Bacterial Meningitis in Newborns – Children’s Health Issues

By

Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Reviewed/Revised Oct 2022

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Topic Resources

Bacterial meningitis is inflammation of the layers of tissue surrounding the brain and spinal cord (meninges) caused by bacteria Overview of Bacteria Bacteria are microscopic, single-celled organisms. They are among the earliest known life forms on earth. There are thousands of different kinds of bacteria, and they live in every conceivable… read more .

• Newborns with bacterial meningitis are usually irritable, vomit, or may have seizures.

• The diagnosis is based on the results of a spinal tap and blood tests.

• All untreated newborns die from the infection.

• Pregnant women who have a certain kind of bacteria (group B streptococci) are given antibiotics during delivery to prevent spreading the bacteria to the newborn.

• Antibiotics are given intravenously to treat the infection.

(For an overview of meningitis, see Introduction to Meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be… read more . See also Overview of Infections in Newborns Overview of Infections in Newborns Infections occur at all ages but are a great cause for concern in newborns because newborns, especially preterm ones, have an underdeveloped immune system and are more susceptible to infection… read more , Meningitis Acute Bacterial Meningitis Acute bacterial meningitis is rapidly developing inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid. .. read more in adults, Meningitis in Children Meningitis in Children Bacterial meningitis is a serious infection of the layers of tissue covering the brain and spinal cord ( meninges). Bacterial meningitis in older infants and children usually results from bacteria… read more , and Viral Meningitis Viral Meningitis Viral meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space) when it is caused… read more .)

Meningitis that is caused by bacteria is life-threatening at any age but is of special concern in newborns.

Bacterial meningitis in newborns usually results from an infection of the blood (sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have… read more ). The infection is most commonly caused by the following bacteria:

A number of other bacteria may cause meningitis as well.

Sometimes bacterial meningitis occurs in newborns when the bacteria enter the body through cuts or punctures in the scalp. The cuts or punctures can be caused by instruments that are used for delivery or by probes that are stuck to the scalp.

Older children with bacterial meningitis usually develop a stiff neck and have a headache. Newborns rarely develop a stiff neck and are unable to communicate specific discomfort. In newborns, important signs of illness that should alert hospital staff or parents to a possibly serious problem include

• Signs of sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have… read more (for example, temperature too high or too low, trouble breathing, yellowing of the skin and eyes [ jaundice Jaundice in the Newborn Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells… read more ], and pauses in breathing [apnea])

• Abnormal drowsiness (lethargy)

• Seizures Seizures in Children Seizures are a periodic disturbance of the brain’s electrical activity, resulting in some degree of temporary brain dysfunction. When older infants or young children have seizures, they often… read more

• Vomiting

• Unusual fussiness and irritability (particularly a newborn who does not calm down when held)

In some newborns with meningitis, increased pressure of the fluid around the brain may make the fontanelles (the soft spots between the skull bones) bulge or feel firm.

A doctor diagnoses bacterial meningitis by removing a sample of spinal fluid obtained through a procedure called a spinal tap Spinal Tap Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which… read more (lumbar puncture). The fluid is analyzed, and if there are any bacteria in that sample, they are examined and grown (cultured Culture of Microorganisms Infectious diseases are caused by microorganisms, such as bacteria, viruses, fungi, and parasites. Doctors suspect an infection based on the person’s symptoms, physical examination results,… read more ) in a laboratory for identification. Doctors also take a sample of blood to be cultured and analyzed.

Doctors may also do the PCR Polymerase chain reaction (PCR) Genetic diagnostic technologies are scientific methods that are used to understand and evaluate an organism’s genes. (See also Genes and Chromosomes.) Genes are segments of deoxyribonucleic… read more test on a sample of spinal fluid. The PCR test looks for the genetic material of the bacteria and enables doctors to rapidly identify the bacteria.

A doctor may do an imaging test such as ultrasonography Ultrasonography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography. .. read more or CT Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually… read more or MRI Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe… read more of the brain to make sure it is safe to do a spinal tap.

Without treatment, nearly all newborns with bacterial meningitis die.

With treatment, the risk of death is 5 to 20%. Of the newborns who survive, 20 to 50% develop serious brain and nerve problems, such as an accumulation of extra fluid in the normal open spaces within the brain (hydrocephalus Hydrocephalus Hydrocephalus is an accumulation of extra fluid in the normal spaces within the brain (ventricles) and/or between the inner and middle layers of tissues that cover the brain (the subarachnoid. .. read more ), hearing loss Hearing Impairment in Children Hearing impairment refers to any degree of hearing loss, mild to severe, and can occur when there is a problem with a part of the ear, including the inner, middle, and outer ears, or the nerves… read more , and intellectual disability Intellectual Disability Intellectual disability is significantly below average intellectual functioning present from birth or early infancy, causing limitations in the ability to conduct normal activities of daily… read more .

