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MENINGITIS
Meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. Meningitis is a potentially life-threatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Doctors need to treat meningitis to decide the exact cause of the problem and to prevent or reduce any long-term effects.
- The inflammation causing meningitis is normally a direct result of either a bacterial infection or a viral infection. However, the inflammation can also be caused by more rare conditions, such as cancer, a drug reaction, or a disease of the immune system.
- Normally, meningitis causes fever, lethargy, and a decreased mental status (problems thinking), but these symptoms are often hard to detect in young children.
- If the infection or resulting inflammation progresses past the membranes of the brain or the spinal cord, then the process is called encephalitis (inflammation of the brain).
- The highest incidence of meningitis is between birth and 2 years, with the greatest risk immediately following birth and at 3-8 months. Increased exposure to infections and underlying immune system problems present at birth increase a child’s risk of meningitis
Symptoms of Meningitis
The symptoms of meningitis vary and depend both on the age of the child and on the cause of the infection. Because the flu-like symptoms can be similar in both types of meningitis, particularly in the early stages, and bacterial meningitis can be very serious, it's important to quickly diagnose an infection.
The first symptoms of bacterial or viral meningitis can come on quickly or surface several days after a child has had a cold and runny nose, diarrhea and vomiting, or other signs of an infection. Common symptoms include:
- fever
- lethargy (decreased consciousness)
- irritability
- headache
- photophobia (eye sensitivity to light)
- stiff neck
- skin rashes
- seizures
Infants with meningitis may not have those symptoms, and might simply be extremely irritable, lethargic, or have a fever. They may be difficult to comfort, even when they are picked up and rocked.
Other symptoms of meningitis in infants can include:
- jaundice (a yellowish tint to the skin)
- stiffness of the body and neck (neck rigidity)
- fever or lower-than-normal temperature
- poor feeding
- a weak suck
- a high-pitched cry
- bulging fontanelles (the soft spot at the top/front of the baby's skull)
Viral meningitis tends to cause flu-like symptoms, such as fever and runny nose, and may be so mild that the illness goes undiagnosed. Most cases of viral meningitis resolve completely within 7 to 10 days, without any complications or need for treatment.
Meningitis in Children Causes
Meningitis normally occurs as a complication from an infection in the bloodstream. A barrier (called the blood-brain barrier) normally protects the brain from contamination by the blood. Sometimes, infections directly decrease the protective ability of the blood-brain barrier. Other times, infections release substances that decrease this protective ability.
Once the blood-brain barrier becomes leaky, a chain of reactions can occur. Infectious organisms can invade the fluid surrounding the brain. The body tries to fight the infection by increasing the number of white blood cells (normally a helpful immune system response), but this can lead to increased inflammation. As the inflammation increases, brain tissue can start swelling and blood flow to vital areas of the brain can decrease.
Meningitis can also be caused by the direct spread of a nearby severe infection, such as an ear infection (otitis media) or a nasal sinus infection (sinusitis). An infection can also occur any time following direct trauma to the head or after any type of head surgery.
* Bacterial meningitis can be caused by many different types of bacteria. Certain age groups are predisposed to infections of specific types of bacteria.
- Immediately after birth, bacteria called group B Streptococcus, Escherichia coli, and Listeria species are the most common.
- After approximately age 1 month, bacteria called Streptococcus pneumoniae, Haemophilus influenzae type B (Hib), and Neisseria meningitidis are more frequent. The widespread use of the Hib vaccine as a routine childhood immunization is dramatically decreasing the frequency of meningitis caused by Hib.
* Viral meningitis is much less serious than bacterial meningitis and frequently remains undiagnosed because its symptoms are similar to the common flu. The frequency of viral meningitis increases slightly in the summer months because of greater exposure to the most common viral agents, called enteroviruses.