Fatigue and changes in mental status
After the initial stage of the disease and when neurological signs start to appear, one of the first things patients report is a change in their energy level. Infants and children become drowsy and lethargic, and adults experience fatigue and muscle weakness. In some cases, these changes may even reach to the point of coma, an alteration in the mental status consisting of a complete loss of consciousness sustained for a long time.
Since the alteration is located in the brain, a change in the mental status is common in meningitis. It is frequent in the elderly, especially after a prolongued fever. Mild cases of drowsiness and lethargy are common in younger patients and 40% of children with meningitis would also have seizures shortly after the onset of the systemic symptoms.