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“Meningitis” is a term that describes inflammation of the membrane layers surrounding your brain and spinal cord, which are called the meninges. Recurrent meningitis is a rare form of this condition. It happens when meningitis goes away and then comes back months or years later.

Some type of infection usually causes meningitis. Viral meningitis is the most common form. Bacterial meningitis is the most serious.

Recurrent meningitis can be viral, bacterial, or of noninfectious origin. Either way, it tends to cause milder symptoms than nonrecurrent (one-time) meningitis.

When recurrent meningitis happens because of a viral infection, it’s called Mollaret’s meningitis.

In this article, you’ll learn about what causes recurrent meningitis, how it affects the body, and how it’s treated.

Meningitis is inflammation in the lining of the brain and spinal cord. Most cases of meningitis are acute, or short term, lasting anywhere from a few days to a few weeks.

Meningitis can also be chronic, or long lasting, lasting over a month or so. Meningitis has many causes. Its cause can determine the severity of symptoms and the course of the condition.

Recurrent meningitis happens when meningitis goes away and then comes back months or years later. This can happen whether meningitis clears up on its own or resolves with treatment.

Between episodes of recurrent meningitis, people typically test negative for meningitis.

Recurrent meningitis can be difficult to distinguish from chronic meningitis. In some cases of chronic meningitis, symptoms can disappear for months or years at a time, then return during a flare-up. Between episodes of symptom flares, people may still test positive for meningitis.

Common viral infections cause most cases of meningitis in the United States. These infections tend to be mild. In healthy people, they usually clear up on their own.

Viral meningitis isn’t typically transmitted from person to person. Only a tiny fraction of people with these infections will develop meningitis.

Bacterial meningitis is a much more severe form of this condition. It requires emergency medical treatment. Bacterial meningitis is transmitted quickly. It often affects groups of people living in tight quarters, such as dorm rooms or military barracks.

Recurrent viral meningitis

Recurrent viral meningitis, which is also known as Mollaret’s meningitis, is typically caused by the herpes simplex virus. This virus is quite common, but it only causes meningitis in rare cases.

Some people with herpes simplex virus experience no symptoms, but others develop oral and genital lesions.

You can still get Mollaret’s meningitis even if you’ve never experienced any symptoms of herpes. More than half of people with Mollaret’s meningitis report no history of genital herpes.

The Epstein-Barr virus, which can cause mononucleosis (mono), has also been associated with recurrent meningitis.

Recurrent bacterial meningitis

Recurrent bacterial meningitis is rare. However, it can occur in people who have certain risk factors (discussed below). A few different bacterial pathogens can cause it.

According to 2021 research, the most common bacterial cause of recurrent meningitis is Streptococcus pneumonia. It’s also a common cause of ear infections, sinusitis, and pneumonia.

Another common cause is Haemophilus influenzae. It can also cause ear infections and more severe bloodstream infections.

Although it’s less common in the developed world, tuberculosis can also cause meningitis. Tuberculosis meningitis is often chronic, rather than recurrent, and requires long-term treatment.

Recurrent noninfectious meningitis

There are also noninfectious causes of recurrent and chronic meningitis, like cancer, lupus, and head injury.

Drug-induced meningitis is another possible cause. This can happen when someone has an unusual response to certain anti-inflammatory medications, like nonsteroidal anti-inflammatory drugs (NSAIDs).

Recurrent meningitis is a rare condition. When someone has recurrent meningitis, doctors typically look for underlying causes that may be making the person more prone to infection or inflammation.

The underlying cause is often a physical abnormality that gives germs easier access to the meninges. For instance, an abnormality in the inner ear could allow an ear infection to spread to the meninges.

Reasons why meningitis may come back include:

Certain conditions can also increase your risk of chronic meningitis, which is meningitis that doesn’t go away between episodes. These include:

The primary symptoms of bacterial and viral meningitis are similar and include:

The symptoms of bacterial meningitis are typically more severe than those caused by viral meningitis. But the symptoms of Mollaret’s meningitis can be more severe than regular viral meningitis.

Symptoms of Mollaret’s meningitis come on quickly. They peak within 12 hours and last about 3 to 4 days.

Bacterial meningitis is always considered a medical emergency that requires hospitalization. If untreated, it can lead to permanent brain damage and death.

The first step doctors use to diagnose meningitis is usually a lumbar puncture (spinal tap). This procedure allows doctors to take a sample of your cerebrospinal fluid. This is the clear fluid that cushions your brain and spinal cord.

Healthcare professionals will analyze your cerebrospinal fluid for markers of meningitis.

The next step is to figure out which type of meningitis you have. Your doctor will ask for a detailed account of your medical history. They will also send blood samples to a lab for analysis.

Finally, your doctor will need to find out why your meningitis is recurring. They will use imaging tests, such as CT scans and MRIs, and other diagnostic tests to look for risk factors, like physical abnormalities or underlying conditions.

Treatment for meningitis depends on what’s causing it. To treat the current case of meningitis, doctors may prescribe:

  • intravenous antibiotics
  • oral antibiotics
  • antifungal agents
  • antiviral medications

After treating the current case of meningitis, doctors will treat the underlying cause of your recurrent meningitis. This might include any number of different therapies, such as:

  • surgery
  • medications
  • long-term condition management

It’s not possible to prevent all types of meningitis. But there are some steps you can take to protect yourself. Primarily, this means getting all of your recommended vaccines.

Meningitis vaccines help protect you from several strains of bacterial meningitis. Vaccines are available to help prevent infection by pneumococcus, meningococcus, and Hib bacteria, all three of which can lead to meningitis.

Vaccination against measles, mumps, and rubella viruses can also reduce your risk of infections that lead to meningitis.

Learn more about what vaccines are available for meningitis.

Recurrent meningitis happens when meningitis goes away and then comes back again months or years later. A bacterial infection, viral infection, or noninfectious causes can lead to meningitis. Bacterial meningitis is a life threatening emergency. Other types are milder.

Symptoms of meningitis include a stiff neck, fever, and nausea. Recurrent viral meningitis, or Mollaret’s meningitis, comes on quickly, with symptoms peaking within 12 hours.

Doctors perform a lumbar puncture to diagnose meningitis. They may need to conduct further testing to find out why your meningitis is recurring.

Treating recurrent meningitis means treating both the acute condition and the underlying cause.