Headache With a Rash May Be Meningococcal Meningitis

Sometimes, your headache is diagnosed by your doctor as a migraine, tension-type headache, or other primary headache disorder. In other cases, though, your doctor may suspect a secondary headache, meaning your headache is caused by some other medical condition. A secondary headache can be benign or more serious.

Meningitis is one example of a very serious infection that causes a secondary headache.

There are different types of meningitis based on the agent that is causing the infection. For instance, meningococcal meningitis is one type of bacterial meningitis. It is relatively rare, with less than 1000 cases in the United States annually, according to the Centers for Disease Control and Prevention or CDC. Nevertheless, meningococcal meningitis is fatal in 10-15% of individuals.

Before reviewing the skinny on meningococcal meningitis, let's review the basics of meningitis.

Meningitis

Meningitis is an infection of the membranes that surround the brain and spinal cord. It is most commonly caused by a bacteria or virus, and rarely a fungus. The diagnosis is made by a lumbar puncture, and treatment typically entails an antiviral and/or antibiotic, depending on the specific infectious agent. Symptoms that can occur during meningitis include:

Headache
Fever
Flu-like symptoms
Neck stiffness
Rash

Sensitivity to light (photophobia) and/or sound (phonophobia)

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

What is Meningococcal Meningitis?

One particular form of bacterial meningitis, known as meningococcal meningitis, is caused by the bacteria Neisseria meningitidis.

It produces a characteristic rash consisting of tiny red dots called petechiae. These tiny red dots represent bleeding into the skin. The dots can coalesce in larger skin lesions called purpura. There are multiple other medical conditions that cause petechiae of the skin, like vasculitis. However, if you have petechiae and other symptoms concerning for meningitis, your doctor will send you immediately to the emergency room for a lumbar puncture.

If you are diagnosed with meningococcal meningitis, you will undergo antibiotics as will close contacts to help prevent the disease. Fortunately, there is a vaccine for meningococcal meningitis, although the vaccine does not cover all the different strains of Neisseria meningitidis bacteria. And remember, vaccines are not 100% effective. So, you can still develop meningococcal meningitis even if you were vaccinated.

How Common is Rash in Meningitis?

Overall, rash is not unusual in those with meningitis but can be particularly symbolic for meningococcal meningitis. For instance, in one study of patients with meningitis caused by a bacteria, rash occurred 26 percent and of those with a rash, 92 percent were associated with meningococcal meningitis.

Please remember, though, an individual can have petechiae and NOT have meningitis or still have a non-meningococcal form of meningitis. Or an individual can have meningococcal meningitis and have a non-petechial rash. This is not a cut and dry or slam-dunk diagnosis.

Take Home Message

If you have a headache and a rash, please seek the advice of a doctor immediately. Meningococcal meningitis, while rare, can be deadly if not recognized and treated rapidly. Please learn more about medical illnesses that cause headache and a variety of other symptoms.