A health care provider can diagnose meningitis based on a medical history, a physical exam and certain tests. During the exam, your provider may check for signs of infection around the head, ears, throat and skin along the spine.
Common tests to diagnose meningitis include:
- Blood cultures. A blood sample is placed in a special dish to see if it grows microorganisms such as bacteria. This is called a blood culture. A sample also may be placed on a slide and stained. Then it will be studied under a microscope to see whether bacteria are present.
- Imaging. Computerized tomography (CT) or magnetic resonance imaging (MRI) scans of the head may show swelling or inflammation. X-rays or CT scans of the chest or sinuses may show an infection that may be associated with meningitis.
Spinal tap. A definitive diagnosis of meningitis requires a spinal tap to collect cerebrospinal fluid. In people with meningitis, the fluid often shows a low sugar level along with an increased white blood cell count and increased protein.
Analyzing the fluid also may help identify which bacterium caused the meningitis. If viral meningitis is suspected, you may need a DNA-based test known as a polymerase chain reaction amplification. Or you may be given a test to check for antibodies against certain viruses to determine the specific cause and proper treatment.
The treatment depends on the type of meningitis you or your child has.
Acute bacterial meningitis must be treated right away with intravenous antibiotics and sometimes corticosteroids. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures.
The antibiotic or combination of antibiotics depends on the type of bacteria causing the infection. Your health care provider may recommend a broad-spectrum antibiotic until the exact cause of the meningitis is known.
Your provider may drain any infected sinuses or mastoids — the bones behind the outer ear that connect to the middle ear.
Antibiotics can't cure viral meningitis, and most cases improve on their own in several weeks. Treatment of mild cases of viral meningitis usually includes:
- Bed rest.
- Plenty of fluids.
- Pain medicine to help reduce fever and relieve body aches.
Your health care provider may prescribe corticosteroids to reduce swelling in the brain and a medicine to control seizures. If a herpes virus caused your meningitis, an antiviral medicine is available.
Other types of meningitis
If the cause of your meningitis is unknown, you may start antiviral and antibiotic treatment while the cause is determined.
Treatment for chronic meningitis is based on the underlying cause. Antifungal medicines treat fungal meningitis. A combination of specific antibiotics can treat tuberculous meningitis. However, these medicines can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal.
Noninfectious meningitis due to allergic reaction or autoimmune disease may be treated with corticosteroids. In some cases, no treatment may be required because the condition can resolve on its own. Cancer-related meningitis requires therapy for the specific cancer.
Preparing for your appointment
Meningitis can lead to death, depending on the cause. If you've been exposed to bacterial meningitis and you develop symptoms, go to an emergency room and tell the health care providers that you may have meningitis.
If you're not sure what you have and you call your provider for an appointment, here's how to prepare for your visit.
What you can do
- Be aware of any pre- or post-appointment restrictions. Ask if there's anything you need to do in advance, such as restrict your diet. Also ask if you may need to stay at your health care provider's office for observation following your tests.
- Write down symptoms you're having, including changes in your mood, thinking or behavior. Note when you developed each symptom and whether you had cold- or flu-like symptoms.
- Write down key personal information, including any recent moves, vacations or interactions with animals. If you're a college student, your provider likely will ask questions about any similar signs or symptoms in your roommates and dorm mates. Your provider also will want to know your vaccination history.
- Make a list of all medicines, vitamins or supplements you're taking.
- Take a family member or friend along. Meningitis can be a medical emergency. Take someone who can help remember all the information you may receive and who can stay with you if needed.
- Write down questions to ask your health care provider.
For meningitis, some basic questions to ask your health care provider include:
- What kinds of tests do I need?
- What treatment do you recommend?
- Am I at risk of long-term complications?
- If my condition is not treatable with antibiotics, what can I do to help my body recover?
- Am I contagious? Do I need to be isolated?
- What is the risk to my family? Should they take preventive medicine?
- Is there a generic alternative to the prescription medicine you're recommending?
- Do you have any printed information I can have? What websites do you recommend?
What to expect from your doctor
Your health care provider is likely to ask you a number of questions, such as:
- When did you begin experiencing symptoms?
- How severe are your symptoms? Do they seem to be getting worse?
- Does anything seem to improve your symptoms?
- Have you been exposed to anyone with meningitis?
- Does anyone in your household have similar symptoms?
- What is your vaccination history?
- Do you take any immunosuppressant medicines?
- Do you have other health problems, including allergies to any medicines?
What you can do in the meantime
When you call your health care provider's office for an appointment, describe the type and severity of your symptoms. If your provider says you don't need to come in immediately, rest as much as possible while you're waiting for your appointment.
Drink plenty of fluids and take acetaminophen (Tylenol, others) to reduce your fever and body aches. Also avoid any medicines that may make you less alert. Don't go to work or school.
Oct. 04, 2023