While pregnant, women are typically screened for group B streptococci (GBS) in their genital tract. Pregnant women who have GBS may be given antibiotics at the time of delivery to prevent passing the bacteria to the newborn.

• Antibiotics

While awaiting culture results, the newborn is given antibiotics (often, ampicillin plus gentamicin, cefotaxime, or both) by vein (intravenously). Once the culture results are available, doctors change the antibiotics, if needed, to ones that are appropriate for the type of bacteria causing the meningitis.

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Symptoms, Causes, Treatment, Vaccine, and More

Overview

Meningitis is inflammation of the three membranes (meninges) that line the brain and spinal cord.

Although meningitis can affect people of any age, babies under 2 are at the highest risk of getting meningitis. Your baby can get meningitis when bacteria, viruses, or a fungus infecting another part of their body travels in the bloodstream to their brain and spinal cord.

Out of 1,000 live births, about 0.1 to 0.4 neonates (a baby less than 28 days old) get meningitis, estimates a 2017 review. It’s a serious condition, but 90 percent of these babies survive. The same study notes anywhere from 20 to 50 percent of them have long-term complications, like learning difficulties and vision problems.

It’s always been uncommon, but the use of vaccinations against bacterial meningitis has dramatically reduced the number of babies getting it.

Before there was a pneumococcal vaccine, 10 out of 100,000 babies under 1 year old got pneumococcal meningitis, reports the Centers for Disease Control and Prevention (CDC). From 2002 through 2007, when the vaccine was routinely used, only about 8 out of 100,000 babies age 1 to 23 months got any type of bacterial meningitis, estimates a 2011 article.

Symptoms of meningitis in babies

The symptoms of meningitis can come on very rapidly. Your baby may be hard to comfort, especially when they’re being held. Other symptoms in a baby may include:

• developing a sudden high fever
• not eating well
• vomiting
• being less active or energetic than usual
• being very sleepy or hard to wake up
• being more irritable than usual
• bulging of the soft spot on their head (the fontanel)

Other symptoms may be difficult to notice in a baby, such as:

• severe headache
• neck stiffness
• sensitivity to bright light

Occasionally, a baby may have a seizure. Many times this is due to the high fever and not the meningitis itself.

Causes of meningitis in babies

Bacteria, viruses, or a fungus can cause meningitis in a baby.

Viral meningitis has long been the most common cause of meningitis. Since the development of vaccines to prevent bacterial meningitis, this type of meningitis has become increasingly uncommon. Fungal meningitis is rare.

Viral meningitis

Viral meningitis usually isn’t as serious as bacterial or fungal meningitis, but some viruses do cause a severe infection. Common viruses that usually cause mild disease include:

• Non-polio enteroviruses. These viruses cause most cases of viral meningitis in the United States. They cause many kinds of infections, including colds. A lot of people contract them, but very few get meningitis. The viruses spread when your baby comes in contact with infected stool or oral secretions.
• Influenza. This virus causes the flu. It’s spread through contact with secretions from the lung or mouth of a person infected with it.
• Measles and mumps viruses. Meningitis is a rare complication of these very contagious viruses. They’re easily spread through contact with infected secretions from the lungs and mouth.

Viruses that can cause very severe meningitis include:

• Varicella. This virus causes chickenpox. It’s easily spread by contact with a person infected with it.
• Herpes simplex virus. A baby usually gets it from their mother in the womb or during birth.
• West Nile virus. This is transmitted by a mosquito bite.

Children under 5, including babies, have a higher risk of getting viral meningitis. Babies between birth and 1 month of age are more likely to develop a severe viral infection.

Bacterial meningitis

During the first 28 days of life, bacterial meningitis is most often caused by bacteria called:

• Group B Streptococcus. This usually spreads from a mother to her baby at birth.
• Gram-negative bacilli, such as Escherichia coli (E. coli) and Klebsiella pneumoniae.E. coli can spread via contaminated food, food prepared by someone who used the bathroom without washing their hands afterward, or from mother to baby during birth.
• Listeria monocytogenes.Neonates usually get this from their mom in the womb. Occasionally a baby may get it during delivery. The mother gets it by eating contaminated food.

In children under 5 years, including babies over 1 month old, the most common bacteria that cause meningitis are:

• Streptococcus pneumoniae. This bacterium is found in the sinuses, nose, and lungs. It spreads through breathing in air that a person infected with it sneezed or coughed into. It’s the most common cause of bacterial meningitis in babies younger than 2 years.
• Neisseria meningitidis. This is the second most common cause of bacterial meningitis. It spreads through contact with secretions from the lungs or mouth of a person infected with it. Babies less than 1 year old are at highest risk of getting this.
• Haemophilus influenzaetype b (Hib). This is spread by contact with secretions from the mouth of a person who’s a carrier. Carriers of the bacteria usually aren’t sick themselves but can make you sick. A baby must be in close contact with a carrier for a couple days to get it. Even then, most babies will only become carriers and not get meningitis.

