Inflamed meninges turn headache and stiff neck into emergency
When the membranes wrapping brain and spinal cord swell, fever, crushing headache, vomiting, and a rigid neck often follow; light or noise can become unbearable. Young children may show only vague distress. Nearness to the central nervous system makes delay dangerous.
Meningitis is inflammation of the meninges, the membranes wrapping the brain and spinal cord; the name joins Greek meninx, membrane, with the suffix for inflammation. Viruses cause most cases, with bacteria, fungi, and parasites behind the rest, and cancer, bleeding beneath the brain’s lining, sarcoidosis, and some drugs can trigger it too. Because the swelling sits so close to the nervous system, it is treated as an emergency, and a lumbar puncture that draws spinal fluid can confirm or rule it out.
In adults with bacterial meningitis, severe headache appears in almost 90% of cases and neck stiffness in about 70%. The textbook trio of stiff neck, sudden high fever, and confusion is complete in only 44–46% of patients, though the absence of all three makes the disease very unlikely. Kernig’s and Brudziński’s signs rarely show up in other illnesses but miss many cases. Babies may only seem irritable, with a bulging soft spot on the skull, and meningococcal infection can announce itself with purple-red spots that do not fade under a pressed glass.
The culprits shift with age. Newborns catch group B streptococci, E. coli, or Listeria from badly prepared food; in adults, meningococcus and pneumococcus cause 80% of bacterial cases. Skull fractures account for about 59% of recurrent cases. Treatment starts with prompt antibiotics, sometimes antivirals and corticosteroids, and vaccines against meningococcus, mumps, pneumococcus, and Hib prevent some forms. Survivors can be left with deafness, epilepsy, hydrocephalus, or cognitive problems.
About 7.7 million people were diagnosed worldwide in 2019 and 236,000 died, compared with 433,000 deaths back in 1990. Properly treated, bacterial meningitis kills fewer than 15% of patients. Outbreaks sweep sub-Saharan Africa’s meningitis belt each year between December and June.
Source: Meningitis
