Signs and Symptoms of Meningitis B

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Meningitis B is a form of bacterial meningitis caused by a specific subtype of Neisseria meningitidis. This infection is rare. The bacteria is transmitted by close contact with another individual. It can invade the body and lead to meningitis, an inflammation around the brain.

There are six subtypes of Neisseria meningitidis, including A, B, C, W, X, and Y. Most cases of infection in the United States are caused by subtypes B, C, or Y.

Meningitis B is an infection with the B subtype of Neisseria meningitidis. The most common symptoms include fever, headache, and stiff neck. Sometimes, people can also have nausea, vomiting, confusion, or light sensitivity.

This subtype of meningitis is separated from the others because, until recently, there was no vaccine available to limit infection by the B subtype. Now, there are two meningococcal vaccines available for use—one that covers meningitis B and another that covers subtypes A, C, W, and Y.

In this article, learn more about the frequent and rare symptoms of meningitis B, complications associated with the illness, and when you should see a healthcare provider.

Person on couch with headache and other symptoms of meningitis B

tommaso79 / Getty Images

Frequent Symptoms

The most common and nonspecific symptoms associated with meningitis B include:

  • Fever
  • Headache

People can also develop neck stiffness.

Other associated symptoms include:

  • Nausea
  • Vomiting
  • Photophobia (light sensitivity)
  • Confusion

The symptoms typically develop three to seven days after exposure to the bacteria.

Severe neurologic symptoms do not always occur but can include abnormal findings on a neurologic exam, such as:

  • Motor problems (difficulty moving the legs or arms)
  • Aphasia (difficulty speaking)
  • Cranial nerve problems (facial muscle paralysis)

Infants and Babies

Some of these symptoms are difficult to assess in newborns and babies or differ in older individuals. Babies may be:

  • Less active
  • Irritable
  • Feeding poorly
  • Have a bulging anterior fontanelle (the soft spot of the skull)

Curable if Treated Early

Meningitis B is treatable and curable without complications if antibiotics are given early.

Older People

The most common symptoms of meningitis in older people include headache, fever, and malaise. Still, older people have these symptoms less frequently than younger people. Their meningitis does not present with classic characteristics.

Instead, they are more likely to have abnormal neurologic findings on exam, such as:

  • Motor problems
  • Difficulty speaking
  • Facial muscle problems from cranial nerve abnormalities

They can also present with seizures (uncontrolled electrical activity in the brain). 

Rare Symptoms

Other more concerning findings that suggest meningitis B and the spread of the bacteria to the bloodstream called septicemia (sepsis) include:

  • Fatigue
  • Muscle aches and pains
  • Diarrhea
  • Rapid breathing
  • Cold hands and feet
  • A dark purple rash called a petechial rash

Meningococcemia (spread of Neisseria meningitidis to the bloodstream) is life-threatening. Once this stage of illness has occurred, death can occur within hours.

However, meningitis B is uncommon, and meningococcemia does not always occur, making this severe manifestation rare. It most often happens in young people (babies, teens, and young adults). Thankfully, young people usually do not have other underlying medical illnesses that put them at risk for death from this disease.  

Mortality Rate for Meningitis B

The mortality rate for people with meningitis B is approximately 10%.

Based on the similarity of symptoms in all cases of meningitis, it is challenging for healthcare providers to differentiate the symptoms of meningitis B from other causes of meningitis. However, the defining characteristic of severe meningitis B is a petechial rash along with other meningitis signs and symptoms.

Complications

Most people recover from bacterial meningitis. However, some people can develop permanent disabilities such as:

  • Hearing loss
  • Learning disabilities
  • Behavioral problems
  • Chronic neurologic problems

Some chronic neurologic issues include:

  • Seizures
  • Difficulties with vision
  • Weakness in the arms or legs
  • Difficulty speaking
  • Memory loss
  • Language deficits

People who develop septicemia (sepsis) can develop scarring on the limbs and might have required amputation. 

Generally, older people, especially those with chronic medical conditions and people who develop neurologic signs of meningitis, are more likely to experience long-term complications. Older people are also at higher risk of dying from meningitis B.

Vaccination Recommendations

Preteens (11 to 12 years) should receive one dose of meningococcal vaccine that protects against subtypes A, C, W, and Y. Teens and young adults (16 to 23 years) should receive a booster dose of meningococcal vaccine, and they should also be vaccinated with a subtype B meningococcal vaccine, preferably between ages 16 to 18.

While the reasons behind this difference are not understood, one recent study found that females are more likely to die from meningitis B than males. Further research into this difference is ongoing.

When to Go to a Hospital

It is difficult for anyone, including healthcare providers, to differentiate meningitis B from other forms of meningitis. The only way to know for sure is to evaluate further with laboratory and cerebrospinal fluid studies.

People who develop the characteristic petechial rash and have meningitis symptoms can be pretty sure they have meningitis B. However, it can be too late when the rash has developed.

Healthcare providers recommend that people with fever, severe headache, and other symptoms of meningitis, such as a stiff neck, vomiting, light sensitivity, or confusion, be evaluated for bacterial meningitis.

Often fever and a headache can seem like another viral illness. If a person is getting worse or has other associated symptoms, meningitis might be the cause.

If a baby or older person has a fever and is not acting right, seek medical care to evaluate for meningitis. 

Summary

Meningitis B is an inflammation around the brain caused by Neisseria meningitidis subtype B. The most common symptoms associated with meningitis B include fever, headache, and neck stiffness. Sometimes people can have other symptoms like nausea, vomiting, confusion, and photosensitivity.

These symptoms are not always present in infants and older people who instead have irritability, less activity, or specific neurologic deficits. People with severe disease can develop meningococcemia, the spread of Neisseria meningitidis to the bloodstream, which is life-threatening.

Most people recover from bacterial meningitis B, but some people can develop chronic neurologic disabilities. It can be challenging to differentiate meningitis B from other forms of meningitis. Diagnosis requires laboratory and cerebrospinal fluid evaluation. People with a severe headache and fever, primarily when associated with one of the other symptoms, should seek medical care.

A Word From Verywell

It is tough to know if you have meningitis B when you have a headache and fever. Any viral syndrome that has a fever can also cause a headache. Viral meningitis is uncomfortable and painful but is not life-threatening like bacterial meningitis B.

Thankfully, meningitis B is rare. If your fever and headache are the worst you’ve ever had and are associated with other symptoms like a stiff neck or photophobia, seek medical care.

10 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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By Christine Zink, MD
Dr. Christine Zink, MD, is a board-certified emergency medicine with expertise in the wilderness and global medicine. She completed her medical training at Weill Cornell Medical College and residency in emergency medicine at New York-Presbyterian Hospital. She utilizes 15-years of clinical experience in her medical writing.