What is meningitis?

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My Child Has:

Meningitis

Programs that treat this condition

Hydrocephalus Infectious Diseases

What is meningitis?

Meningitis is an inflammation of the membranes that surround the

brain and the spinal cord.

What causes meningitis?

Meningitis is usually caused by a bacterial or viral infection that

invades the cerebral spinal fluid (CSF). Cerebral spinal fluid (CSF)

is the fluid within the open spaces of the brain that protect and

cushion the brain and spinal cord. A fungus or parasite may also

cause meningitis. The severity of a child's symptoms and prognosis

depend on the specific organism that is causing the meningitis.

Meningitis can occur in infants, children, and adults. Some bacteria

and viruses are more common in certain age groups than others,

including the following:

Bacteria that can cause meningitis (bacterial meningitis):

In newborns and young babies, possible bacteria include the

following:

Group B streptococcus

Escherichia coli (or E. coli)

Listeria monocytogenes

In older babies and children, possible bacteria include the

following:

Streptococcus pneumoniae

Neisseria meningitides (meningococcal meningitis)

Haemophilus influenzae type b or H. influenzae

Other bacteria that may cause meningitis include the following:

syphilis

tuberculosis (TB)

Viruses that can cause meningitis (viral meningitis):

polioviruses

mumps (paramyxovirus)

herpes simplex virus (HSV)

Other microorganisms that can cause meningitis:

Borrelia burgdorferi (Lyme disease)

fungi such as candida, aspergillus, or cryptococcus neoformans

Meningitis caused by a virus is more common and usually less severe.

Bacterial meningitis is usually more severe and may produce long-

term complications or death.

How is a meningitis infection transmitted?

The organisms that cause meningitis are usually spread by close

contact with persons who may be carrying the infection, or by

touching infected objects such as doorknobs, hard surfaces, or toys

and then touching the nose, mouth, or eyes. The organisms may also

be transmitted through respiratory secretions from a sneeze, close

conversation, or by touching infected matter. The infection usually

starts in the respiratory tract and then travels into the

bloodstream where it can reach the brain and spinal cord. The

organism may cause a cold, sinus infection, or ear infection (more

common in children), and then travel through the sinuses into the

brain and CSF, although this method of transmission is less common.

A child may have no symptoms at all, but may carry the organism in

his/her nose and throat.

What are the symptoms of meningitis?

The symptoms of meningitis vary depending on the organism that is

causing the infection. However, each child may experience symptoms

differently. Symptoms may include:

in infants (symptoms may be difficult to pinpoint):

irritability

fever

sleeping all the time

poor feeding

high-pitched cry

arching back

cries when picked up or being held

inconsolable crying

bulging fontanelle (soft spot on an infant's head)

noticeably different temperament

seizures

in children older than one year:

neck and/or back pain

headache

sleepiness

confusion

irritability

fever

refusing to eat

decreased level of consciousness

seizures

photophobia (sensitivity to light)

nausea and vomiting

neck stiffness

The symptoms of meningitis may surface several days after your child

has had a cold and runny nose, or diarrhea and vomiting. The

symptoms of meningitis may resemble other problems or medical

conditions. Always consult your child's physician for a diagnosis.

How is meningitis diagnosed?

In addition to a complete medical history and physical examination,

diagnostic procedures for meningitis may include:

lumbar puncture (spinal tap) - a special needle is placed into the

lower back, into the spinal canal. This is the area around the

spinal cord. The pressure in the spinal canal and brain can then be

measured. A small amount of cerebral spinal fluid (CSF) can be

removed and sent for testing to determine if there is an infection

or other problems. CSF is the fluid that bathes your child's brain

and spinal cord.

blood testing

computerized tomography scan (Also called a CT or CAT scan.) - a

diagnostic imaging procedure that uses a combination of x-rays and

computer technology to produce cross-sectional images (often called

slices), both horizontally and vertically, of the body. A CT scan

shows detailed images of any part of the body, including the bones,

muscles, fat, and organs. CT scans are more detailed than general x-

rays.

Treatment for meningitis:

Specific treatment for meningitis will be determined by your child's

physician based on:

your child's age, overall health, and medical history

extent of the disease

the organism that is causing the infection

your child's tolerance for specific medications, procedures, or

therapies

expectations for the course of the disease

your opinion or preference

Treatment may include:

bacterial meningitis - Treatment for bacterial meningitis usually

involves intravenous (IV) antibiotics. The earlier the treatment is

initiated, the better your child's outcome. Your child's physician

may start treatment with antibiotics before the results of the

lumbar puncture are available. If your child is very ill, a lumbar

puncture may not be recommended and treatment with antibiotics will

be started immediately.

viral meningitis - Treatment for viral meningitis is usually

supportive (aimed at relieving symptoms). With the exception of the

herpes simplex virus, there are no specific medications to treat the

organisms that cause viral meningitis. Most children with viral

meningitis recover on their own without treatment.

fungal meningitis - An intravenous anti-fungal medication may be

administered to the child with fungal meningitis.

tuberculous (TB) meningitis - A long course (one year) of

medications is recommended for children who develop TB meningitis.

The therapy usually involves treatment with several different

medications for the first few months, followed by other medications.

What is supportive therapy for meningitis?

While your child is recovering from meningitis, other therapies may

be initiated to improve healing and comfort, and provide relief from

symptoms. These may include the following:

bed rest

medications (to reduce fever and headache)

supplemental oxygen or mechanical ventilation (respirator) may be

required if your child becomes very ill and has difficulty breathing

Prevention of meningitis:

Several vaccines are currently available to prevent some of the

bacterial organisms that can cause meningitis, including the

following:

H. influenzae type b vaccine is given as a three or four part series

during your child's routine immunizations starting at 2 months.

Although pneumococcal vaccines have been used for older children and

adults for many years, the American Academy of Pediatrics (AAP) now

recommends a new form of pneumococcal vaccine for all children

younger than age 2. This vaccine is called pneumococcal conjugate

vaccine (PCV7).

The AAP also recommends that PCV7 be given to all children ages 24

to 59 months of age that are at very high risk for pneumococcal

infection. This includes children who have weakened immune

(infection-fighting) systems, such as those with sickle cell disease

and HIV infection (human immunodeficiency virus).

PCV7 can be given along with other childhood vaccines and is

recommended at the following ages:

2 months

4 months

12 to 15 months

Children who are sick or have a fever should wait until they are

well to get the PCV7 vaccine. Children who have had a prior reaction

to any type of pneumococcal vaccine should not receive PCV7.

For Neisseria meningitidis (meningococcal meningitis), a

meningococcal vaccine is currently only used for high-risk groups.

Immunization for the bacteria is not widespread due to its uncommon

occurrence. Individuals who may require immunization include the

following:

asplenic children (children without a spleen)

college students (immunization of college students is recommended by

the American College Health Association)

military recruits

individuals who are traveling to countries where the incidence of

meningococcal infections is higher (parts of Africa)

treatment of family members or close contacts of individuals with

meningitis may be necessary if your child has the following type of

bacterial meningitis:

H. influenzae type b

Neisseria meningitidis (meningococcal)

If you have questions regarding prevention, consult your child's

physician.

The information on this website should not be taken as medical

advice,

which can only be given to you by your personal health care

professional.