Bacterial meningitis symptoms typically begin suddenly and progress rapidly, within 24 hours. In adults and elderly patients, bacterial meningitis symptoms may include the following:

1. Sudden high fever
2. Headache
3. Stiff neck
4. Confusion
5. Drowsiness
6. Irritability
7. Seizures
8. Stroke

However, elderly patients often do not present with the typical meningitis symptoms. Even if meningitis symptoms are present in the​se patients, they may be mild or attributed to some other underlying medical ​condition.

“Often, confusion may be the only symptom of bacterial meningitis in the elderly,” says ​Dr Limin Wijaya​, Senior ​Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), a member of the SingHealth group.

Bacterial meningitis is diagnosed with the help of a combination of a thorough physical examination, blood and urine tests, and imaging tests (X-ray and CT scan). A lumbar puncture (spinal tap) is usually recommended to analyse the patient’s cerebrospinal fluid. It is important to know what bacteria is causing the meningitis so as to help the doctors understand how best to treat and predict the severity of the meningitis.

Given the serious nature of the disease, bacterial meningitis patients are hospitalised immediately and treated with intravenous antibiotics. Corticosteroids may also be administered as part of bacterial meningiti​s treatment, to bring down the inflammation of the meninges. These are dependent on the bacteria causing the meningitis.

Early bacterial meningitis treatment can help elderly patients with underlying medical conditions or a weak immune system recover. If treatment is delayed, patients may develop complications such as blood poisoning (septicaemia) and brain damage, which can lead to death.

​​Ref. Q15