Meningococcal Meningitis

A Closer Look at This Dangerous Cause of Headache and Rash

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A rash with a headache can be a sign of a very serious infection called meningococcal meningitis. Most people recover from this infection, but without proper treatment, it can lead to permanent disability and even death in just a few hours.

This article discusses meningococcal meningitis and some of its symptoms. It also goes over how this infection is treated and ways it can be prevented.

woman with eyes closed feeling unwell

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Meningococcal meningitis is always a medical emergency. With treatment, the disease is fatal in 10%-15% of cases, according to the CDC. Without treatment, the World Health Organization says it kills half of the people it infects.

What Is Meningococcal Meningitis?

A meningitis infection leads to inflammation of the membranes surrounding the brain and spinal cord. Meningococcal meningitis is caused by the bacteria Neisseria meningitidis.

Different types of meningitis are caused by different infectious agents (i.e., virus or bacteria). Meningococcal meningitis is a rare type of bacterial meningitis. The Centers for Disease Control and Prevention (CDC) reported only 210 cases in the United States in all of 2021.

Meningitis is spread through respiratory germs and secretions from your mouth, such as those that can be passed by kissing. Overall, the infectious agents that cause meningitis are not as easily spread as those that cause the common cold or the flu.

When to Get Emergency Help

If you have a headache and a rash, get medical attention immediately. Meningococcal meningitis can be deadly if isn't treated promptly.

Adult Symptoms

The main symptom of meningitis is usually a headache. The headache causes significant pain all over the head. The pain may worsen when bending the neck forward. People with meningitis often also have a fever and a stiff neck.

In bacterial forms, those symptoms come on and worsen quickly.

Other meningitis symptoms include:

  • Rash
  • Photophobia (sensitivity to light) and/or phonophobia (sensitivity to sound)
  • Fatigue or trouble waking
  • Nausea and vomiting
  • Low appetite
  • Irritability
  • Lethargy
  • Confusion

Meningococcal meningitis produces a characteristic rash consisting of tiny red dots called petechiae. These tiny red dots represent bleeding into the skin. You can help identify this type of rash by placing a clear drinking glass over the rash and pressing down. If the spots do not "blanch" or disappear, it may be petechiae.

Petechiae can coalesce to form larger skin lesions called purpura. Neither the smaller dots nor the purpura spots will blanch.

Many other medical conditions can also cause petechiae of the skin, including vasculitis, leukemia, and lupus. If you have petechiae and other symptoms that could indicate meningitis, your healthcare provider will immediately start treatment and may send you for a lumbar puncture.

Symptoms in Infants and Children

Meningitis looks different in infants and children than it does in adults. Symptoms can vary depending on the child's age:

  • Newborns may have a fever, extreme sleepiness, excessive crying, and may be difficult to wake. 
  • Babies and toddlers may have a fever, irritability, vomiting, poor appetite, and rash. 
  • Older children may have a headache, stiff neck, back pain, photosensitivity, and rash.

Diagnosis

This infection is diagnosed by an invasive test called a lumbar puncture (also called a spinal tap). During this test, a needle is placed in the lower back to collect spinal fluid. The fluid is tested for signs of infection, inflammation, bleeding, and the presence of infectious organisms.

Treatment typically entails antiviral and/or antibiotic medication, depending on the specific infectious agent.

Meningitis Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

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How Common Is Rash in Meningitis?

Overall, a rash is not unusual with other forms of meningitis. It's more common in meningococcal disease, though, with about 50% of infected people developing petechiae.

You can have petechiae and not have meningitis, or you could have a non-meningococcal form of meningitis. Alternately, you can have meningococcal meningitis and not have a petechial rash. This is not a cut-and-dried correlation.

Complications of Meningococcal Meningitis

It's important to seek emergency medical care if you have symptoms of meningitis. Meningitis progresses quickly, but most people recover with prompt treatment. 

Even with treatment, however, it is possible to develop complications after you've recovered. These may include:

  • Memory loss
  • Speech or learning problems
  • Problems hearing
  • Vision problems 
  • Weakness or paralysis
  • Seizures

Treatment and Prevention

The treatment for meningococcal meningitis is antibiotics. Starting treatment quickly reduces the risk of death. Because of the seriousness of the disease, healthcare providers recommend treatment for the people you're in close contact with as well, to help keep them from developing it.

There is a vaccine for meningococcal meningitis, but it isn't 100% effective. It lowers your risk of infection, but you can still develop meningococcal meningitis after being vaccinated.

Summary

A headache with a rash could be a sign of meningococcal meningitis. This is a bacterial infection that causes inflammation in the membranes that surround the brain and spinal cord. Meningococcal meningitis is always an emergency and requires prompt treatment. Most people who seek immediate medical attention will recover, but complications like memory loss and speech problems are possible.

Symptoms of meningococcal meningitis include headache, fever, stiff neck, and a characteristic rash that does not blanch when you press on it. In infants and children, the infection can cause extreme sleepiness, excessive crying, and fever.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Colleen Doherty, MD

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.