Viral meningitis typically resolves on its own and has a far less severe course than bacterial meningitis, which is generally fatal if left untreated. A life-threatening complication of bacterial meningitis (especially meningococcal meningitis) is Waterhouse-Friderichsen syndrome, which is characterized by disseminated intravascular coagulation and acute adrenal gland insufficiency. Bacterial meningitis requires rapid initiation of empiric treatment. If increased ICP is suspected, a CT of the head should be performed first. The diagnosis is confirmed with lumbar puncture ( LP) and CSF analysis. Patients may also present with neurological deficits, altered mental status, and seizures, indicating increased intracranial pressure ( ICP).
In infants and young children, the presentation is often nonspecific. The classic triad of meningitis is fever, headache, and neck stiffness. Rarer forms of bacterial meningitis include tuberculous meningitis and Lyme-associated meningitis. Enteroviruses and herpes simplex virus are the leading causes of viral meningitis, while Neisseria meningitidis and Streptococcus pneumoniae are the pathogens most commonly responsible for bacterial meningitis. Meningitis is a serious infection of the meninges in the brain or spinal cord that is most commonly viral or bacterial in origin, although fungal, parasitic, and noninfectious causes are also possible.
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