Meningitis and septicaemia

Published by Bupa's Health Information Team, April 2010.

This factsheet is for people who have meningitis or septicaemia, or who would like information about it.

Meningitis is an infection of the meninges - the membranes that cover the brain and spinal cord. Meningitis sometimes causes blood poisoning called septicaemia, which can be serious. Septicaemia may also be caused by other infections in the body, including infections in the skin and lungs. Meningitis and septicaemia can occur separately but they are often found together.

About meningitis and septicaemia

Meningitis is usually caused by a bacterial or viral infection. There are many different bacteria and viruses that can cause meningitis.

Everybody carries bacteria and viruses harmlessly in their nose and throat. But occasionally, these can overcome the body's immune system and cause meningitis. The infections can be spread through close contact, such as by kissing and coughs and sneezes. These bacteria and viruses are very common and only rarely cause meningitis.

Some groups of people are more at risk of catching meningitis than others. Babies and young children are most likely to get meningitis, but the reasons why aren't fully understood. It's thought that it could be because their immune systems are less developed. Teenagers and young adults are also more at risk of catching a type of meningitis called meningococcal disease.

Sometimes, meningitis can be a complication of a head injury or brain surgery. Very rarely, it can be caused by a fungal infection or amoeba. Some types of meningitis can be mild, others can be much more serious and, in some cases, life threatening.

Bacterial meningitis sometimes causes a type of blood poisoning called septicaemia. This happens if bacteria or their toxins enter the bloodstream and the rest of the body and multiply in large numbers. Septicaemia is a very serious condition that can also be life-threatening.

Symptoms of meningitis and septicaemia

It can be very difficult to recognise meningitis, because at first the symptoms can be like those of other illnesses such as flu. However, you should get urgent medical help if you suspect that you or someone else has meningitis.

The symptoms of meningitis and septicaemia can develop very quickly, over just a few hours.

Meningitis symptoms

The symptoms of viral and bacterial meningitis are similar, although the viral form of the disease is generally far less severe. They can appear in any order, and may include some, but not necessarily all of the symptoms listed below.

Early symptoms include:

• fever
• feeling sick or being sick
• severe headache
• muscle or leg pains
• cold hands and feet
• pale, blotchy skin

Later symptoms include:

• neck stiffness
• drowsiness
• sensitivity to bright lights
• confusion
• fits (seizures)
• rash (anywhere on your body)

Babies and young children may also have other symptoms including:

• high-pitched crying
• not wanting to eat or feed
• being irritable and not wanting to be held or touched
• a floppy body or a rigid body with jerky movements
• a bulging soft spot on the top of the head (the fontanelle)

Septicaemia symptoms

Septicaemia can occur with or without meningitis. The symptoms include:

• fever
• being sick
• pale or blotchy skin
• drowsiness
• confusion
• fast breathing
• shivering, or having cold hands and feet
• aching limbs or joints
• rash
• low blood pressure
• feeling dizzy

The rash caused by septicaemia looks like tiny bright red spots, which may join together to give the appearance of fresh bruises. If you see a rash you can do what is called the 'tumbler test'.

Take a glass and press it against the skin where the spots are. If you can still see the spots through the glass and they don't fade, then you should get medical help immediately.

Not everyone with septicaemia will have a rash. If someone is very ill and doesn't have a rash, you should still get help straightaway.

Complications of meningitis and septicaemia

Many people with meningitis and septicaemia recover fully and have no after-effects from their illness. However, some people do experience problems. This is now rare - people are more aware of the symptoms, and there are more effective treatments available.

Some of the main complications from meningitis and septicaemia are listed below.

• Learning difficulties. These can be temporary or long-term. You may also have memory loss, difficulty concentrating and coordination problems.
• Paralysis or weakness in of parts of your body. If this is permanent it's sometimes called cerebral palsy.
• Altered senses. You may lose your sight or have or vision problems. You may also find that your hearing is affected and you may become deaf.
• Headaches.
• Skin scarring or loss of limbs as a result of septicaemia.
• Lung or kidney damage.
• Fits.
• Speech problems.

Causes of meningitis and septicaemia

Bacterial meningitis

Over 50 different types of bacteria can cause meningitis. The two most common forms of meningitis are listed below.

Meningococcal meningitis is the most common form of meningitis in the UK. There are several different strains, but most cases in the UK are caused by strain B. Strain C used to be common, but vaccination now prevents most cases. As well as infecting the meninges, meningococcal bacteria can also cause septicaemia. This may be called meningococcal septicaemia.

Pneumoccocal meningitis is the second most common form of meningitis, It can also result in septicaemia. These bacteria usually cause less serious illnesses than meningitis, such as ear infections and sore throats.

Bacterial infection in babies

Group B streptococcal bacteria are the most common cause of meningitis in newborn babies. These bacteria are present in the vagina and bowel and can be transferred from mother to baby during birth.

Viral meningitis

One of the most common causes of viral meningitis are enteroviruses, which normally live in the lining of your bowels (intestines). Usually, you only get a mild cold or flu-like illness when you're infected by these viruses.

Many other types of virus, such as those causing herpes or measles, can also cause viral meningitis.

Viral meningitis doesn't cause septicaemia. Most cases of viral meningitis are relatively mild, and it is only rarely life-threatening.

Diagnosis of meningitis and septicaemia

If your GP thinks that you have meningitis, he or she will refer you to hospital immediately.

You're likely to have a lumbar puncture if your doctor thinks you may have meningitis. A lumbar puncture is a test in which a sample of fluid is taken from your lower back. A computerised tomography (CT) scan, which uses X-rays to make a three-dimensional image of part of your body may be done to check for swelling or damage to your brain tissue. Other tests may include a blood test to check for septicaemia, throat and nose swabs, a chest X-ray, and a faeces sample to check for viruses.

Treatment of meningitis and septicaemia

The treatment you have will depend on the type of infection you have.

Bacterial meningitis

Bacterial meningitis or septicaemia is treated urgently in hospital. You will be given antibiotics immediately, usually via a 'drip' directly into a vein. You may also have oxygen to help with breathing difficulties and intravenous fluids to combat dehydration and shock. You may be looked after on a general word in hospital or, if you're seriously ill, you may be treated in an intensive care unit.

Viral meningitis

If you have viral meningitis the main treatment is to ease your symptoms. This means resting and keeping cool and hydrated. You can take over-the-counter painkillers for a headache. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

The symptoms usually clear up within two weeks. If you have a severe infection, you may need to be treated in hospital, but most people can stay at home.

Prevention of meningitis and septicaemia

If you come into close contact with someone with meningococcal meningitis - for example - if you live in the same house or have kissed the infected person you should seek medical advice. You may need to take a preventive course of antibiotics. Other types of meningitis are usually less infectious.

Other steps to prevent the spread of meningitis include avoiding contact with people known to have possible meningitis. Regular hand-washing and placing your hand over your mouth when coughing and sneezing can help to stop meningitis spreading from person to person.

In the UK immunisation is available to prevent some types of meningitis. These vaccinations are listed below.

• Pneumococcal vaccination. This protects against pneumococcal meningitis and is routinely given to babies and also offered to those aged 65 and over.
• MenC vaccination. This protects against meningococcal group C bacteria and is routinely given to babies and is available to anyone under the age of 25.
• Hib vaccination. This protects against H influenzae bacteria and is routinely given to babies.

Vaccinations are also offered to other groups such as people who have low resistance to infection and people travelling to areas where meningitis is common.

Vaccination doesn't prevent all types of meningitis but it has helped to reduce the number of some types of meningitis.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.