Avisena Specialist Hospital Logo
Appointments +(603) 5515 1966
General Line +(603) 5515 1888
Highlights / Health Articles

Health Articles

July 24, 2024

Meningitis in Children: Early Detection, Emergency Care, and Post-Treatment Recovery

Meningitis is a severe and potentially life-threatening infection that affects the protective membranes covering the brain and spinal cord, known as the meninges. While meningitis can affect individuals of any age, it is particularly dangerous in children due to their developing immune systems.

Understanding how to detect, manage, and recover from meningitis is important for parents, caregivers, and healthcare professionals. This comprehensive guide will cover the early signs of meningitis, emergency care protocols, and the steps involved in post-treatment recovery.


Understanding Meningitis

Meningitis can be caused by various pathogens, including bacteria, viruses, fungi, and parasites. However, the most common forms are bacterial and viral meningitis.

  • Bacterial Meningitis: This is the more severe form and can be life-threatening if not treated promptly. Common bacterial pathogens include Neisseria meningitis, Streptococcus pneumonia, and Haemophilus influenza type b (Hib).
  • Viral Meningitis: Generally, less severe than bacterial meningitis, this type is often caused by enteroviruses, herpes simplex virus, and mumps virus. Viral meningitis usually resolves on its own with supportive care.
  • Parasitic Meningitis: This is caused by parasites like Naegleria fowler or Angiostrongyliasis cantonises, which enter the body through contaminated water or food.
  • Fungal meningitis: This is caused by various types of fungi entering the body through inhalation or skin contact.

Causes of Meningitis

Let’s understand the causes of the various types of meningitis:

1. Bacterial Meningitis

Bacterial meningitis is the most severe form and can lead to significant complications or even death if not treated promptly. The most common bacteria responsible for meningitis in children include:

  • Neisseria meningitis (Meningococcal Meningitis): This bacterium is a leading cause of bacterial meningitis in children and adolescents. It spreads through respiratory droplets from coughing, sneezing, or close contact. Rapid onset of symptoms, including fever, headache, stiff neck, and a distinctive rash.
  • Streptococcus pneumonia (Pneumococcal Meningitis): This is another common cause of bacterial meningitis, particularly in younger children. It spreads through respiratory droplets and direct contact with respiratory secretions. The symptoms are fever, headache, neck stiffness, and altered mental status.
  • Haemophilus influenza type b (Hib): Once a leading cause of bacterial meningitis in children, Hib infections have significantly decreased due to vaccination. It spreads through respiratory droplets, similar to other forms of bacterial meningitis, including fever, headache, and neck stiffness.
  • Group B Streptococcus: This is a common cause of meningitis in newborns, often acquired during childbirth. This is transmitted from mother to baby during delivery. The symptoms are fever, irritability, poor feeding, and lethargy in newborns.
  • Listeria monocytogenes: Meningitis can be a serious condition that poses a risk to newborns and individuals with weakened immune systems. It is typically transmitted through contaminated food or from mother to child during childbirth. The symptoms of bacterial meningitis are similar to those of other types of meningitis.

2. Viral Meningitis

Viral meningitis is generally less severe than bacterial meningitis and often resolves without specific treatment. Common viruses that cause meningitis include:

  • Enteroviruses: The most common cause of viral meningitis, especially in children. This is transmitted through respiratory secretions, the faecal-oral route, and contaminated surfaces. The symptoms are fever, headache, nausea, vomiting, and sometimes a rash.
  • Herpes Simplex Virus (HSV): Meningitis can be caused by various viruses, with HSV-2 being particularly prevalent in newborns. This virus is typically transmitted during childbirth or through direct contact with an infected individual. Symptoms of HSV-2 meningitis include fever, irritability, poor feeding, and in severe cases, seizures.
  • Mumps Virus: Mumps can lead to meningitis, especially in children who have not been vaccinated. The virus is spread through respiratory droplets. Common symptoms include fever, headache, swollen salivary glands, and stiffness in the neck.
  • Varicella-Zoster Virus (VZV): The virus that causes chickenpox and shingles can also lead to meningitis. It is transmitted through respiratory droplets or direct contact with lesions. The symptoms are fever, headache, and vesicular rash.

