Bacterial meningitis in children what you need to know. The treatment and prognosis of bacterial meningitis in infants and children are discussed separately, as are the epidemiology and pathogenesis of bacterial meningitis and the clinical features, diagnosis, treatment, and prognosis of bacterial meningitis in neonates meningitis is an infection of the protective membranes that surround the brain and spinal cord meninges. Division of infectious diseases, children s mercy hospitals and clinics, kansas city, mo. Most children with viral meningitis recover on their own without treatment. Possible reactions to vaccines side effects redness, swelling and pain around the site of the injection may occur after any vaccine and may last a few days.
Management of bacterial meningitis in children and young people. In the developed world, meningococcus and pneumococcus currently cause 95% of cases of acute bacterial meningitis in children. Being a subacute illness, early symptoms may be missed leading to clinical deterioration and late presentation. Read about causes, symptoms, and treatment of meningitis in children. Even when it is treated, meningococcal disease kills 10 to 15 infected people out of 100. Most children will make a full recovery after meningitis, but it can take time. Meningitis and septicaemia higher risk for young children. Tuberculous meningitis in children continues to be associated with a significant risk of death even with treatment 19%, and a significant proportion of the surviving children have ongoing neurological problems. Meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. Viral meningitis is more common, but it is less serious than bacterial meningitis. However, the use of conjugate vaccines has reduced the incidence of bacterial meningitis in children and adults. If tb meningitis in the differential diagnosis, refer to nice ng33 before administering steroids.
Charles pat davis, md, phd, is a board certified emergency medicine doctor who currently practices as a consultant and staff member for hospitals. Meningitis is a viral, bacterial, or fungal infection of the lining of the brain and spinal cord, the meninges. Viral meningitis is the most common form of meningitis in the uk, but bacterial meningitis continues to be important, with a high mortality. Different incidences of acute bacterial meningitis in. Meningitis is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid csf. Meningitis can be caused by many different pathogens including viruses and fungi but the highest global burden is seen with bacterial meningitis. Pathophysiology and treatment of bacterial meningitis.
The signs and symptoms of meningitis can be different depending on the age of your child, and whether the disease is caused by a virus or bacteria. Feb 03, 2020 bacterial meningitis is inflammation of the lining that surrounds and protects your childs brain and spinal cord. Other bacteria can cause meningitis, but these cases are rare and usually not spread from person to person. Some bacteria and viruses are more common in certain age groups than others.
Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Meningitis is a severe acute infectious disease caused by several microorganisms, including viruses, bacteria, parasites, and fungi. I wasted a ton of money on garbage stop snoring products like mouth guards, throat sprays, lozenges and nasal strips, to name just a few. Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. Nearly 10,000 children in the united states with severetoprofound hearing loss currently have a cochlear implant, a. This is more common only in children with a weak immune system. For suspected bacterial meningitis in children 6 weeks old, consider. Diagnosis, initial management, and prevention of meningitis. Bacterial meningitis identified in 26 children with cochlear implants. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. Meningitis symptoms in children meningitis research foundation.
Learn more about how you get meningitis, its symptoms, and how its treated at webmd. The peak incidence of tbm occurs in younger children who are less than five years of age, and most children present with latestage disease. Meningitis in children symptoms, warning signs, treatment. Viral meningitis if meningitis is caused by a virus, it is called viral meningitis. Meningitis in children clinical excellence queensland. Risk factors of meningitis age viral meningitis occur in children younger than age 5 bacterial meningitis most commonly occurs in preteens and young adults community setting. Pneumococcal meningitis still is the major and most lethal cause of community acquired bacterial meningitis in cuban children. Le saux n, canadian paediatric society, infectious diseases and immunization committee. Introduction of introduction of cuban new heptavalent pcv serotypes 1, 5, 6b, 14, 18c, 19f, 23f might decrease considerably pnm and other clinical features in a near future. About 1,0002,600 people get meningococcal disease each year in the u. It is a leading cause of bacterial meningitis in children 2 through 18 years old in the united states. Be on the lookout for these signs in you or your family. The etiology of acute meningitis and encephalitis syndromes in a.
