Diagnosis of meningitis is based on a medical history, a physical exam, and tests.
Your doctor will almost always do a lumbar puncture. This is done by inserting a long, thin needle into the spinal canal. The doctor uses the needle to collect samples of spinal fluid to check for bacteria and viruses.
Other tests that may be done include:
- Complete blood count, to check for signs of infection.
- Blood culture, to check for infections.
- Urine test, to check for infection in the urinary tract.
- Chest X-ray, to check for lung infections.
- Biopsy of a skin rash.
- CT scan or MRI, to look for swelling of brain tissue or for complications such as brain damage.
The decision about what medicine to use depends on the organism causing the infection, the extent of the infection, and the person’s age and general health.
Medicines used for treating meningitis include:
- Antibiotics to treat bacterial infection. Often two antibiotics are given together. Antibiotics aren’t given for viral meningitis.
- Medicines to treat seizures.
- Medicines to treat pressure on the brain.
- Medicines to treat fever and muscle aches. The most common ones are nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol).
The treatment depends on the type of meningitis you or your child has.
Acute bacterial meningitis requires prompt treatment with intravenous antibiotics and, more recently, cortisone medications, to ensure recovery and reduce the risk of complications, such as brain swelling and seizures. The antibiotic or combination of antibiotics that your doctor may choose depends on the type of bacteria causing the infection.
Antibiotics can’t cure viral meningitis, and most cases improve on their own in several weeks. Treatment of mild cases of viral meningitis usually includes:
- Bed rest
- Plenty of fluids
- Over-the-counter pain medications to help reduce fever and relieve body aches
If the cause of your meningitis is a herpes virus, an antiviral medication is available.
Other types of meningitis
Fungal meningitis is treated with antifungal medications. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal. Chronic meningitis is treated based on the underlying cause, which is often fungal.
Noninfectious meningitis due to allergic reaction or autoimmune disease may be treated with cortisone medications. In some cases, no treatment may be required, because the condition can resolve on its own. Cancer-related meningitis requires therapy for the individual cancer.