

Symptoms include:

• High fever
• Mental status changes
• Nausea
• Purple, bruise-like areas (purpura)
• Rash, pinpoint red spots (petechiae)
• Sensitivity to light (photophobia)
• Severe headache
• Severe general ill feeling (malaise)
• Stiff neck
• Vomiting

Physical examination will show:

• Fast heart rate
• Low blood pressure
• Possible rash
• Stiff neck

For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.

Tests may include:

• Blood culture
• CSF culture
• CT scan of the brain
• Special stains of spinal fluid
• White blood cell (WBC) count

Antibiotics such as ceftriaxone are prescribed and given through the arm by IV (intravenous line). Other medicines may be used to treat the complications from increased spinal fluid pressure.

Sometimes steroid medication is used, more often in children than adults.

People in close contact with someone with meningococcal meningitis should be given antibiotics to prevent infection. Such people include:

• Household members
• Roommates in dormitories
• Those who come into close contact with an infected person

Early diagnosis and treatment is extremely important to prevent serious illness or death. The death rate ranges from 5% - 15%. Young children and adults over 50 have the highest risk of death.

• Brain damage
• Deafness
• Hydrocephalus
• Increased spinal fluid pressure
• Mental retardation
• Myocarditis
• Paralysis of various muscles
• Shock

Go to an emergency room or call the local emergency number (such as 911) if:

• You notice symptoms of meningitis
• Symptoms get worse or do not improve with treatment
• You think you have been exposed to someone with meningitis

Meningitis can quickly become life-threatening.

All family and close contacts (especially in health care or school settings) of people with this type of meningitis should begin antibiotic treatment as soon as possible to prevent spread of the infection. Ask your health care provider about this during the first visit.

Close contacts in the same household, school, or day care center should be watched for early signs of the disease as soon as the first case is diagnosed. Always use good hygiene habits, such as washing hands before and after changing a diaper, or after using the bathroom.

Vaccines are effective for controlling epidemics. They are currently recommended for:

• College students
• Military recruits
• Travelers to certain parts of the world

Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 437.