How To Spot Meningitis In An Adult

Here is my personal experience of how to spot Meningitis in an adult, young person or older child. No two cases of Meningitis are the same, just as no two cases of a cold are the same. There will be similarities because the way they attack will be the same, but it is how your body copes and reacts that determines what happens next. Some people will never realise they had Meningitis and some will die.
Fortunately my partner is still here.

More adults get Meningitis than children (although children under 5 are most at risk - know the signs).

Young people are the second most likely age group to develop Meningitis, with year 1 University students the most at risk group.

Having Meningitis is like the worst hangover ever. It's an 'OMG please make it stop because I can't stand it any more and I can't go downstairs to get Paracetamol because I won't survive the journey and my head will explode' kind of headache.

Your forehead feels so tight, and your shoulders and neck are just so sore that you don't even want to look straight ahead, there's no way you could look down at your own belly button. It's so much worse than your standard hangover or dehydration headache, and you can't bear the noise or the light, and no, no, no please don't try and have a conversation with me or put the TV on again because I can't concentrate on that just now, and why would I want to because I just want to be sick, again.

And the pain, it's so bad. Everything hurts. Your face hurts, your skin hurts, your hands cramp, your tummy cramps, your Head. Is . Exploding. Your eyes are sore and if you could just sleep it might get better, but the nausea and the shaking won't let you, and your brain is trying to force it's way out through your eye sockets.

And the pain in your thighs, what did you do to deserve that? It feels like your leg muscles are ripping apart. And why is it so cold? Why is the room so cold that you are shaking and shivering and yet sweat is pouring off you?

This isn't a hangover, it can't be because I didn't drink and it can't be the flu because I don't have a cough or a runny nose, and it can't be dehydration because it wasn't even hot yesterday and I drank plenty, and despite the fact I've said it many times before in my life - every one of which I now regret - this really is THE worst pain ever. Ever.  

And who are these people? Why are they here? Where am I going? I don't understand, but I think I need a Doctor. Am I in hospital? When did this happen? If I could just..get...some....sleep....
 

There are a very well known list of possible signs and symptoms of Meningitis:

Fever and/or vomiting
Severe headache
Stiff Neck
Photophobia (dislike of bright lights - TV, lamplight, sunlight etc)
Very sleepy, vacant, difficult to wake
Confused or delirious
Seizures (fits)
Skin rashes

When someone with Meningitis develops Septicaemia then the following symptoms may also be present:

Skin rash that does not disappear when pressed (bleeding under the skin)
Breathing fast or breathlessness
Pale or mottled skin
Cold hands or feet/shivering
Limb, joint or muscle pain

To this I'd add -

1. If you wait for a rash you'll be waiting too long. It is NOT usually one of the early signs of Meningitis and you could be wasting very precious time.
2. Chin to chest really is clearly a brilliant measure. My partner thought he was almost touching, but in fact he was barely even looking straight ahead. He physically could not bend his neck to touch his chin to his chest or look at his own feet.
3. Pain in the thighs. I'd never heard of it before, so didn't realise the significance, but it's a well-recognised symptom
4. My partner didn't get photophobia until after we had been in hospital for 2 or 3 hours, in fact he was fine with the Nurse shining lights directly into his eyes, which in itself was a bit disturbing.
5. My partner is a stubborn man. He was determined not to go to hospital, he was determined not to give up until he was incredibly ill. We were in a private room in the Walk-In Centre when he started passing out as we were talking to him, until that point Adrenaline kept him going.

Meningitis is an inflammation of the lining of the brain and spinal cord caused by an infection. The infection is usually bacterial or viral. Bacterial Meningitis can kill in only a few hours and kills around 1 person for every 8-10 who develop it. Viral Meningitis is far more common, usually less severe and in fact a large number of people will get better without treatment within 7-10 days.

My partner developed his Meningitis in July 2013. Over 2 years later he has memory loss, and long and short term memory problems. He has pain in his back and leg which has never gone away, and he walks with a limp. He has problems with sound, he can't distinguish between noises, so busy environments or lots of things happening at once confuse him. He falls asleep when he is stressed. He is still lucky.

Meningitis can move very fast and I will be painfully aware for the rest of my life that despite everything I knew and all of my first aid training, I allowed my partner to sleep downstairs on his own for 4 hours while I went to bed upstairs. If he'd had Bacterial Meningitis he could well have died during this time.

No-one can know too much about how to spot Meningitis. We knew plenty, we've both been First Aiders and parents a very long time, but we still didn't dare think it could really be Meningitis and tried to dismiss it. The Hospital and Walk In Centre staff tried to dismiss it.

It took 2 lots of IV antibiotics for 'Suspected Bronchitis' (despite a clear chest x-ray and no hint of a cough or shortness of breath) before anyone suggested the obvious, but by then we all really knew anyway.
 

No-one wants to say the word Meningitis. Even when the evidence is glaring at you and you've ruled out anything else obvious, no-one wants to say it. The test for Meningitis is a Lumbar Puncture and nobody wants to give a healthy person a diagnostic test that carries any risk. It may be up to you to stand firm and insist that your patient is not well at all. You may have to be that person who says Meningitis first.


For more information about Meningitis:

Meningitis Now have a free Meningitis symptoms app or card for your wallet and an online symptom checker.

My help for the symptoms list - Meningitis Research Foundation
The UK NHS
Recent news about University students from the BBC
The UK Meningitis charity - Meningitis Now