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This is an infection or inflammation of the membranes covering the brain and spinal cord (meninges) that can be caused by bacteria or viruses.

Viral meningitis is also called acute aseptic meningitis, is caused by a virus and is less severe than the bacterial forms of meningitis. Viral meningitis may occur on its own or after another viral illness. The symptoms include fever, headache, stiffness and soreness of the neck and back, nausea and vomiting. It tends to have a sudden onset and patients often require hospitalisation to control the high fever, vomiting and consequent dehydration. If the symptoms are managed properly the condition will generally improve.

Bacterial meningitis is a dangerous illness that can be fatal, particularly if untreated. Two of the most common bacteria that can cause meningitis are Streptococcus pneumonia and Neisseria meningitides. The symptoms of bacterial meningitis include severe headache, fever, nausea and vomiting, visual discomfort caused by light, stiffness of the neck and back, joint pain, confusion, drowsiness and even seizures. Infants and very young children may refuse feeds, become floppy, irritable or difficult to wake and /or may develop a high-pitched moaning cry. The fontanelle (soft spot on the skull of babies) may be tense or bulging. Adults can become very ill within 24 hours of contracting bacterial meningitis and the course can be much shorter for a child.

When a patient is suspected to be suffering meningitis, Doctors need to establish the exact type of meningitis a patient has in order to optimise their treatment. A sample of the fluid the surrounds the brain and the spinal cord, called cerebro-spinal fluid (CSF), is taken via a procedure known as lumbar puncture, in which fluid is drawn from the lower-back region of the spinal column.

Emergency medical treatment must be sought if symptoms are present. A delay might be fatal. Hospitalisation is usually necessary. Some mild cases of viral meningitis can be managed at home but only after proper diagnosis. Paracetamol can be taken for relief of pain and fever. Children under 16 cannot be given aspirin due to the risk of Reye’s Syndrome. The patient should rest in a quiet, dark room, as bright lights and noise will be very irritating to the patient. If bacterial meningitis is diagnosed, family members and people who have been in contact with the patient may need a course of preventive antibiotics.

There are vaccines against some organisms that cause meningitis including the bacterium Haemophilus influenza. An antibiotic called rifampicin is used to prevent the spread of meningococcal bacteria among people who have come in close contact with people diagnosed with meningococcal disease. This medication will not stop meningococcal disease once a person has already become ill. There are vaccines available against various groups of meningococcal bacteria but there is no vaccine available against meningococcal group B.

Recovery from meningitis, be it viral or bacterial, can be a lengthy process. Meningitis can leave some patients with permanent physical disabilities such as deafness, eyesight problems and brain damage. The Doctor will advise on how to deal with these problems and may refer the patient to an Occupational Therapist who will help the patient adjust to the disability.

Further information is available from Meningitis Research Foundation at 5 Cullenswood Road, The Triangle, Ranelagh, Dublin 6; Phone: 01-4969664/5 or LoCall 24 Hour Helpline 1850-413344.

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Kevin McCormack B.Sc. Pharm. MPSI