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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:
- Blood cultures. Blood drawn from a vein is sent to a laboratory and placed in a special dish to see if it grows microorganisms, particularly bacteria. A sample may also be placed on a slide to which stains are added (Gram's stain), then examined under a microscope for bacteria.
- Imaging. X-rays and computerized tomography (CT) scans of the head, chest 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.
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Spinal tap (lumbar puncture). The definitive diagnosis of meningitis requires an analysis 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. If your doctor suspects viral meningitis, he or she may order a DNA-based test known as a polymerase chain reaction (PCR) amplification or a test to check for antibodies against certain viruses to check for the specific causes of meningitis. This helps to determine proper treatment and prognosis.
- Meningitis and encephalitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm. Accessed Dec. 29, 2012.
- Bacterial meningitis. Centers for Disease Control and Prevention. http://www.cdc.gov/meningitis/bacterial.html. Accessed Jan. 2, 2013.
- Bartt R. Acute bacterial and viral meningitis. Continuum Lifelong Learning in Neurology. 2012;18:1255.
- Viral meningitis. Centers for Disease Control and Prevention. http://www.cdc.gov/meningitis/viral.html. Accessed Jan. 2, 2013.
- Fungal meningitis. Centers for Disease Control and Prevention. http://www.cdc.gov/meningitis/fungal.html. Accessed Jan. 2, 2013.
- Derber CJ, et al. Head and neck emergencies. Medical Clinics of North America. 2012;96:1107.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 28, 2012.
- Acute bacterial meningitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/meningitis/acute_bacterial_meningitis.html. Accessed Dec. 31, 2012.
- Prevention — Listeriosis. Centers for Disease Control and Prevention. http://www.cdc.gov/listeria/prevention.html. Accessed Jan. 2, 2013.
- Subacute and chronic meningitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/meningitis/subacute_and_chronic_meningitis.html. Accessed Jan. 2, 2013.
- Van de Beek D, et al. Advances in treatment of bacterial meningitis. The Lancet. 2012;380:1693.
- Recommended immunization schedule for persons aged 0 through 18 years — United States, 2013. Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Accessed Feb. 19, 2013.
- Recommended adult immunization schedule — United States, 2012. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf. Accessed Dec. 28, 2012.
- Meningococcal vaccine: Who and when to vaccinate. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate-hcp.htm. Accessed Dec. 28, 2012.
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