Frank McCourt, Pulitzer Prize winning author of Angela’s Ashes, ‘Tis, and Teacher Man, is gravely ill with meningitis according to his brother, author/actor Malachy McCourt. McCourt had recently been treated for malignant melanoma, a dangerous skin cancer, but according to his brother, had been doing very well of late. About two weeks ago, McCourt became ill and was diagnosed with meningitis. Currently in a hospice facility in New York City, “his faculties (are) shutting down,” says brother Malachy. “He is not expected to live.”

Meningitis is an infection of the coverings which surround the brain and spinal cord. It can be caused by bacteria, viruses, and fungi. Meningitis usually starts as an infection in the blood stream which then spreads to the coverings of the brain or spinal cord and causes an infection there. As Mr. McCourt has recently undergone cancer treatment, it is not unreasonable to assume that his immune system may not have been completely normal, as a side effect of chemotherapy. This would make him more vulnerable to infection, and cause more severe disease if he became infected.

Symptoms of meningitis typically include high fever, headache and stiff neck. The neck stiffness comes from irritation of the meninges around the spinal cord, which increases with movement of the head. Affected individuals, therefore, reflexively tend to hold their head and neck very still. Other symptoms may include nausea, vomiting, discomfort looking into bright lights (also known as photophobia), confusion, and sleepiness. Treatment and prognosis are dependent on what organism may be causing the infection. This information can only be obtained by direct examination and culture of the spinal fluid that bathes the meninges. This is done by a procedure called a spinal tap (or lumbar puncture): After local anethesthetic is injected into the skin over the lower lumbar spine, a long spinal needle is inserted into a space between the vertebrae (bones of the spine). A small amount of fluid is drawn off and sent to the lab for culture, observation under a microscope and to chemistry to measure the amount of sugar and protein in the fluid. Since meningitis is a potentially life threatening infection, antibiotics are usually started while awaiting test results.

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