In the initial phase of the disease, there are usually relatively unspecific symptoms.
These include flu-like symptoms like high fever, body aches, a headache, as well as nausea and vomiting.
Those affected complain of a severe feeling of illness. The symptoms usually arise within three to four days after infection with the pathogen.
Only in the further course of the disease does a specific symptom of meningitis appear, the so-called Neck stiffness (Meningism).
The head can no longer be moved towards the chest without severe pain, while turning the head usually causes fewer problems.
The Meninges, In contrast to the brain itself, those infected with the disease are supplied with nerve fibers so that they are sensitive to pain.
Therefore, when the skin is irritated, the inflammation and, especially when the skins are stretched, pain occurs.
To test if a Neck stiffness is present, the doctor will have the child stretch out on their back.
The doctor then passively lifts the child's head for examination. If the neck is stiff, the child draws the knees reflexively in order to reduce the resulting pain.
Because the spinal cord is also surrounded by meninges, if the head tilts, these are stretched and pain occurs.
The stretching of the meninges is counteracted by bending the knees.
As part of a Meningitis one speaks of a typical Symptom triadarising from the characteristic symptoms Fever, headache, and stiff neck consists.
In addition to the typical symptoms like fever, one more increased sensitivity to light and noise, a disorder of the state of consciousness, neurological deficits and epileptic seizures.
How severe the symptoms are always depends on the type of pathogen.
The symptoms of bacterial meningitis are usually more severe than those of viral meningitis.
Viral meningitis is more common than bacterial inflammation and is much slower and milder, so that it is often only associated with mild flu symptoms and can resolve itself without treatment.
As a complication, especially with the Meningococcal pathogens, blood poisoning can occur, which is noticeable, among other things, by skin bleeding, paleness and changes in consciousness.
As a rule, at the beginning of a purulent (bacterial) Meningitis notice a slight increase in temperature that is accompanied by other symptoms such as fatigue and tiredness. In most cases this phase follows rapid rise in fever with up to 40 ° C as soon as the meningitis (meningitis) is fully developed. The fever remains constant in many cases, although cases with a fluctuating fever curve have also been described.
In rare cases the body temperature rises further and reaches values above 42 ° C, at which one must assume an acute danger to life (septic fever).
At a tubercular meningitis however, is usually a slower rise determine the body temperature, which rises to values of over 39 ° C within a week.
Headaches are usually the next to a general exhaustion and tiredness first symptom with which meningitis becomes noticeable. With fever and neck stiffness, they are among the leading symptoms of bacterial meningitis. Although the headache increases slowly at first, severe headaches are often reported as the disease progresses, caused by irritation of the meninges.
Meningitis is often difficult to diagnose in babies at an early stage because symptoms such as headaches are only noticeable by loud screaming and are far less specific than adults.
Nausea and vomiting
At the beginning of meningitis, patients often report flu-like symptoms that are accompanied by severe nausea and vomiting. These symptoms are very unspecific, but in combination with severe headaches and a stiff neck they can already point to the diagnosis of meningitis.
Meningitis often presents itself at an early stage with increasing sensitivity to light (Photophobia). This can exacerbate existing headaches. The reason for this is that meningitis also often affects the Conjunctiva overlaps and one Conjunctivitis (Conjunctivitis) caused. However, this symptom is not specific to meningitis and can be caused by other conditions such as one migraine caused.
The stiff neck is one of the first, but also one of the first most specific signs for meningitis. It is accompanied by a pain-related inhibition of passive flexion of the head and can be so strong that it can be felt by one Opisthotonus speaks, which is accompanied by a strong backward tilt of the head and an extreme extension of the trunk.
The reason for this phenomenon is that the meninges, which also run in the spinal cord, shorten in the event of an inflammation and thus a normal head position is already painful, as this causes tension in the irritated meninges (Meninges) arises.
Stiff neck is one of the symptoms that can usually distinguish meningitis from severe migraines. Nevertheless, further diagnostics are of course carried out.
If the night stiffness occurs in combination with a fever and severe headache, a visit to the doctor is highly recommended, as early diagnosis and therapy are very important for meningitis.
Back pain often occurs as a result of meningitis and the associated severe irritation of the meninges. They are often described as the result of tubercular meningitis.
The back pain can persist for a few days even after successful therapy.
In about a third of all cases, one occurs in addition to the symptoms already described epilepsy on. This can be limited to one area (focal) or from there to other areas of the brain (secondary generalized).
The Symptoms of epilepsy depend on the region in the brain in which it spreads, but cramping of the extremities, twitching and unconsciousness can usually be observed.
As a result of meningitis, dizziness similar to migraine occurs, which further exacerbates the existing headaches and nausea. The cause of this is an irritation of the cranial nerves, which are responsible for the sense of balance (Vestibular nerve).
Rashes can often occur with meningitis. This is especially the case with bacteria such as the Meningococcithat have a systemic effect, i.e. are distributed throughout the body. The full expression of this disease is called Waterhouse-Friedrichsen Syndrome.
Furthermore, there can sometimes be minor bleeding into the skin, so-called Petechiae, which can give a first indication of the causative agent of the disease.
Meningitis without fever
At Babies and toddlers it sometimes happens that developing meningitis presents without fever, which makes early diagnosis in this case very difficult.
In young people and Adult cases are also described in which an increase in body temperature did not occur as part of the disease, but this is only very rare the case. The reasons for this are not yet known.
Symptoms in Babies and Young Children
The symptoms mentioned in the introduction mainly apply to older children and adults.
In infants, unfortunately, the symptoms are not so clear-cut.
In particular, the disease-specific neck stiffness is mostly missing. Babies are more likely to fail unspecific symptoms on, such as increased tiredness and indifference, poor drinking, fever and irritability.
The irritability and the lack of wellbeing are usually expressed through more frequent and above all high-pitched screams.
The children work tired and limp. They are also often more sensitive to touch. Sometimes vomiting occurs, although nausea and vomiting occur much less frequently than in older children.
A Meningitis in children is therefore much more difficult to detect than meningitis in adulthood.
It can also be more common in babies and toddlers than in older children illness-related seizure come.
Furthermore, in the further course of the disease there is also often one bulging fontanel. The fontanel is the not yet ossified part of the skull.
The initial signs of the disease in particular are not easy to recognize and so also occur in other diseases. If in doubt, a doctor should always be consulted, because the earlier the disease is treated, the better.
In babies and also in toddlers, one can usually be harmless viral meningitis, take a stronger course, because their immune system is not yet as mature as that of older children.
Older children have already come into contact with many pathogens, so that their immune system can quickly fend off these pathogens without the disease breaking out. This is not yet the case with young children.
Symptoms in the child
The symptoms of a Meningitis In children they correspond essentially to the symptoms listed in the introduction, as they also occur in adults.
The diagnosis in children is based on symptoms, especially those that are mostly present Neck stiffness, easier to put than with babies and toddlers.
Nevertheless, to back up the diagnosis, a Puncture of Nerve water carried out, also to be able to determine the pathogen.
As a complication that occurs very rarely and more in older children, it can be called Waterhouse-Friderichsen Syndrome come.
Mostly it is caused by a bacterial meningitis Meningococci triggered. This complication leads to profuse internal bleeding, which mainly affects the adrenal cortex, which is an important hormone producer and can no longer fulfill its function.
Waterhouse-Friederichsen syndrome is fatal in 90% of cases. The children fall symptomatically through strong Signs of skin bleeding which initially look like small reddish dots and then enlarge as the process progresses. This dreaded complication is one reason why meningitis should be recognized and treated as quickly as possible.