Definition
Meningitis is an inflammation of the membranes that line the brain and spinal cord. It is usually caused by a bacterial or viral infection.
What is going on in the body?
The central nervous system (CNS), consists of the brain and spinal cord. Three layers of fibrous tissue cover the surfaces of the brain and spinal cord. These layers cushion and protect the CNS. Sometimes organisms, such as bacteria or viruses, can infect these layers.
When this happens, the body takes steps to defend itself from infection. White blood cells and other infection-fighting substances pour into the cerebrospinal fluid (CSF), the fluid that circulates within the brain and over its surface. This process results in a series of symptoms known as meningitis.
What are the signs and symptoms of the infection?
Meningitis may cause the following symptoms in infants and children:
bulging of the soft spot on top of a child's head in children younger than 2 years old
What can be done to prevent the infection?
Routine childhood immunizations are the first line of defense against meningitis. These include the Hib, PCV, polio, and MMR vaccines. A vaccine against meningococcal meningitis is available for children over 2 years of age with medical conditions that place them at high risk for this infection.
Breastfeeding may provide some protection to infants. When there is an outbreak of meningitis caused by certain bacteria, children may be given antibiotics, such as rifampin, to prevent meningitis. Parents should call their child's healthcare professional if the child has been exposed to someone with this condition.
How is the infection diagnosed?
Diagnosis of meningitis begins with a medical history and physical exam. The healthcare professional may order blood tests. A spinal tap usually will be done to obtain a sample of cerebrospinal fluid. A sample of CSF is taken by placing a hollow needle through the skin in the middle of the lower back. The needle is advanced into the spine, where the CSF surrounds the spinal cord. A small sample of CSF fluid is withdrawn and sent to the lab for study.
What are the long-term effects of the infection?
Bacterial meningitis is quite serious, with a relatively high death rate, especially in newborns. Long-term problems from the disease are common.
Half the newborns who survive the illness will have serious long-term effects, including:
Herpes virus meningitis is also a severe condition. The more common types of viral meningitis are less severe, but can be painful and frightening, especially until bacterial meningitis has been ruled out.
What are the risks to others?
A person with meningitis is often contagious and may spread the infection to other children or adults. Parents should call their child's healthcare professional if the child has been exposed to anyone who develops meningitis.
What are the treatments for the infection?
The primary treatment for bacterial meningitis is antibiotic therapy, which is often given through an intravenous, or IV, line. One or more of the following antibiotics may be given:
ampicillin (i.e.,Principen)
cefotaxime (i.e., Claforan)
ceftazidime (i.e., Fortaz, Tazicef)
ceftriaxone (i.e., Rocephin)
chloramphenicol (i.e., Chloromycetin)
gentamicin
vancomycin (i.e., Vancocin)
tobramycin (i.e., Tobrex)
Other treatments, such as the following, may be given:
acetaminophen (i.e., Tylenol) to reduce fever
corticosteroids, such as dexamethasone (i.e., Decadron), to reduce inflammation
intravenous fluids to prevent or treat dehydration
medicines to stop seizures if they occur
The length of treatment depends on the cause of the meningitis and the age of the child. Treatment generally lasts from 1 to 3 weeks.
What are the side effects of the treatments?
Antibiotics may cause allergic reactions, kidney damage, or liver damage. Corticosteroids may increase the risk of bleeding in the gut or worsen the infection. Medicines to stop seizures may cause low blood pressure
or allergic reactions.
What happens after treatment for the infection?
A child may feel weak and tired for several weeks after the meningitis goes away. It may take weeks or months for normal brain function to return in children who went into a coma during the illness. Some children may have permanent brain damage. This can cause deafness or problems in school or later in life. Children who survive very serious meningitis may have severe mental retardation.
How is the infection monitored?
The child will have checkups for years after the illness to look for problems with vision, hearing, or movement. Mental functioning is also monitored to detect mental retardation or learning disabilities. Any new or worsening symptoms should be reported to the healthcare professional.
Author: Adam Brochert, MD Date Written: 05/17/00 Medical Review: Patti Francis, MD Date Written: 9/21/2006 Reviewer: Reginald Finger, MD Date Reviewed: 12/2/2006
Contributors
Potential conflict of interest information for reviewers available on request
