The first sign often described in meningitis is a stiff neck. Meningitis is an infection characterized by inflammation of the meninges—the protective membranes covering the brain and spinal cord. Irritation of these membranes is associated with neck rigidity and discomfort that can extend to the back. Limited range of motion with a sensation of tightness is frequently reported, together with a general feeling of soreness.
Fever is frequently noted in people diagnosed with meningitis. Elevated temperature can be accompanied by chills and a sense of anxiety or restlessness. Descriptions include peripheral coolness and shivering during temperature changes. Viral meningitis is often characterized as clinically milder than bacterial forms, though fever intensity and pattern can vary across individuals.
Persistent headache is commonly reported with meningitis. The pain ranges from moderate to severe and may resemble migraine-like pressure or throbbing. Headache can arise before, during, or after fever onset, and is frequently considered alongside other systemic and neurologic symptoms that evolve over several days.
Meningitis shares several nonspecific, flu-like features. Viral etiologies such as enteroviruses are common causes of aseptic (viral) meningitis and can present with symptoms that overlap with colds or influenza-like illnesses. Reports mention runny nose, cough, and fever in some cases, while variability among individuals is emphasized in clinical summaries.
Nausea with or without vomiting is frequently documented. These symptoms occur in the context of meningeal inflammation and systemic illness and may fluctuate in intensity. Descriptions refer to centrally mediated triggers for nausea during infections affecting the central nervous system, with individual differences in frequency and severity.
Confusion, difficulty concentrating, and lightheadedness can occur in association with severe headache, fever, or nausea. Blurred vision is also reported in some accounts. Fluctuations in attention and decision-making are described during episodes, reflecting the effects of systemic illness and meningeal irritation on overall cognitive state.
Heightened sensitivity to light (photophobia) is commonly described. Exposure to bright natural or artificial light can intensify headache and visual discomfort. Vision-related complaints may accompany these reactions. Onset can be relatively early in the course of illness, though timing and prominence vary across cases.
Sensitivity to sound (phonophobia) is also mentioned. Loud or high-frequency sounds may feel intolerable during episodes of meningitis, similar to photophobia with light exposure. Reports note a preference for quiet, dim environments while systemic and neurologic symptoms are present.
Muscle pain can become pronounced. Early constitutional symptoms such as nausea, fatigue, and sleep disruption are often accompanied by myalgias. Individuals describe marked tiredness and reduced capacity for usual activities, with movement sometimes perceived as effortful during the active phase of illness.
A skin rash does not occur in every case, but when present it is a notable visible feature. Descriptions include red or purple lesions, sometimes as small pinpoint spots. In infants, a bulging fontanelle (soft spot) may be observed. Certain rashes associated with meningococcal disease are described as non-blanching under pressure, and distribution commonly involves the trunk and extremities.
Learn more about meningitis at Centers for Disease Control and Prevention.