3. Fungal Meningitis

Fungal meningitis is rare in children and usually affects those with weakened immune systems. The most common fungi involved include:

  • Cryptococcus neoformans: Cryptococcus neoformans can cause meningitis, particularly in individuals with compromised immune systems. The fungus is transmitted through the inhalation of spores found in the environment. Symptoms of infection include a gradual onset of headache, fever, and neck stiffness.
  • Candida species: Meningitis can be a serious concern for premature infants or individuals with weakened immune systems. The transmission of this condition typically occurs through the bloodstream in hospital settings. Common symptoms of meningitis include fever, irritability, and lethargy. It is important to be vigilant and seek medical attention promptly if any of these symptoms are present, especially in vulnerable populations.

4. Parasitic Meningitis

Parasitic meningitis is extremely rare but can be life-threatening. It includes:

Naegleria Fowler: The brain-eating amoeba, also known as Naegleria Fowler, is responsible for causing primary amoebic meningoencephalitis (PAM). This deadly infection is transmitted when contaminated water enters the nose.

Symptoms of PAM include a rapid onset of severe headache, fever, nausea, vomiting, and a stiff neck. It is crucial to seek medical attention immediately if you experience any of these symptoms after being in contact with potentially contaminated water.


Risk Factors for Meningitis

Various factors can increase a child’s risk of developing meningitis. Understanding these risk factors can help in taking preventive measures.

  • Age: The highest risk of bacterial and viral meningitis is in infants and young children due to their underdeveloped immune systems.
  • Immunization Status: Children who have not received recommended vaccines for Hib, pneumococcus, and meningococcus are at higher risk.
  • Community and Environmental Exposure: Settings such as daycare centres, schools, and dormitories facilitate the spread of infectious agents. Travelling to or living in areas with high incidences of meningitis can increase risk.
  • Medical Conditions: Conditions such as HIV, cancer, or the use of immunosuppressive drugs can increase susceptibility to infections. Conditions like diabetes or kidney disease may also elevate risk.
  • Birth and Neonatal Factors: Premature infants are at higher risk due to their immature immune systems. Mothers with infections during pregnancy can pass pathogens to the newborn during childbirth.
  • Recent Infections or Head Trauma: Infections in the ear or sinuses can potentially spread to the meninges, the protective membranes surrounding the brain and spinal cord. Individuals who have recently experienced head trauma or undergone brain surgery are at a higher risk of developing meningitis, an inflammation of the meninges.
  • Genetic and Racial Factors: Certain genetic conditions can affect the immune system, increasing susceptibility. Some studies suggest higher incidences in certain racial and ethnic groups, possibly due to genetic and socioeconomic factors.

Early Detection of Meningitis in Children

Early detection of meningitis is vital for effective treatment and improved outcomes. The symptoms of meningitis can vary depending on the age of the child and the type of pathogen involved. Here are the common signs and symptoms to watch for:

In Infants (under 2 years old)

  • Fever: Often the first sign, though it may be absent in newborns.
  • Irritability and Crying: Infants may be inconsolable and cry more than usual.
  • Poor Feeding: Refusal to eat or difficulty feeding.
  • Vomiting: Unexplained vomiting can be a symptom.
  • Lethargy: Excessive sleepiness or difficulty waking up.
  • Bulging Fontanelle: The soft spot on the top of the baby’s head may appear swollen or bulging.
  • Seizures: In severe cases, the child can experience seizures.

In Older Children

  • Severe Headache: Persistent and intense headaches are common.
  • Stiff Neck: Inability to bend the neck forward due to rigidity.
  • Fever and Chills: High fever and chills can occur suddenly.
  • Nausea and Vomiting: Similar to symptoms in infants but more pronounced.
  • Photophobia: Sensitivity to light.
  • Altered Mental State: Confusion, delirium, or difficulty concentrating.
  • Rash: A distinctive rash that does not fade under pressure (a glass test can be used).

Emergency Care

Once meningitis is suspected, immediate medical attention is crucial. Here are the steps involved in emergency care:

Initial Assessment: To begin with, an initial assessment is conducted where the child’s temperature, heart rate, respiratory rate, and blood pressure are checked. This is often followed by a thorough examination to identify symptoms and potential exposure risks.

