Bacterial vs. Viral Meningitis: Knowing the Difference Could Save a Life

• We’ve all seen a case of meningitis before, but did you know it could potentially be fatal?
• Nursing CE Central breaks down the key differences of bacterial vs. viral meningitis to increase your awareness!
• Understanding, identifying and recognizing the differences could save lives.

As a nurse, have you ever wondered what the differences are between bacterial vs. viral meningitis? Yeah, me too! 

Shockingly, the difference is more prevalent and life-threatening than we may think.  

I remember being in my early 20’s and getting a call from my husband saying that one of his best friends (who was also an RN) was in the ICU in critical condition with bacterial meningitis.  

I’m sorry, what? I thought meningitis was something you got if you were in the military or a college dorm.  

And although those places do have a higher prevalence of meningitis, you can get it in many other ways, and depending on the type, it can potentially lead to sepsis if not treated immediately.  

Did you know there were significantly different patient outcomes and treatment options for bacterial vs. viral meningitis?  If not, don’t worry, you are not alone. Keep reading!  

Meningitis  

Meningitis, according to meningitis.org is an inflammation of the fluid and meninges (lining of the brain) surrounding the brain and spinal cord. Oftentimes, it is caused by an infection whether it is bacterial or viral. However, it can also be caused by other factors such as medications or medical conditions. 

So now that we’ve established what can cause this inflammation, let’s break down the differences between bacterial vs. viral meningitis! 

Bacterial vs. Viral Meningitis

Bacterial Meningitis

Bacterial meningitis is less common than viral, but it can still occur in anyone of any age.  

What causes it? 

Meningitis.org says that various types of bacteria can cause meningitis, but the most common include meningococcal, pneumococcal, Haemophilus influenzae.

How serious is it? 

Bacterial meningitis requires urgent medical treatment due to the infection moving through the bloodstream. If not treated quickly, the disease can cause sepsis which can be life-threatening.  

What are the symptoms? 

The initial symptoms are usually non–specific and identical to viral meningitis; these include fever, vomiting, and headache. A few other symptoms that are commonly traced to viral meningitis are neck stiffness, light sensitivity, and confusion.  

The next phase of symptoms includes limb pain, pale skin and cold hands and feet, which can be followed up with a rash.  

What is the treatment? 

Antibiotic treatments are the most effective, but they must be administered urgently upon hospital admission in order to prevent life-threatening outcomes.  

Viral Meningitis

Viral meningitis is the more common of the two, however, it is more prevalent in babies and young children. 

What causes it? 

Various viruses can cause it, but the most common are herpes simplex virus, chickenpox or shingles virus (varicella-zoster), and enterovirus.  

Is it Contagious? 

Viral meningitis is not generally considered to be contagious. Contact with someone who has the illness does not usually increase the risk of the disease to others. Linked cases of viral meningitis are extremely rare and, in almost every case, occurs as an isolated event.  

How do you determine a diagnosis? 

Viral diagnosis informs prognosis, enhances the patient’s care, reduces the use of antibiotics, decreases the length of stay in the hospital, and can help prevent further infection transmission.  

Considering there are no significant differences between the symptoms of viral and bacterial meningitis, a lumbar puncture analysis of cerebrospinal fluid (CSF) is recommended in order to exclude bacterial meningitis.  

Is there treatment? 

There is no specific treatment for most cases. Patients should be encouraged to hydrate with fluids and rest. In some cases, antibiotics may be administered as a precaution upon hospital admission due to the cause of the disease not yet being determined. However, if a patient is diagnosed with viral meningitis, the antibiotic treatment will not help.   

What are the symptoms?  

Common symptoms for viral meningitis include:
– Fever
– Headache
– Neck stiffness
– Rash
– Light sensitivity
– Vomiting
– Irritability
– Nausea 

The Difference Between Bacterial vs. Viral Meningitis

To determine if a person is suffering from bacterial or viral meningitis because they present many of the same symptoms, a lumbar puncture must be performed. This involves collecting a CSF sample to determine what is causing the disease.  

If the results identify a specific virus or bacteria, then the diagnosis is clear.  

However, if the specific root cause is not identified, there are other clues to rely on, including the white blood cell count as well as protein and glucose levels in CSF.  

Whether you are determining if a patient has bacterial or viral meningitis, it is essential to determine the cause, as this will outline their treatment route and potentially determine the outcome.  

Although patients with viral meningitis may feel sick for some time after the illness, it is rarely fatal. However, bacterial meningitis can become fatal rapidly. 

Due to the similarities in the presenting symptoms of both types, yet significantly different outcomes if not properly treated, the ability to identify and treat bacterial vs. viral meningitis can be life-saving.  

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