brain, spinal cord, and nerve disorders
Acute Bacterial Meningitis
Symptoms of Acute Bacterial Meningitis
Symptoms of acute bacterial meningitis vary by age. Innewborns and infants,early symptoms usually do not suggest a particular cause. Symptoms most often include A high or low body temperature Feeding problems Vomiting Irritability, such as excessive fussiness or crying that continues or worsens after being comforted and cuddled by the mother or caregiver Smacking the lips, chewing involuntarily, gazing in different directions, or periodically going limp (a type of seizure) Sluggishness or listlessness (lethargy) A high-pitched crying that is unusual for the baby Unlike older children and adults, most newborns and infants do not have a stiff neck. If meningitis becomes severe, the soft spots between skull bones (called fontanelles), which are present in infants before their skull bones grow together, may bulge because pressure within the skull is increased. Inmost children and adults,acute bacterial meningitis begins with symptoms that slowly worsen for 3 to 5 days. These symptoms may include a general feeling of illness, fever, irritability, and vomiting. Some people have a sore throat, cough, and a runny nose. These vague symptoms may resemble those of a viral infection. Early symptoms that suggest meningitis specifically include Fever Headache A stiff neck (usually) Confusion or decreased alertness Sensitivity to light The stiff neck due to meningitis is more than just sore. Trying to lower the chin to the chest causes pain and may be impossible. Moving the head in other directions is not as difficult. However, some people do not have a stiff neck, and some have back pain. Some people have symptoms of a stroke, including paralysis. Some have seizures. As infection progresses, children and adults can become increasingly irritable, confused, and then drowsy. They may then become unresponsive and require vigorous, physical stimulation to be aroused. This mental state is called stupor. Adults may become seriously ill within 24 hours, and children even sooner. Meningitis may cause coma and death within hours. Bacterial meningitis is one of the few disorders in which a previously healthy young person may go to sleep with mild symptoms and never awaken. In older children and adults, such a rapid death often results from swelling of the brain. Inmeningococcal meningitis,the bloodstream and many other organs are often infected. The bloodstream infection (called meningococcemia) can become severe within hours, and blood clots may form. As a result, areas of tissue may die, and bleeding may occur under the skin, causing a reddish purple rash of tiny dots or larger splotches. Bleeding can occur in the digestive tract and other organs. People may vomit blood, or stool may appear bloody or tarry black. Without treatment, blood pressure drops, leading to shock and death. Typically, bleeding occurs in the adrenal glands, which shut down, making shock worse. This disorder, called Waterhouse-Friderichsen syndrome, is often fatal unless treated promptly. In some situations, symptoms of bacterial meningitis are much milder than normal, making the disorder more difficult for doctors to recognize. Symptoms are milder when people are being treated with antibiotics for another reason. For example, they may be being treated for another infection (such as an ear or throat infection) when meningitis develops, or early meningitis may be mistaken for another infection and be treated with antibiotics. Symptoms can also be milder in people with a weakened immune system due to use of drugs or disorders that suppress the immune system (such as AIDS), in people with alcohol use disorder, and in very old people. In the very old, the only symptom may be confusion. If bacterial meningitis develops after surgery on the brain or spinal cord, symptoms often take days to develop. 