Meningitis (page 4)

About Meningitis

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. Most cases are caused by bacteria or viruses, but some can be due to certain medications or illnesses.

Bacterial meningitis is rare, but is usually serious and can be life threatening if not treated right away. Viral meningitis (also called aseptic meningitis) is relatively common and far less serious. It often remains undiagnosed because its symptoms can be similar to those of the common flu.

People of any age can get meningitis, but because it can be easily spread among those living in close quarters, teens, college students, and boarding-school students are at higher risk for infection.

If dealt with promptly, meningitis can be treated successfully. So it's important to get routine vaccinations, know the signs of meningitis, and if you suspect that your child has the illness, seek medical care right away.

Causes of Meningitis

Many of the bacteria and viruses that cause meningitis are fairly common and associated with other routine illnesses. Bacteria and viruses that infect the skin, urinary system, or gastrointestinal and respiratory tract can spread by the bloodstream to the meninges through cerebrospinal fluid, the fluid that circulates in and around the spinal cord.

In some cases of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis).

Bacterial and Viral Types

Many different types of bacteria can cause bacterial meningitis. In newborns, the most common causes are Group B streptococcus, Escherichia coli, and less commonly, Listeria monocytogenes. In older kids, Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are more often the causes.

Another bacteria, Haemophilus influenza type b (Hib), also can cause the illness but because of widespread childhood immunization, these cases are rarer.

Similarly, many different viruses can lead to viral meningitis, including enteroviruses (such as coxsackievirus and poliovirus) and the herpesvirus.

Symptoms of Meningitis

Meningitis symptoms vary, depending both on the age of the patient and the cause of the infection. The first symptoms of bacterial or viral meningitis can come on quickly or surface several days after someone has had a cold, 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

Meningitis in Infants

Infants with meningitis may not have common symptoms. They might simply have extreme irritability, lethargy, or 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
• 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 headache, 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.

Treatment

Because bacterial meningitis can be so serious, if you think that your child has any form of meningitis, it's important to see the doctor right away.

If meningitis is suspected, the doctor will order laboratory tests to help make the diagnosis, probably including a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of inflammation and whether a virus or bacteria is causing the infection.

Someone with viral meningitis may be hospitalized, although some kids are allowed to recover at home if they are not too ill. Treatment aimed at relieving symptoms includes rest, fluids, and over-the-counter pain medication.

If bacterial meningitis is diagnosed — or even suspected — doctors will start intravenous (IV) antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.