MDM Health

Can Meningitis Come Back Years Later

With prompt treatment, meningitis should not cause serious complications. Early treatment, especially for bacterial meningitis, is very crucial to prevent serious damage from the disease. While new treatments work more effectively, the issue of the recurrence may make you worry. Can the disease come back years later?

Brief summary of meningitis

The word meningitis refers to a condition whereby you have swelling (inflammation) of protective membranes that cover your brain and spinal cord. Medically, these membranes are also called ‘meninges’.

Your brain and spinal cord, together, form a complex system called the ‘central nervous system’. This system is responsible for many body functions. Even we can say that it runs the whole show. For examples; it is responsible to regulate talking, thinking, walking, emotions, memory, etc – as well as what you do automatically such as breathing and digesting food!

So any problem that affects this system could be fatal, especially if the problem is out of control. The same goes for meningitis. Sometimes it cause serious complications or even become life-threatening.

The inflammation of meninges in meningitis can be caused by several causes. The most common one is infections, especially viral infections.

In fact, viral meningitis accounts about 60-80 percent of all cases. The good news, it usually doesn’t cause serious problem. Many times people can fully recover from the disease without developing any serious complication, though sometimes it could also turn into serious.

Other infectious causes are bacterial and fungal infections. Bacterial meningitis is more dangerous, because it tends to leave lingering effects which some can be serious and life-threatening. Therefore, it must be treated immediately. The longer someone with the disease without treatment, the greater the risk of serious complications to occur! See also long-term effects of meningitis!

Early prompt treatment is also necessary for fungal meningitis. But fortunately, it’s rare (not as common as bacterial meningitis)!

Meningitis can also be caused by non-infectious causes. These include non-infectious disorders (such as systemic lupus, rheumatoid arthritis, and certain cancers), certain medications /antibiotics /vaccines, or injury. But overall, these conditions are rarely associated with meningitis. In other words, non-infectious meningitis is not common (rare).

Identifying the exact cause of the disease is important to determine the treatment. In fact, the treatment varies and differs, depending on the cause! For example, home treatment is often enough for viral meningitis. On the other hand, hospitalization is usually required for bacterial meningitis.

Since early treatment is very crucial for the outcome of the disease, see a doctor promptly if you have any symptom of the disease!

Though it’s not always easy to tell meningitis apart from milder conditions, here are some common symptoms to remember:

  1. Unusual skin rash. It usually doesn’t easily fade even though under pressure, see more in here! This symptom is common in people with bacterial meningitis.
  2. More sensitivity to light.
  3. Stiffness, particularly in the neck. Neck stiffness can signal that something is going wrong with your central nervous system.
  4. And seizures, this is particularly true if the disease has become advanced.

Additional symptoms include: severe headache (it may come with nausea /vomiting), difficulty concentrating, sudden high fever, drowsiness (difficulty waking), thirst, or appetite loss. In babies, the disease may also cause fontanel (a bulging soft spot on the baby’s head), constant crying, poor feeding, inactivity, and irritability.

With prompt treatment, including bacterial meningitis, the complications of the disease is preventable. After treatment, another issue that takes attention is the risk of the recurrence.

Can meningitis come back years later?

Most cases of the disease are acute, in which it usually lasts less than a month (4 weeks). Acute meningitis is mostly caused by viral infections. But though it is faster to relieve, it can present abruptly and the symptoms could be severe enough to interfere with your daily life!

Sometimes the disease become chronic, meaning it will last more than a month or even a year! It usually develops slowly. The symptoms may come and go. Chronic meningitis, especially if the cause is bacterial infections, is more likely to leave lingering effects.

Occasionally, some people have more than one episode of meningitis (also called as ‘recurrent meningitis’). The disease can come back years later. The risk of this recurrence can vary from person to person.

Recurrent meningitis can be attributed by several causes. In general, these include bacteria, viruses, or something else.

Bacteria

Meningitis associated with bacterial infection may come back when certain conditions (an unrepaired injury or/and birth defect, for example) allow bacteria to easily enter the space between meninges. This unrepaired injury /defect could be:

  1. In the meninges surrounding the spinal cord (especially in the lower back or neck),
  2. In the base of the skull, a prone area where bacteria elsewhere in the body (particularly such as from the bone behind the ear, sinuses, or middle ear) can enter more easily.

Typically, recurrent bacterial meningitis doesn’t strike suddenly. Instead, it’s more likely to develop gradually that may take months or even years. Here are other things to remember:

… Continued …

  1. In rare cases, recurrent bacterial meningitis occurs due to a congenital /hereditary disorder (especially if it affects specific part of the body immune system called the ‘complement system’). For such cases, Streptococcus pneumonia is the most common type of bacteria to blame!
  2. Still, antibiotics are the main treatment to fight against the infection. Doctors may also suggest additional medications. For example, a corticosteroid such as dexamethasone is sometimes prescribed to help treat the inflammation.

With prompt treatment, another recurrence of the disease should be preventable!

Early diagnosis of the recurrence is important to prevent the complications. Tests and procedures to help diagnose the disease include physical examination, imaging tests (like CT-scan or X-rays) to look for any defect, or sometimes blood tests to check whether you have any congenital disorder that contribute to cause the recurrence!

Viruses

As mentioned before, viral meningitis it’s less likely to cause serious complications. But there is also a chance for some viral infections to cause recurrent meningitis (though this is not common, rare).

For example, one of the main ones is HSV-2 (Herpes simplex virus type 2). HSV-2 that causes the recurrent is usually called ‘Mollaret meningitis’, which is also sometimes called recurrent aseptic or lymphocytic meningitis.

What is Mollaret meningitis?

It is usually characterized by repeated episodes of neck stiffness, fever, severe headaches, and muscle aches. Each episode can be separated by weeks or months of remission (with no symptoms).

Although there is no specific treatment, the treatment is usually necessary to prevent the complications. Without prompt treatment, it may turn into serious and cause long-term problems affecting the nervous system (such as vision problem, some paralysis, abnormal reflex, hearing loss, seizure, or even coma).

The good news, most people can fully recover from the disease. This is especially true if the disease is properly treated.

Other causes of recurrent meningitis

Non-infectious causes can also lead to the recurrent in very rare cases. See the previous page for more information about these non-infection causes! For example, if the first episode of the disease was triggered by certain medication, the disease may come back if your take the medication again.

A leakage of a brain cyst may also trigger the recurrence. The cyst can be diagnosed with imaging tests, such as CT-scan or MRI.

Again, identifying the exact cause of the recurrent meningitis is crucial since it will determine the way of how the treatment will go. See your doctor promptly if you notice any symptom of the recurrent – remember, early treatment is often associated with a better outcome!

Article sources:
  1. http://www.msdmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/meningitis/recurrent-meningitis
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1765649/pdf/v075p00i16.pdf