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Tests and diagnosis
By Mayo Clinic staffYour family doctor or pediatrician can diagnose meningitis based on a medical history, a physical exam and certain diagnostic tests. During the exam, your doctor may check for signs of infection around the head, ears, throat and the skin along the spine. You or your child may undergo the following diagnostic tests:
- Throat culture. A throat culture can find and identify the bacteria causing throat pain, neck pain and headache, but can't determine what pathogens may be in your spinal fluid.
- Imaging. X-rays and computerized tomography (CT) scans of the chest, skull or sinuses may reveal swelling or inflammation. These tests can also help your doctor look for infection in other areas of the body that may be associated with meningitis.
- Spinal tap (lumbar puncture). The definitive diagnosis of meningitis is often made by analyzing a sample of your cerebrospinal fluid (CSF), which is collected during a procedure known as a spinal tap. In people with meningitis, the CSF fluid often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein. CSF analysis may also help your doctor identify the exact bacterium that's causing the illness. Traditionally, it can take up to a week to get these test results. In March 2007, the Food and Drug Administration approved the Xpert EV test, a test that takes only two and one-half hours. This test identifies any genetic material in the CSF from a class of viruses responsible for approximately 90 percent of viral meningitis cases. A positive test tells your doctor you likely have viral meningitis, and a negative test strongly suggests no viral meningitis, making the less common bacterial form of meningitis more likely. This can help those with viral meningitis avoid unnecessary treatment with antibiotics.
- Polymerase chain reaction analysis. If your doctor suspects meningitis, he or she may order a DNA-based test known as a polymerase chain reaction (PCR) amplification to check for the presence of certain causes of meningitis.
If you have chronic meningitis caused by cancer or an inflammatory illness, you may need additional tests.
