Meningitis

The signs of meningitis can appear very quickly, sometimes in just a few hours. They differ depending on the age of the person affected. In adults and older children, the most common symptoms are sudden high fever, severe headache, neck stiffness, nausea or vomiting, sensitivity to light, unusual drowsiness, or confusion. In some cases, a rash (petechiae/purpura—an absolute warning sign) may also be observed, especially in cases of meningococcal meningitis.

In children and babies, the symptoms are often less typical. A baby with meningitis may refuse to feed, cry unusually, be difficult to wake up, seem less alert than usual, or vomit. An important sign to watch for is a bulging fontanelle: the fontanelle is the soft spot on the top of an infant's skull, where the bones have not yet completely fused. In cases of meningitis, this area may appear tense or bulging, indicating abnormal pressure inside the skull. This is a warning sign that requires immediate medical attention.

Meningitis can be caused by infectious agents—bacteria, viruses, fungi, parasites—or be secondary to non-infectious causes such as autoimmune diseases, certain medications, or cancers.

Bacterial meningitis: This is generally the most serious form. The bacteria most frequently involved are Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), Haemophilus influenzae type b, Listeria monocytogenes, E. coli, and Streptococcus agalactiae (group B streptococcus).

Viral meningitis: This is generally less severe. Enteroviruses are the main culprits, followed by mumps, herpes, measles, influenza, HIV, and West Nile virus.

Fungal meningitis: Rare, it mainly affects immunocompromised individuals and is often caused by Cryptococcus neoformans. Its development can be slow and symptoms may only appear after several weeks. Although treatable, fungal meningitis recurs in nearly half of those affected.

Parasitic meningitis: Like and cerebral malaria, these are even rarer. Amoeba infections, also rare, are often linked to swimming in fresh water and can be rapidly fatal.

Non-infectious meningitis: Some forms are linked to inflammatory reactions, cancer, or medication use (e.g., nonsteroidal anti-inflammatory drugs).

Meningitis can affect anyone, at any age. However, certain groups are at greater risk than others. Infants under 2 months of age are particularly vulnerable because their immune systems are not yet fully developed. In this age group, bacterial meningitis is rare but potentially serious.

Young children, adolescents, and young adults living in communities are more often exposed to the bacteria that cause meningitis. Similarly, people with weakened immune systems, for example due to chronic illness, HIV infection, or immunosuppressive treatment, are more at risk.

Failure to follow vaccination schedules is also a significant risk factor. Vaccines against pneumococcus, meningococcus, and Haemophilus influenzae type b (Hib) have drastically reduced the number of meningitis cases, but remain essential for protecting young children.

When symptoms are suggestive, the diagnosis of meningitis is based on a series of clinical and biological tests. The doctor's first step is to assess the patient's general condition, neurological signs, and response to stimuli.

The standard test is a lumbar puncture. This procedure involves inserting a thin needle between two vertebrae to withdraw a small amount of cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord. This fluid is then analyzed in a laboratory to check for the presence of bacteria, viruses, or inflammation. 

Other tests may be performed to supplement the analysis: blood tests, urine tests, or even imaging (CT scan or MRI) if high intracranial pressure is suspected or if there are atypical neurological signs.

Treatment depends on the identified cause. If it is bacterial meningitis, immediate hospitalization is necessary. Antibiotics are administered intravenously, often as soon as clinical suspicion arises, without waiting for final results. This rapid treatment can make all the difference. Sometimes, a corticosteroid such as dexamethasone is added to reduce brain inflammation and lower the risk of complications, particularly hearing problems.
In cases of meningococcal meningitis, isolation is implemented in the initial phase to prevent transmission.

On the other hand, viral meningitis is often benign. It primarily requires rest, good hydration, and sometimes medication to relieve symptoms (fever, pain). Antiviral drugs are only prescribed in certain specific cases, such as meningitis caused by the herpes virus.

Fungal and parasitic meningitis, which are rarer, require specific treatments, such as antifungal or antiparasitic drugs.

