What Are the Complications and Long-Term Risks of Meningitis
Meningococcal meningitis can lead to serious complications, such as hearing loss, scarring, or even amputation. Getting treatment early can prevent these outcomes.
Meningitis is a condition characterized by swelling of the lining of the brain and spinal cord. It can be caused by viruses, bacteria, or fungi.
Meningococcal meningitis occurs when the bacterium Neisseria meningitidis infects the meninges (tissues around the brain and spinal cord). Neisseria meningitidis can also infect the bloodstream. Meningococcal meningitis and bloodstream infections are two common types of meningococcal disease.
An infection of the meninges can cause a dangerous buildup of pressure on the brain. Symptoms of infection may include:
headache
stiff neck
confusion
sensitivity to light
high fever
nausea
skin rash
vomiting
Main complications of meningitis
Meningococcal disease is fatal in about 10 to 15 people out of every 100 receiving a diagnosis, according to the Centers for Disease Control and Prevention (CDC). The disease may lead to long-term complications in about 20% of those with the condition.
Among the possible complications of meningococcal disease are:
chronic pain
scarring
amputation
hearing impairment
vision impairment
motor function impairment
post-infection inflammatory syndromes
arthritis
post-traumatic stress disorder (PTSD)
anxiety
depression
Some complications of meningococcal disease that require immediate medical attention are:
septic shock
seizures
purpura fulminans (skin rash and possible organ failure)
hydrocephalus (fluid buildup on the brain)
cerebral venous sinus thrombosis (stroke)
Waterhouse-Friderichsen syndrome (bleeding into the adrenal glands)
subdural empyema (pus between layers of the brain's protective tissue)
Bacteremia and septicemia
One type of meningococcal disease is an infection of the tissues around the brain and spinal cord (meningococcal meningitis). Neisseria meningitidis can also infect the bloodstream, resulting in bacteremia or septicemia.
Meningococcal septicemia is a dangerous form of bloodstream infection. The bacteria multiply and release toxins that can damage blood vessel linings. Bleeding into the skin or organs may occur. A characteristic dark purple rash may develop in the later stages.
Other symptoms may include:
fatigue
vomiting
cold hands and feet
chills
diarrhea
rapid breathing
severe aches or pains in the muscles, joints, chest, or belly.
This form of infection also requires immediate care and can cause some of the most serious complications of meningococcal disease, such as:
necrosis (skin death)
hearing loss
deafness
seizures
amputation
skin scarring
impaired blood flow to the organs
heart failure
Diagnosis and treatment
Diagnosing meningococcal disease can be a challenge because early symptoms look like other conditions. When a doctor suspects meningococcal disease, they can test for the presence of bacteria in cerebrospinal fluid or blood. Getting a sample of spinal fluid requires a lumbar puncture procedure.
Antibiotics are the mainstay of treatment. Doctors typically start antibiotic treatment as soon as they suspect meningococcal disease to reduce the risk of serious complications.
In some cases, someone with meningococcal disease will require hospitalization. Some types of care they might receive include:
intensive care unit (ICU) admission and medications to help maintain a stable blood pressure, especially if it drops too low due to severe infection
intravenous (IV) fluids and rehydration
breathing and airway support
blood transfusions
wound and skin care
How common are meningitis outbreaks?
According to the CDC, there were 438 confirmed and probable cases of meningococcal disease in the United States in 2023.
The recent rise in cases has been mostly linked to the serogroup Y strain of Neisseria meningitidis, one of several strains that can cause meningococcal disease. Serogroup Y has been spreading more frequently in recent years, contributing to localized outbreaks.
Some groups are more at risk than others. Infants, teens, and young adults tend to have higher rates of developing an infection, as do people with certain medical conditions or those living in close quarters like college dorms or military barracks.
Outbreaks also tend to occur in communities with lower vaccination rates or limited access to preventive care.
That's why it's so important to recognize the signs, respond quickly to symptoms, and stay up to date with recommended vaccines, especially for people at a higher risk.
Vaccines are available that help protect against different types of meningococcal disease, including the strains most often linked to outbreaks, such as serogroups A, C, W, Y, and B.
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