Fungal meningitis

Fungal meningitis is very rare because it usually only affects people with a weak immune system.

Several types of fungi can cause meningitis. Three types of fungus live in the soil, and one type lives around bat and bird droppings. The fungus enters the body by being breathed in.

Babies born prematurely who don’t weigh very much have a higher risk of getting a blood infection from a fungus called Candida. A baby usually contracts this fungus in the hospital after birth. It can then travel to the brain, causing meningitis.

Diagnosis of meningitis in babies

Tests can confirm the diagnosis of meningitis and determine what organism is causing it. Tests include:

• Blood cultures. Blood removed from your baby’s vein is spread on special plates that bacteria, viruses, or a fungus grows well on. If something grows, that’s probably the cause of the meningitis.
• Blood tests. Some of the blood removed will be analyzed in a lab for signs of infection.
• Lumbar puncture. This test isalso called a spinal tap. Some of the fluid that surrounds your baby’s brain and spinal cord is removed and tested. It’s also put on special plates to see if anything grows.
• CT scan. Your doctor may get a CT scan of your baby’s head to see if there’s a pocket of infection, called an abscess.

Treatment of meningitis in babies

The treatment for meningitis depends on the cause. Babies with some types of viral meningitis get better without any treatment.

However, always take your baby to the doctor as soon as possible any time you suspect meningitis. You can’t be sure what’s causing it until your doctor does some tests because the symptoms are similar to other conditions.

When needed, treatment has to start as soon as possible for a good outcome.

Viral meningitis

Most of the time, meningitis due to non-polio enteroviruses, influenza, and mumps and measles viruses is mild. However, young infants are at higher risk of having severe disease. A baby who has it may get better within 10 days without needing any treatment.

Meningitis caused by other viruses, like varicella, herpes simplex, and West Nile virus, can be serious. This may mean your baby needs to be hospitalized and treated with intravenous (IV) antiviral medication.

Bacterial meningitis

Antibiotics are used to treat bacterial meningitis. They’re often given through an IV. Your baby will probably have to stay in the hospital.

Fungal meningitis

Fungal infections are treated with IV antifungal medication. Your baby will most likely have to get treatment in the hospital for a month or more. This is because fungal infections are hard to get rid of.

Preventing meningitis in babies

Vaccines can prevent many, but not all, kinds of meningitis if they’re given as recommended by the CDC. None are 100 percent effective, so even babies that are vaccinated can get meningitis.

Note that although there’s a “meningitis vaccine,” it’s for one specific type of bacterial meningitis called meningococcal meningitis. It’s generally recommended for older children and teens in the United States. It’s not used in babies.

In some countries such as the United Kingdom, babies often do receive a meningitis vaccine.

Viral meningitis

Vaccines against viruses that can lead to meningitis are:

• Influenza. This protects against meningitis caused by the flu virus. It’s given every year starting at 6 months of age. Although younger babies don’t get this vaccine, it does offer protection when family members and others who will be around your baby are vaccinated.
• Varicella. This vaccine protects against chickenpox. The first is given when your baby is 12 months old.
• Measles, mumps, rubella (MMR). If your baby gets the measles or mumps, it can lead to meningitis. This vaccine protects against those viruses. The first dose is given at 12 months of age.

Bacterial meningitis

Vaccines to prevent infections that can lead to bacterial meningitis in babies are:

• Haemophilus influenzae type b (Hib) vaccine. This protects against H. influenza bacteria. In developed countries, like the United States, this vaccine has nearly eliminated this type of meningitis. The vaccine protects a baby from getting meningitis and from becoming a carrier. Reducing the number of carriers leads to herd immunity. This means that even babies who aren’t vaccinated have some protection since they’re less likely to come in contact with a carrier. The first dose is given at 2 months of age.
• Pneumococcal (PCV13) vaccine. This protects against meningitis due to many strains of Streptococcus pneumoniae. The first dose is given at 2 months of age.
• Meningococcal vaccine. This vaccine protects against Neisseria meningitidis. It’s not routinely given until age 11, unless there’s an issue with a baby’s immune system or they’re traveling to countries where the bacterium is common. If that’s the case, then it’s given starting at 2 months of age.

For group B strep, antibiotics can be given to the mother during labor to help prevent the baby from getting it.

Pregnant women should avoid cheese made with unpasteurized milk because it’s a common source of Listeria. This helps prevent the mother from contracting Listeria and then transferring it to her baby.

