This page gives information on meningitis in infants and children including symptoms, diagnosis and treatment. Information is also given on causes of meningitis.
The following questions are answered:
Meningitis is inflammation of the covering of the brain (called the meninges). It is a serious infection in children, especially babies.
Meningitis in infants and children can be either:
The bacteria that usually cause childhood meningitis are:
The symptoms of bacterial meningitis can vary depending on age.
Babies with meningitis may:
These are similar symptoms for other infections as well. In babies under 3 months of age, we don't take chances so if your baby is unwell with a fever, we will do the test for meningitis.
To help you, you can use BabyCheck to score your baby to see if she is seriously unwell or needs medical attention.
Toddlers under 18 months with meningitis may:
Children over 18 months of age with meningitis will usually have a stiff neck plus any of the following symptoms and signs:
Not necessarily. I have seen babies who have prominent (bulging) fontanelles (soft spots) who are perfectly well. Not only that, many babies who do have meningitis do not have a bulging fontanelle - especially if they are not drinking and are a bit dehydrated.
If your baby has a bulging fontanelle and is well in every other way, particularly if your baby is alert and happy, then it is unlikely that anything too serious is going on. As long as your baby continues to behave normally and doesn't have new symptoms such as vomiting, then you could just wait and see what happens.
Causes of a bulging fontanelle that are serious are when the bulging fontanelle means there is high pressure in the brain - this can happen in meningitis in infants and in some other conditions. Because of the high pressure, babies are usually irritable, not interested in their surroundings or even drowsy when awake and they can be floppy or abnormally stiff. If your baby has a bulging fontanelle and any of these symptoms or new vomiting, seek urgent medical advice.
So a bulging fontanelle may be seen in meningitis in infants but is not always present.
Bacterial vs viral meningitis:
Meningitis in infants and children is diagnosed by examining the spinal fluid (cerebrospinal fluid or csf). The csf is obtained by a lumbar puncture - a special needle is put into the back to obtain the fluid - it sounds scary but is a relatively easy and safe procedure in experienced hands.
A lumbar puncture is also referred to simply as an LP.
If there is childhood bacterial meningitis, the csf will have white blood cells and bacteria seen under the microscope. This confirms infection.
If there are cells under the microscope but no bacteria, and no antibiotics have been given, then this is probably a viral meningitis in the child.
A child with suspected meningitis will also have blood tests done as well as the lumbar puncture.
In some cases, a lumbar puncture can not be performed in the initial phase of the illness because you child will be too ill. In those cases, treatment is started as if there is meningitis and the lumbar puncture can be delayed until your child is more stable. In such cases, blood tests may help identify the organism causing the meningitis.
The treatment of meningitis in infants and children is antibiotics, given intravenously. The length of time varies depending on the bacteria found and the age of the child but is usually at least 7 days and often up to 14 days (newborn babies may require 3 weeks of treatment).
If your child is drowsy or there is concern that there is an associated encephalitis (brain infection), aciclovir (acyclovir) may be added to the treatment as well as the antibiotic - aciclovir (acyclovir) is an antiviral medication that is useful in treating encephalitis caused by one particular virus (herpes simplex).
Dexamethasone, a steroid, is sometimes given as well for the first 48 hours of treatment - studies have shown that in some cases of meningitis, dexamethasone reduces the complication of hearing loss.
Meningitis in infants and children is not contagious in itself but some of the bacteria that cause meningitis can be spread. For that reason, if your child has meningitis caused by Haemophilus influenzae type B or by Neisseria meningitidis, close contacts will be given medication to prevent spread of the organism in the family.
Generally, only family and close contacts require this treatment - if you are unsure, the public health (communicable diseases) physician will be able to help as these are notifiable diseases and should be notified to the public health (communicable diseases) department.
In the acute phase of the illness, meningitis in infants and children:
Long term complications on meningitis in infants and children are usually related to some form of brain damage, including:
Long term problems are more likely after meningitis in infants less than 1 year and particularly less than 1 month of age.
There is not one vaccine against meningitis in infants and children but there are vaccines against the bacteria that commonly cause meningitis, so there are vaccines against:
You can give your child the best chance of not getting meningitis by ensuring she is appropriately vaccinated (immunized). However, even with immunization, there is still a chance of a child developing meningitis so if your child has worrying symptoms, don't delay in seeking medical attention.
If you have a baby less than 18 months of age who has a fever, please see your doctor if she:
If you have an child who is over 18 months who has a fever, see your doctor if she:
Last reviewed 5 June 2012
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