When to Suspect Meningitis
Headaches occur for all sorts of reasons and most get better on their own. However, there are some circumstances in which a bad headache can be the sign of something very serious, such as meningitis. Meningitis is an infection of the meninges, the thin membranes that surround the brain. These membranes are bathed in fluid and if viruses or bacteria get to them, they can grow rapidly in this ideal moist and nutrient-rich environment.
In general, bacterial meningitis is the more serious; viral meningitis is not usually fatal and although it requires medical attention, it does not develop very rapidly. Bacterial meningitis can affect someone so quickly that they go from being well to being on the verge of death within a few hours, so early recognition and treatment are vitally important.
Bacterial meningitis caused by the bacterium Neisseria meningitidis usually affects children under five years old and teenagers aged 15 to 17. Only about 1 in 4 people infected by the bacterium develops meningitis; most people are carriers.
If a carrier passes the bacterium to someone who is susceptible, either by close contact through playing (in the case of small children) or intimate kissing (in the case of teenagers), meningitis can occur. Older people who develop bacterial meningitis are usually infected by the bacterium Streptococcus pneumoniae.
Headaches And MeningitisAdults and teenagers with bacterial meningitis usually complain of a headache that becomes worse very quickly. They may have other symptoms and these can help the people around them decide that the situation is serious and to suspect meningitis.
Someone with meningitis often has a very stiff neck that prevents them from bending forwards. They may also have a rash that does not disappear when a glass is pressed against the skin. This is a sign that the bacterial infection has spread through the blood, causing septicaemia. Fever is often present, but the hands may be cold and the person may shiver. Repeated vomiting may occur with abdominal cramps. They may appear confused and 'vacant' in their expression and not make much sense.
The problem is that headache, fever, rash, confusion and vomiting are also signs of other infections such as flu, but it is better to suspect meningitis and take the affected person to an emergency department in a hospital so that they can be checked out.
Recognising Meningitis In Young ChildrenRecognising meningitis in adults who can explain how they feel is hard enough but with small children who cannot yet speak, it is even more difficult. They too may have a headache but you cannot know this. You must instead look at their general behaviour.
Pain causes babies and young infants to be irritable when picked up, they will turn away from light and they may have a fever. Their skin may be cold and turn bluish and they may also develop a rash due to septicaemia. Frequent vomiting usually occurs. Babies can be hard to wake and be very 'floppy' and unresponsive and their fontanelle might bulge outwards. These are all serious signs of illness in babies and warrant urgent medical attention, whether or not the underlying problem turns out to be meningitis.
Recognising Meningitis In YourselfIf nobody else is around and you start to feel ill with bad flu symptoms and your headache becomes very severe, with light phobia, a stiff neck and vomiting, it is a good idea to call for help. Meningitis causes people to become disorientated very quickly and if you become unconscious, there is a risk that you will not be found until you are beyond help. One in ten people who develops meningitis dies, even with prompt treatment. Without rapid medical help, the mortality rate is almost 100% and those that survive risk long-term brain damage or deafness.
Once in hospital, a diagnosis will be made on the basis of a lumbar puncture and spinal tap but an antibiotic drip is usually started straight away to avoid delaying potentially life saving treatment. Once meningitis is confirmed, steroids are also given to damp down the immune response that can damage the body's tissues and do more harm than good. Someone with meningitis is admitted to intensive care as their body often goes into shock and they need constant life support to get over this critical period.
In all cases of suspected meningitis, it is better to get medical help immediately; the consequences of being wrong and raising a false alarm are never worse than the consequences of being right but putting off taking action. It could be, literally, a matter of life or death.