Meningitis
child; meningitis; amoebic; viral; bacterial; headache; fever; rashes; infectious; diseases ;
Contents
There are many different types of meningitis, depending on what is causing the illness, but usually meningitis is a serious illness which can cause death if not treated quickly. Meningitis caused by bacteria is now uncommon in developed countries but it is still frequent and life threatening in poorer countries.
Alert!
Any child who appears very ill, especially if there is a rash, needs to be urgently seen by a doctor. Rapid treatment may be lifesaving.
- Meningitis is an infection around the brain and spinal cord (meninges).
- It can be caused by bacteria, viruses or parasites (amoeba).
Signs and symptoms
A child with meningitis will be obviously very unwell but the symptoms may not directly point to meningitis. Symptoms can include the following:
- fever, drowsiness or confusion
- vomiting
- looking pale
- being 'floppy' or unusually stiff (especially stiff neck)
- irritability, often being even more irritable when moved,
- high pitched cry
- convulsions (seizures, fits)
- in an older child, complaints of headache and/or back pain
- bulging of the fontanelle in a baby
- irregular breathing
- refusal to feed
- sometimes the child will have been unwell with a 'cold' for a day or so before
- sometimes there is a fine red rash, red-purple spots or bruises (meningococcal infection).
Testing for meningitis
If the doctor thinks your child may have meningitis, the child will need to have a lumbar puncture to be sure. To do this a needle is put into the spine in the lower back to collect some of the fluid from around the brain and spinal cord. Blood tests will also be done to help find the cause of the illness.
Bacterial meningitis
Bacterial meningitis is meningitis caused by bacteria. The most common ones in children are:
- Neisseria meningitidis (causing meninogcoccal meningitis)
- Streptococcus pneumonia
.
Many people, including children, can have these bacteria in their throat or other parts of the body and they only rarely cause meningitis. Haemophilus influenzae type B (Hib), used to be a common cause of bacterial meningitis but since immunisation for Hib is being done, it is now rare in Australia. Hib and the other infections can cause other health problems including ear infections, epiglottitis (caused by Hib), chest infections.
Although rare, when bacterial meningitis occurs it is serious and can be life-threatening.
How long it takes to develop
- Bacterial meningitis takes one to ten days to develop, depending on the cause.
- The symptoms usually develop over a few hours.
Infectious time
- Children with meningitis may spread the bacteria causing the meningitis until antibiotic treatment has been given for at least a day, but most people who are in contact with them will not become unwell.
- Depending on what causes the meningitis, antibiotics may also be given to others who have been in contact with the person who has meningitis.
Treatment
- The child will be admitted to hospital for tests to find the cause.
- Antibiotics will be given, usually through a drip into the child’s vein.
Health problems from meningitis
A small number of children who have bacterial meningitis will die from the illness despite treatment, and some others will have major or minor ongoing problems.
- The effect on the brain will depend on the how bad the illness is and on the age of the child.
- Most children who receive treatment early will recover with no further health problems.
- Meningitis is one of the causes of cerebral palsy when a child has it in the first year of life, and older children can have developmental delays.
- Hearing loss is fairly common following meningitis - all children should have hearing checks as soon as they recover then repeated after six months or a year, since the hearing loss may get worse.
- Seizures (fits, convulsions) can occur after meningitis.
- Other health problems can occur depending on the type of infection (for examples see meningococcal infection and haemophilus influenza type B).
Prevention
- Immunisation against haemophilus influenzae type B (Hib) has been available in Australia since 1992 and is recommended for all children.
- A vaccine against some of the common kinds of meningococcal infection is also available. See 'Meningococcal infection'
Viral meningitis
- Many different viruses can affect the brain and the fluid around it. For example people with mumps can have a severe headache and stiff neck as well as the swollen glands. Other examples of viruses that can cause menigitis are measles, chickenpox, herpes.
- Viral meningitis may come on quickly and seem to be bacterial meningitis, or may start more slowly.
- The child will usually not seem as ill as he would with bacterial meningitis.
- As well as the symptoms of meningitis listed above there may be abdominal (tummy) pain and a rash.
Treatment
- Unless it is very clear what the cause is (eg obvious mumps) a lumbar puncture will usually be needed to tell whether or not there is a bacterial infection.
- Antibiotics may be started "just in case" but these will not treat the virus.
- Once it is certain that it is a viral infection, no special treatment is needed.
- Children almost always recover well from viral meningitis and there are usually no lasting health problems. An exception is measles where rarely there may be brain damage a long time after the illness.
Amoebic meningitis
- Amoebic meningitis is caused by a very small, single-celled creature called an amoeba.
- It usually affects the brain as well as the tissues over the brain. This is called meningo-encephalitis.
- It is a very rare disease, which may be caught while swimming, diving or jumping in fresh water, so it is more likely to occur in summer.
- If water in swimming pools is not properly treated (eg chlorinated) amoeba may be present and get into the body through the nose.
- Amoebic meningitis takes from 2 to 15 days to develop.
- Amoebic meningitis is a very serious disease. It gets worse very quickly and is often fatal.
Treatment
- It is treated with a number of antibiotics, but they often do not help.
Prevention
- It is important to keep swimming pools correctly treated and clean. Paddle pools should be emptied regularly.
- If a case of amoebic meningitis occurs in a public pool, the pool would be closed until the amoeba have been destroyed.
References
Broughton, RA. 'Meningitis, bacterial' in Mosby's Pediatric Clinical Advisor. Garfunkel et al (Ed). Mosby Inc, 2002.
Saez-Liornes X, Mc Cracken Jr GH, 'Bacterial meningitis in children: Seminar' The Lancet vol 361. June 2003, p2139-38.
www.thelancet.com
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
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child's sex.