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FAQ: Meningitis in Infants and Children

Shiloh

Editor, Senior Moderator
Source: http://www.24medica.com/content/view/1146/2/

FAQ: Meningitis in Infants and Children
Written by Phillip LaVeque
Tuesday, 27 October 2009

Meningitis is an inflammation of the membranes that line the brain and spinal cord. It is usually caused by infection.

What is going on in the body?
The central nervous system, also called the CNS, consists of the brain and spinal cord. Three layers of fibrous tissue cover the surfaces of the brain and spinal cord. These layers cushion and protect the CNS.

Sometimes organisms, such as bacteria or viruses, can infect these layers. When this happens, the body takes steps to defend itself from infection. White blood cells and other infection-fighting substances pour into the cerebrospinal fluid, or CSF. This is the fluid that circulates within the brain and over its surface. This process results in a set of symptoms known as meningitis.

What are the causes and risks of the infection?

Meningitis can be caused by a number of different organisms, including:
- bacteria, such as Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae
- organisms similar to bacteria, such as mycobacteria that cause tuberculosis
- viruses, such as Herpes simplex

Following are some of the risk factors for meningitis in children:
- chronic diseases, such as diabetes or sickle cell anemia
- conditions that weaken the immune system, such as cancer or HIV
- day care, preschool, or other large gatherings of children
- head injury
- infections that involve the face and sinuses, such as cellulitis or sinusitis
- poor or crowded conditions
- septic arthritis
- severe illness in newborns
- viral illnesses, such as measles, mumps, or rubella

What are the treatments for the infection?
The primary treatment for meningitis is antibiotic therapy, which is often given through an intravenous, or IV, line. One or more of the following antibiotics may be given:
- ampicillin
- cefotaxime
- ceftazidime
- ceftriaxone
- chloramphenicol
- gentamicin
- vancomycin

Other treatments, such as the following, may be given:
- acetaminophen to reduce fever
- corticosteroids, such as dexamethasone, to reduce inflammation
- intravenous fluids to prevent or treat dehydration
- medicines to stop seizures if they occur

The length of treatment depends on the cause of the meningitis and the age of the child. Treatment generally lasts from 1 to 3 weeks.

What are the side effects of the treatments?
Antibiotics may cause allergic reactions, kidney damage, or liver damage. Corticosteroids may increase the risk of bleeding in the gut or worsen the infection. Medicines to stop seizures may cause low blood pressure or allergic reactions.

What happens after treatment for the infection?

A child may feel weak and tired for several weeks after the meningitis goes away. It may take weeks or months for normal brain function to return in children who went into a coma during the illness. Some children may have permanent brain damage. This can cause deafness or problems in school or later in life. Children who survive very serious meningitis may have severe mental retardation.

How is the infection monitored?
The child will have checkups for years after the illness to look for problems with vision, hearing, or movement. Mental functioning is also monitored to detect mental retardation or learning disabilities. Any new or worsening symptoms should be reported to the healthcare provider.
 
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