Meningitis, especially in its bacterial form, can lead to serious complications, even after appropriate treatment. This is why rapid treatment is essential. Without treatment, the outcome can be fatal. But even when treated properly, the disease can leave lasting effects.
Possible consequences include partial or total hearing loss, memory, attention, or language problems, difficulty walking or concentrating, or persistent seizures. Some children may develop learning or developmental disorders after meningitis.
In the most severe cases, irreversible brain damage can occur. A severe bacterial infection can also lead to sepsis, an extreme response by the body that can damage organs and even lead to amputations.

Prevention starts with vaccination. Several vaccines are available and widely recommended from an early age. They protect against the most serious forms of bacterial meningitis, particularly those caused by meningococcus, pneumococcus, and Haemophilus influenzae type b (Hib). 

It is also essential to practice good hygiene. Washing your hands regularly, avoiding sharing personal items such as glasses, cutlery, or toothbrushes, and covering your mouth when coughing or sneezing are all simple but effective measures.

For people who have been in close contact with someone with meningococcal meningitis, preventive antibiotics may be prescribed within hours. This reduces the risk of transmission of the bacteria, even if no symptoms are present.

Meningitis is a medical emergency. If a person has a high fever accompanied by unusual headaches, neck stiffness, drowsiness, or confusion, do not wait. These signs, especially when associated with vomiting or an unexplained rash, require emergency treatment.

In infants, particular attention should be paid. Marked irritability, difficulty feeding, unusual behavior, or excessive drowsiness should prompt immediate consultation. A bulging fontanelle or convulsions are also alarming signs.
If in doubt, the reflex should be to go to the emergency room quickly.

Hôpital de La Tour has all the necessary expertise and infrastructure to provide rapid, comprehensive, and safe treatment for cases of meningitis. If meningitis is suspected, patients can go directly to the emergency department, which is open 24 hours a day, 7 days a week.
The assessment is based on rigorous clinical expertise. If bacterial meningitis is confirmed or strongly suspected, antibiotic treatment is initiated without delay.

Hôpital de La Tour also offers specialized follow-up care after the acute phase, including hearing, neuropsychological, or neurological assessments, depending on the patient's progress. Care is coordinated by pediatricians or internists, in collaboration with infectious disease specialists, neurologists, and family doctors.

What exactly is meningitis?
Meningitis is an inflammation of the membranes surrounding the brain and spinal cord, often caused by an infection. It can be bacterial, viral, fungal, or parasitic in origin.

Is meningitis contagious?
Yes, some forms are, particularly those caused by meningococcus. It is transmitted through saliva, respiratory droplets, or close contact.

What should you do if a case is reported in your circle (family, work, school, etc.)?
Contact your doctor to assess the need for preventive antibiotic treatment. This treatment is recommended for close contacts: family, daycare, saliva contacts. Vaccination may be offered depending on the germ identified. Watch for symptoms (fever, headache, stiff neck, rash, etc.) within 10 days of contact. If in doubt, seek medical advice immediately.

How long does it take to recover from meningitis?
It all depends on the cause. Viral meningitis can be cured in 1 to 2 weeks. Bacterial meningitis requires hospitalization and may require several weeks of convalescence.

Is there a vaccine against meningitis?
Yes. Several vaccines exist against the bacteria responsible: meningococcus, pneumococcus, and Haemophilus influenzae type b (Hib). According to the recommendations of the FOPH (2024 vaccination plan), MenB (Bexsero) and MenACWY (Nimenrix, Menveo, or MenQuadfi) are recommended.

Are children at greater risk?
Yes. Their immune systems are still immature, making them more vulnerable, especially children under the age of 5.

Can meningitis come back?
It is rare, but some viral forms can recur, especially if the immune system is weakened.

How can you tell if a baby has meningitis?
Signs may include a bulging fontanelle, unusual irritability, loss of appetite, or excessive sleepiness.

Is a lumbar puncture always necessary?
Not systematically, but it is the gold standard test for making a diagnosis and determining the source of the infection.