What are the symptoms of meningitis?

Early signs: Early signs and symptoms of meningitis are similar to the flu. They may develop over a period of one or two days and typically include: a high fever (over 102 degrees Fahrenheit), a severe headache; vomiting or nausea with headache; and confusion, or difficulty concentrating. In the very young, this may appear as inability to maintain eye contact; seizures; sleepiness or difficulty awakening; stiff neck; sensitivity to light; a lack of interest in drinking and eating; and a skin rash in some cases, such as in viral or meningococcal meningitis.

Earlier signs and symptoms that may suggest a serious infection, although not necessarily meningitis, include leg pain, ice-cold hands and feet, and abnormally pale skin tone.

Signs in newborns: Newborns and young infants may not have the classic signs and symptoms of headache and stiff neck, as they cannot express themselves appropriately at that age. Instead, they may cry constantly, seem unusually sleepy or irritable, and eat poorly. Sometimes the soft spots on an infant's head may bulge. A very late sign may be a spasm consisting of extreme hyperextension of the body (opisthotonos).

If an individual (adult or child) has bacterial meningitis, delaying treatment increases the risk of permanent brain damage. In addition, bacterial meningitis can prove fatal in a matter of days. Medical care should be sought right away if symptoms of meningitis are present.

The most common signs and symptoms of enteroviral infections are rash, sore throat, joint aches, and headache. Many older children and adults with enteroviral meningitis have severe headaches. These viruses tend to circulate in late summer and early fall. Viruses associated with mumps, herpes infection, West Nile virus, or other diseases also can cause viral meningitis.

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The most common signs and symptoms of meningitis include high fever, intense headache, and sensitivity to light and sound. If untreated, symptoms can progress to vomiting, convulsions and/or coma. If meningitis is suspected, the individual should see a doctor as soon as possible. He or she should also avoid close contact with other people to prevent spreading the illness.

(This answer provided for NATA by the Georgia College & State University Athletic Training Education Program.)

Symptoms of bacterial meningitis usually appear suddenly. Symptoms of viral meningitis may appear suddenly or develop gradually over a period of days. For example, the symptoms of viral meningitis after mumps may take several days or weeks to develop.

The most common symptoms of either form of meningitis include:

• Fever.
• Severe and persistent headache.
• Stiff and painful neck, especially when trying to touch the chin to the chest.
• Vomiting.
• Confusion and decreased level of consciousness.
• Seizures.

Less common symptoms include:

• Sluggishness, muscle aches and weakness and strange feelings (such as tingling) or weakness throughout the body.
• Eye sensitivity and eye pain from bright lights.
• Skin rash.
• Dizzy spells.

Babies, young children, older adults and people with other medical conditions may not have the usual symptoms of meningitis.

• In babies, the signs of meningitis may be a fever, irritability that is difficult to calm, decreased appetite, rash, vomiting and a shrill cry. Babies also may have a stiff body and bulging soft spots on the head that aren't caused by crying. Babies with meningitis may cry when handled.
• Young children with meningitis may act like they have the flu (influenza), cough or have trouble breathing.
• Older adults and people with other medical conditions may have only a slight headache and fever. They may not feel well and may have little energy.

Other conditions with symptoms similar to meningitis include viral hepatitis and flu.