When to worry about headache with meningitis

Meningitis is inflammation around the brain and spinal cord. Headache may occur with fever, neck stiffness, vomiting, sensitivity to light, marked sleepiness, confusion, or a rash. Symptoms can develop quickly and do not always appear together. A rash that does not fade when pressed is especially concerning, but waiting for a rash can delay care.

If meningitis is a possibility, seek emergency medical help immediately and explain the symptoms and their timing. Do not drive yourself if confused, faint, very drowsy, or seriously unwell. Keep the person safe while waiting, avoid giving food or drink to someone who cannot swallow normally, and take a list of medicines and allergies if this does not delay help.

Call emergency services for headache with fever and a stiff neck, confusion, difficulty waking, seizure, fainting, breathing difficulty, repeated vomiting, severe light sensitivity, or a rapidly spreading purple or blotchy rash. Babies may show poor feeding, unusual irritability, a weak cry, or a bulging soft spot. Do not wait for symptoms to become more complete.

What tests are needed to identify the cause? Which symptoms should prompt immediate return? How should close contacts or household members respond if infection is suspected?