Stiff neck that sometimes makes it hard to touch your. Pneumococcal and meningococcal meningitis occur with an annual incidence in the range of 4 to 5 and 2. Pathophysiology and treatment of bacterial meningitis olaf hoffman and joerg r. Guidelines for the management of suspected and confirmed bacterial meningitis in canadian children older than one month of age. Vaccine information statement meningococcal vis cdc. Meningitis can be very serious if not treated quickly. How to use clinical signs of meningitis adc education. The inflammation is most commonly caused by a virus or a bacterium, which travels from an infection in another part of the body through the bloodstream to the meninges. Fatality rates associated with this disease can be as low as 2% in infants and children, and as high as 2030% in neonates and adults. Focal neurological signs may also be found, as may a reduced level of consciousness. Most children either experience a mild reaction or no reaction at all following vaccination. Recognize the complications and sequelae of bacterial meningitis in children. Guidelines for care at the firstreferral level in developing.
The first symptoms are usually fever, vomiting, headache and feeling unwell. Meningitis powerpoint 2009 warren hills regional school. In both children and adults, there may be a rash of tiny, redpurple spots. The bacteria are found in the mouth, throat, or nose.
It can cause lifethreatening blood poisoning septicaemia and result in permanent. Meningitis is a critical diagnosis not to miss in children presenting with fever. The inflammation is caused by a bacterial infection and can be lifethreatening. Aug 15, 2019 a different meningococcal vaccine is available that can help protect against serogroup b. A recent study has suggested that the presence of complex seizures more than doubles the risk of meningitis. Routine neuroimaging is not necessary for the initial medical evaluation of children with suspected bacterial meningitis who do not have clinical signs of brain. Jul 16, 2019 meningitis is a clinical syndrome characterized by inflammation of the meninges. Meningitis symptoms in children meningitis research. Guidelines for the management of acute meningitis in children and. Meningococcal disease also causes blood infections. Dec 01, 2015 understand the indications for neuroimaging, adjunctive corticosteroids, and repeat lumbar puncture in children with bacterial meningitis. This axial nonenhanced computed tomography scan shows mild ventriculomegaly and sulcal effacement. These classical signs are nuchal rigidity, kernigs sign and brudzinskis sign.
Guidelines for their management have been published elsewhere. The clinical presentation is vague, due to the immaturity of cns in infants and children. Meningitis is a rare but serious disease, so its important to learn the symptoms. In general, the younger the patient, the more subtle and atypical are the signs and symptoms. This is normally caused by infection but can also have noninfectious causes. A long course one year of medications is recommended for children who develop tb meningitis. Bacterial meningitis in children is an infection with the greatest burden in lowincome and under developed countries and it is a life threatening infection disease with high mortality and disability rate.
The treatment and prognosis of bacterial meningitis in infants and children are discussed separately, as are the epidemiology and pathogenesis of bacterial meningitis and the clinical features, diagnosis, treatment, and prognosis of bacterial meningitis in neonates pdf. Seizures may be present in 2030% of children with bacterial meningitis, more commonly with s. Approximately 70 percent of meningitis cases occur in children under the age of 5. Meningitis background general presentation meningitis is an important infectious disease to rule out in the pediatric population because it can have serious medical and social complications. Management of bacterial meningitis in children and young. In newborns and young babies, possible bacteria include. Meningococcal b vaccine can help protect against meningococcal disease caused by serogroup b. He has a phd in microbiology ut at austin, and the md univ.
A different meningococcal vaccine is available that can help protect against serogroups a, c, w, and y. In children under 5 years, including babies over 1 month old, the most common bacteria that cause meningitis are. Children over 1 year old and adults with meningitis may have a severe headache, high. Diseases which can cause viral meningitis or encephalitis include measles, mumps and polio. Estimated annual incidence of bacterial meningitis in the. Viral meningitis in children inpatient care what you need. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process. More than 23rd of cases of meningitis occur in the first 2 years of life, owing to decreased immunity and high vascularity of the brain. You get it when a virus enters the body through the nose or mouth and travels to the brain. Guidelines for the management of acute meningitis in children and adults in south africa this guideline provides a rational and costeffective approach to patients with acute meningitis, which causes considerable morbidity and mortality, predominantly in children. Meningitis can occur in infants, children and adults.
