Meningitis in Children

Meningitis is the medical term for inflammation of the tissues (meninges) that surround the brain and spinal cord. It is  commonly caused by a virus or a bacteria, which travels from an infection in another part of the body through the bloodstream to the meninges.

Types of Meningitis:

The two main types of meningitis are Viral and Bacterial.

• Bacterial Meningitis- Many types of bacteria can cause meningitis but the common ones which can also be life threatening are caused by Streptococcus pneumoniae or pneumococcal and Meningococcal.
• Viral meningitis- Can be caused by airborne droplet infection, direct contact, bite of animal or bug. There are many viruses which can cause meningitis. The presenting symptoms of viral and bacterial meningitis are nearly similar but viral meningitis is comparatively less severe and the chances of complete recovery are more.

Presenting symptoms of Meningitis:

• Fever
• Headache
• Neck stiffness
• Vomiting
• Photophobia
• Irritability
• Confusion may be early symptoms.
• The more severe symptoms may include seizure, loss of consciousness, decreased awareness of surroundings.
• In the more severe type of meningococcal meningitis the child may develop a purpuric rash or petechiae which do not blanch on pressure. The child may rapidly deteriorate and go into shock. Meningococcal meningitis is a very dangerous type of meningitis with a high mortality rate. It is not uncommon to see an absolutely healthy child deteriorating to a very severe life threatening situation within 24 hours.

Treatment associated with Meningitis:

• The mainstay of treatment in bacterial meningitis is appropriate antibiotics, supportive and intensive care. Child may also need supportive measures to aid in breathing, maintaining blood pressure, hydration and nutrition.
• In viral meningitis the treatment is essentially supportive and symptomatic. Specific antiviral medications are given only is certain specific viral meningitis.

Prognosis of Meningitis:

• With early institution of appropriate treatment most children may recover without any neurological sequel. However certain bacteria like meningococcal have a high morbidity and mortality. Sometimes the patients may also develop neurological deficit requiring physiotherapy later on.

Prevention of Meningitis:

• Hygiene is important – Prevention is better than cure. General hygiene measures and proper handwashing should be taught to children.
• Opt for vaccination – There are some vaccines which can protect against certain types of meningitis- Pneumococcal, meningococcal, H Influenza type B. Certain viral infections which may lead to meningitis can be prevented by vaccinating against those viral infections eg:- influenza, varicella, mumps, measles.
• Preventive antibiotics- They are required for close contacts and family members of a patient who is diagnosed with a bacterial meningitis.
• Limit close contact – Close contact is defined as a person who lives with the child or who spent ≥4 hours with the child for at least five of the seven days before the child developed symptoms.

When should the parents seek help for Meningitis?

If you feel your child may have symptoms of meningitis you should seek immediate opinion of the pediatrician in the nearest hospital.

• Symptoms of fever, headache, nausea, vomiting, stiff neck, and complain that the light bothering their eyes. The child is confused or difficult to awaken.
• Newborns who are lethargic, poor feeding, irritable, having a bulging frontanelle , restless.
• Purplish spots on the skin, seizure, loss of or altered consciousness may also be symptoms.

Finally remember that prevention and early intervention is the key to a positive outcome.

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