Emily Stillman had stayed up late studying for tests. Jackson Ingram had helped his mother move furniture at her office. Andy Marso had covered a high school softball game for the local newspaper. Within 24 hours, however, they all went from feeling healthy to suffering various effects of bacterial meningitis.

Time is of the essence if you suspect you may have meningitis, doctors agree.

One common indicator is a severe headache that over-the-counter medications don't relieve. Fever frequently is present, and other signs include changes in mental status, photophobia (sensitivity to light), and a stiff neck. Particularly if fever and stiff neck are present, it is important to get to the emergency department quickly for evaluation, says Thomas Murray, MD, PhD, an infectious disease specialist and professor of pediatrics at Yale School of Medicine.

Because meningitis spreads through respiratory secretions, donning a mask before going to the emergency department can be helpful, since it is important to avoid close contact with others. Patients should let the care providers in triage know they might have meningitis so they can take extra precautions or wait in the car while a loved one checks them into the emergency department to help avoid exposing people in the waiting room to the disease.

Treatment should begin as soon as bacterial meningitis is suspected, rather than waiting for all of the test results to come back, but patients should expect to undergo a lumbar puncture once they reach the emergency department. This collects cerebrospinal fluid, which appears clear in a healthy person. Ingram's fluid, however, was so cloudy when collected that doctors told his mother, Connie, that they were confident it was meningitis before they even tested it, she says.

Matthijs Brouwer, MD, PhD, professor of neurology at Amsterdam UMC in the Netherlands, was involved in a recent study that found the C-reactive protein (CRP), which is already tested in blood to detect bacterial infections, can be tested in cerebrospinal fluid to distinguish between viral and bacterial meningitis. This testing can be done quickly using existing infrastructure, since the device that measures CRP in blood is sensitive enough to measure the protein in cerebrospinal fluid. And having a test result available after just half an hour means the correct treatment can begin quickly.

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