Endorsed by management of bacterial meningitis in children and young people incorporates nice bacterial meningitis and meningococcal septicaemia guideline cg102. Viral meningitis in children inpatient care what you. Mar 18, 2020 tuberculous meningitis tbm in children may mimic bacterial meningitis in the early stages. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Viral meningitis is usually not as severe as bacterial meningitis, except in cases where the virus has also caused inflammation of the brain encephalitis. Meningitis is the medical term for inflammation of the tissues meninges that surround the brain and spinal cord. Bacterial meningitis is inflammation of the lining that surrounds and protects your childs brain and spinal cord. Bacterial meningitis continues to be an important cause of mortality and morbidity in neonates and children throughout the world.
Pdf acute bacterial meningitis in infants and children. The classic manifestations noted in older children and adults are rarely present in infants. Meningitis is an inflammation of the membranes meninges surrounding your brain and spinal cord. Meningitis is an infection of the fluid surrounding the brain and spinal cord. Meningitis occurs in people of all ages, but it is more common in children and people over 65. The image below depicts acute bacterial meningitis. Summary clinical practice guidelines for the acute management of infants and children with bacterial meningitis. Each of these relies on the principle that stretching the inflamed meningeal membranes causes clinically detectable. Csf is the fluid that protects and cushions the brain and spinal cord. Since the early 20th century, classical clinical signs have been used to aid the diagnosis of meningitis. An intravenous antifungal medication may be administered to the child with fungal meningitis. Children with meningitis often present with nonspecific symptoms and not the. The epidemiology of bacterial meningitis in children is changing. Although the occurrence of tuberculous meningitis tbm in children is relatively rare, but it is associated with higher rates of mortality and severe morbidity.
Most cases of meningitis in the united states are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Limb pain, pale skin, and cold hands and feet often appear earlier than the rash, neck stiffness, dislike of bright lights and confusion. The inflammation is most commonly caused by a virus or a bacterium, which travels from an infection in another part of. Guidelines for the management of acute meningitis in children. It can affect anyone, but is most common in babies, young children, teenagers and young adults. Care guide for viral meningitis in children inpatient care. A total of 240 cerebrospinal fluid csf samples from 171 children meeting the case. Diagnosis and management of bacterial meningitis in the.
Disease control and prevention revised guidelines for intrapartum antibiotic. Mar 06, 2008 meningitis in children harim mohsin 02. Tuberculous meningitis tbm in children may mimic bacterial meningitis in the early stages. May 30, 2018 meningitis occurs when the membranes that cover the brain and spinal cord become inflamed. What increases my childs risk for bacterial meningitis. Meningitis childrens health queensland queensland health. The clinical symptoms and signs of bacterial meningitis in children vary. Feb 03, 2020 care guide for viral meningitis in children inpatient care. The authors indicate that the system achieved a good accuracy for all the organs and subsystems, and for some specific conditions, such us bacterial meningitis with an accuracy of 0. Bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical. Diagnosis and management of bacterial meningitis in the paediatric. Meningococcal disease can cause meningitis infection of the lining of the brain and spinal cord and infections of the blood. The introduction of the protein conjugate vaccines against haemophilus infl uenzae type b, streptococcus pneumoniae, and. Risk of bacterial meningitis in children with cochlear.
Just over a third of all cases survives with no problems. Classic meningitis of children and adults usually begins with fever, chills, vomiting, photophobia, and severe headache. Consider tb meningitis if raised csf wbc count and risk factors for tb. Most treatment guidelines recommend the use of a thirdgeneration. Original research article pneumococcal meningitis in. Many vaccine information statements are meningococcal b vaccine. Different incidences of acute bacterial meningitis in children of central punjab in pakistan abstract background. Acute bacterial meningitis abm is a serious public health problem demanding early diagnosis, effective treatment, prevention, and control. Refer to pediatric antimicrobial dosing guideline for further guidance on dosing in children, and neonatal dosing guideline for infants pediatric infectious. Clinical features are poor discriminators for meningitis, so urgent investigations, starting with lumbar puncture, are key. Corrected gestational age meningitis results from the haematogenous dissemination of microorganisms from a distant site of infection.
Addendum for meningitis april 01, 2016 download pdf. Meningitis is a devastating disease and remains a major public health challenge. Together with sepsis, meningitis is estimated to cause more deaths in children under 5 years of age than malaria. There are many aetiologies, but a small number of bacteria and viruses. Meningitis is a swelling inflammation of the thin membranes that cover the brain and the spinal cord. Most patients do not need brain imaging before lumbar puncture. The typical rash caused by meningitis is reddish or purple spots or bruises that do not turn white or disappear when you push on them.
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