Meningitis is an infection that affects the meninges – the tissue covering the brain and spinal cord. This information sheet from Great Ormond Street Hospital (GOSH) explains the causes, symptoms and treatment of meningitis and where to get help.

There are two types of meningitis – bacterial, which is rarer and tends to be more severe and viral, which is more common. Meningitis can affect anyone of any age but is usually more common in children and young people.

What causes meningitis?

  • Bacterial meningitis is caused by bacteria, which are spread through the air by coughing and sneezing or by contact with skin or surfaces. It is most common in children under a year old and in teenagers.
  • Viral meningitis is caused by a virus, tends to have milder symptoms and is more common during the summer.
It is impossible to tell which type of germ is causing the meningitis without laboratory tests. Vaccination such as the measles, mumps and rubella (MMR) vaccine and Meningitis C vaccination have had a great impact on the numbers of people developing meningitis. However, they are only effective if children and young people receive them as part of their routine vaccination schedule.

What are the signs and symptoms of meningitis?

The main symptoms of meningitis (both bacterial and viral) are similar and include:

  • High temperature
  • Severe headache
  • Vomiting
  • Stiff neck
  • Aversion to light
  • Drowsiness
The most commonly known symptom of meningitis is a distinctive rash, although this does not affect everyone and may not be visible when the other symptoms develop. If a rash develops, it is important to use a glass to press on the rash – if it does not fade, immediate medical help should be sought.

How is meningitis diagnosed?

Meningitis can be difficult to diagnose as the initial symptoms are quite similar to other illnesses such as influenza. Once meningitis is suspected, blood samples will be taken to work out whether a bacterium or virus is causing the condition. A lumbar puncture will also be taken to check whether the germs have travelled to the cerebro-spinal fluid (CSF) that surrounds the brain and spinal cord inside the meninges. A lumbar puncture may be delayed if there is a severe headache as draining off the CSF may make symptoms worse.

How is meningitis treated?

The symptoms of viral meningitis tend to be milder than those of bacterial meningitis so may not require any treatment other than rest and pain relief.

Severe viral meningitis and all bacterial meningitis will require treatment in hospital. Usually intravenous antibiotics will be started on admission – although they will be stopped if the laboratory tests show that a virus caused the infection – and will continue for a week or so. Steroids may also be prescribed to reduce any swelling of the meninges, which could put pressure on the brain and spinal cord. Intensive care may be needed to allow the body to rest and heal while being closely monitored for any complications.

What happens next? 

Hearing loss also affects a number of children. Children who develop septicaemia alongside meningitis may develop tissue death (gangrene) affecting their extremities such as fingers and toes. In severe cases, this may lead to amputation.

Last review date:
July 2014