Diagnostic Tests: Next the doctor may conduct several diagnostic tests such as:

  • Lumbar Puncture (Spinal Tap): This definitive test for diagnosing meningitis involves collecting cerebrospinal fluid (CSF) to identify the organism that’s causing the disease.
  • Blood Tests: Blood cultures and other laboratory tests to identify infection and assess overall health.
  • Imaging: In some cases, a CT scan or MRI may be performed to check for complications such as brain swelling.

Treatment Protocols

Let’s talk about treatment. Usually, the treatment path followed for different kinds of meningitis are:

  • Bacterial Meningitis: Requires immediate administration of intravenous antibiotics. The choice of antibiotics depends on the age of the child and the likely causative bacteria.
  • Viral Meningitis: Treatment is mainly supportive, including fluids, pain management, and antiviral medications in specific cases.
  • Antifungal medications: These are prescribed for fungal meningitis treatment, with surgery sometimes required to remove infected tissue. Treatment duration varies based on infection severity, ranging from weeks to months.
  • Parasitic meningitis: This is treated with antiparasitic medications and supportive care. Follow your healthcare provider’s recommendations and attend all appointments for proper management of the infection.

Post-Treatment Recovery

Recovering from meningitis involves careful monitoring and supportive care to address both immediate and long-term effects.

Hospitalisation

Children diagnosed with bacterial meningitis typically require hospitalisation for several days to weeks, depending on the severity and response to treatment. During this time, they will receive:

  • Intravenous Antibiotics: Continued administration of antibiotics until the infection is controlled.
  • Hydration and Nutrition: Ensuring the child is well-hydrated and receives adequate nutrition.
  • Monitoring for Complications: Regular monitoring for complications such as seizures, hearing loss, or developmental delays.

Home Care

Once discharged, ongoing care at home is essential for full recovery. Parents and caregivers should:

  • Follow Medication Schedules: Complete the full course of prescribed antibiotics or other medications.
  • Monitor Symptoms: Watch for any signs of recurrence or complications, such as fever, headaches, or behavioural changes.
  • Regular Check-ups: Attend follow-up appointments with healthcare providers to monitor recovery and address any concerns.

Long-term Effects and Rehabilitation

Some children may experience long-term effects from meningitis, requiring additional support and rehabilitation:

  • Hearing Loss: Regular hearing tests and, if needed, hearing aids or cochlear implants.
  • Cognitive and Developmental Issues: Assessment by paediatric neurologists or developmental specialists, with possible interventions such as speech therapy, occupational therapy, or physical therapy.
  • Psychological Support: Counselling or support groups for emotional and psychological recovery.

Prevention Strategies

Preventing meningitis, particularly bacterial meningitis, is a key component of child health care. Here are some effective strategies:

Vaccination

  • Routine Vaccinations: Ensure children receive routine vaccinations as recommended, including Hib, pneumococcal, and meningococcal vaccines.
  • Catch-up Vaccinations: For children who missed vaccines during infancy, catch-up vaccinations can be scheduled.

Hygiene Practices

  • Handwashing: Regular handwashing with soap and water can prevent the spread of infections.
  • Cough Etiquette: Teach children to cover their mouths when coughing or sneezing and use tissues.

Avoiding Exposure

  • Sick Contacts: Minimise contact with individuals who are sick, especially during outbreaks of meningitis.
  • Crowded Places: Limit time spent in crowded places where infections can spread more easily.

Summing it Up

Meningitis in children is a medical emergency that requires rapid diagnosis, prompt treatment, and careful post-treatment care. Early detection can significantly improve outcomes, while comprehensive emergency care and supportive home care can enhance recovery. Preventive measures, particularly vaccination, play a vital role in protecting children from this serious infection.

By staying informed and vigilant, parents, caregivers, and healthcare providers can work together to safeguard children’s health and ensure they receive the best possible care in the face of meningitis.


Frequently Asked Questions

1. Can a 5-year-old get meningitis?

Yes, a 5-year-old can get meningitis.

2. How to protect a child from meningitis?

Vaccinating your child is the most effective way to protect them from meningitis.

3. What are the first symptoms of meningitis in children?

The first symptoms of meningitis in children often include high fever, severe headache, and neck stiffness.


Require expert advice or specialized treatment? Please arrange an appointment with our specialist.

Dr Mohd Raffiz Mohd Ali
Consultant Neurosurgeon & Spine Surgeon (Visiting)

Go to Specialist Profile



Back to All Highlights