Meningitis in Children

Inflammation of the membranes that cover the brain and spinal cord, usually caused by a bacterial or viral infection

  • Living in close communities is a risk factor
  • Age as a risk factor depends on the cause
  • Gender and genetics are not significant factors

Meningitis is a serious infection of the meninges (the membranes that cover the brain and spinal cord). Bacterial meningitis is a potentially fatal condition and causes between 150 and 200 deaths each year in the UK. Most cases of bacterial meningitis occur in infants under the age of 3 and in young people between the ages of about 15 and 25. Outbreaks of the infection can occur in communities where children are in close contact with one another, such as nurseries and schools.

Meningitis that is caused by a viral infection is a much less severe disorder and is rarely life-threatening.

What are the causes?

Bacterial meningitis in children is most often due to infection with Neisseria meningitidis (meningococcus), of which there are several types, or Streptococcus pneumoniae. Until recently, another major cause of meningitis was the bacterium Haemophilus influenzae type b (Hib). In the UK, the introduction of routine immunization for Hib and meningococcus type C has made these particular infections uncommon. However, no vaccine is available for meningococcus type B, which is now one of the most common causes of meningitis. A further meningococcal bacterium, type A, is rare in the UK. Tuberculosis can also be a cause of bacterial meningitis but this form of the disease is uncommon in children.

Viral meningitis can be caused by a number of different viruses, including those responsible for chickenpox and mumps.

What are the symptoms?

The symptoms of bacterial and viral meningitis are similar. However, bacterial meningitis tends to develop much more rapidly, and can cause serious illness within a few hours. Unlike adults, young children, especially those under 2 months of age, may not have obvious symptoms, and it is often difficult to distinguish the disease from other less serious infections. Symptoms likely to appear in young children include:

  • Fever.

  • Drowsiness or restlessness and high-pitched crying.

  • Vomiting and/or diarrhoea.

  • Reluctance to feed.

  • In meningococcal meningitis, a distinctive rash of flat, reddish-purple lesions varying in size from pinheads to large patches that do not fade when pressed (see Checking a red rash).

Older children may, in addition, have the characteristic symptoms of meningitis in adults, which are:

  • Severe headache and an extremely stiff neck, particularly when bending the head forwards.

  • Dislike of bright lights.

If bacterial meningitis is left untreated, seizures may occur, followed by loss of consciousness, coma, and possibly death. Rarely, pus may collect in the brain (see Brain abscess).

What might be done?

A child with meningitis needs urgent hospital treatment, often in an intensive therapy unit. When bacterial meningitis is suspected, one or more intravenous antibiotics will be given before any tests are carried out. A lumbar puncture, to remove a sample of fluid from around the spinal cord, will be performed to confirm the diagnosis. The antibiotics will be discontinued if the spinal fluid does not contain bacteria associated with meningitis. The child will be given fluids intravenously to prevent dehydration, and anticonvulsant drugs may be prescribed if he or she has seizures.

Close contacts, such as family members and children in the same class as the child, may be given oral antibiotics as a precaution.

What is the prognosis?

Children with viral meningitis usually recover fully in about 2 weeks. Bacterial meningitis proves fatal in about 1 in 10 cases. About 1 in 10 children who recovers has long-term problems such as impaired hearing or epilepsy.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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