Follow general precautions to avoid infections and help lower the risk of getting meningitis from any bacteria or viruses:

• Wash your hands often, especially before handling food and after:
  • using the bathroom
  • changing your baby’s diaper
  • covering your mouth to sneeze or cough
  • blowing your nose
  • taking care of someone who might be contagious or has an infection
• Use proper hand-washing technique. This means washing with soap and warm water for at least 20 seconds. Make sure to wash your wrists and under your nails and rings.
• Cover your mouth with the inside of your elbow or a tissue every time you sneeze or cough. If you use your hand to cover, wash it right away.
• Don’t share things that may carry saliva, such as straws, cups, plates, and utensils. Avoid kissing a person who’s sick.
• Don’t touch your mouth or face if your hands aren’t washed.
• Frequently clean and disinfect objects you often touch, such as your phone, computer keyboard, remote controls, doorknobs, and toys.

Fungal meningitis

There are no vaccines for fungal meningitis. Babies aren’t normally in the environments where most fungi live, so they’re unlikely to get fungal meningitis.

Since it’s usually picked up in the hospital, using routine infection precautions can help prevent a Candida infection, which can lead to meningitis, in low-weight premature babies.

Long-term effects and outlook

Meningitis is an uncommon but serious, life-threatening infection. However, a baby will almost always fully recover when it’s diagnosed and treated early.

If treatment is delayed, a baby can still recover, but they may be left with one or more long-term effects, including:

• blindness
• deafness
• seizures
• fluid around the brain (hydrocephalus)
• brain damage
• learning difficulties

The CDC estimates 85 to 90 percent of people (babies and adults) with meningitis due to meningococcal bacteria survive. Around 11 to 19 percent will have long-term effects.

This may sound scary, but put another way, about 80 to 90 percent of people who recover have no long-term effects. The CDC estimates estimated 92 percent of children with meningitis due to pneumococcus survive.

Meningitis – Hadassah Medical Moscow

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Hadassah Medical Moscow Clinic successfully treats meningitis of any etiology and pathogenesis. First-class modern equipment allows for accurate diagnosis. With the help of research in the clinic’s own laboratory, the causative agent of the disease will be identified as soon as possible, which contributes to the timely start of adequate treatment and its effectiveness.

Meningitis is a generalized name for a group of dangerous diseases of the membranes of the brain and spinal cord of infectious and non-infectious etiology. The disease can be primary or secondary, with a rapid or slow course, erased or obvious symptoms, often disguised as other diseases.
Meningitis primarily affects people at risk, but can affect anyone. The danger is in the complications. The disease causes irreversible processes in the brain and spinal cord, has a high mortality rate, and survivors often become disabled for life.
If you suspect a disease in yourself or loved ones, contact the Hadassah Medical Center in Moscow, do not waste valuable time!

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Benefits of treatment at the Hadassah clinic

Own laboratory with advanced equipment

The laboratory at the Hadassah clinic performs all types of general clinical, biochemical studies. Rapid identification of the pathogen, the cause of the disease allows you to prescribe adequate therapy in a timely manner and quickly achieve success in treatment.

Strict quality control of all stages of diagnosis and treatment

All manipulations in the medical center meet the best international standards. Multi-stage control of appointments, actions of medical staff, treatment procedures allows you to avoid medical errors and the human factor in the process.

Multidisciplinary approach

In addition to the attending physician, doctors of related specialties are involved in the treatment of each patient. Russian and Israeli specialists of world renown can be involved in the diagnostic and treatment procedure.

Medical consultation is one of the forms of successful professional interaction

Diagnosis and treatment of each patient does not depend on the opinion of only one doctor. A consultation of at least three specialists is involved in making a diagnosis, determining the optimal appointments. This contributes to the objectivity of the medical view of the case, all appointments and conclusions.

Original drugs

The Medical Center cooperates with the largest pharmaceutical companies, so it is able to offer its patients original drugs of the highest quality. Many medicines used in treatment are not yet registered in Russia, but they have already shown themselves effectively in foreign clinics.

Medical support, rehabilitation and care.

Our patients receive full medical support. After treatment, we offer an individual rehabilitation program, and if necessary, care for the patient. Our medical staff will not only provide all types of medical services, but also teach the relatives of a sick person the necessary techniques.

Signs of meningitis in adults and children are often disguised as SARS, influenza, but the disease in most cases has a rapid progression with a sharp deterioration.

Consequences of meningitis can be life-threatening, therefore, if symptoms of the disease are likely, you should consult a doctor, self-treatment can be dangerous!

Meningitis – what is it?

The brain is covered by several membranes – hard, arachnoid and soft. Between the soft and arachnoid membranes there is a subarachnoid space filled with cerebrospinal fluid. Capillaries and cerebrospinal fluid are often “transmitters” of infectious agents to the brain.

The disease affects the pia mater, as the most vulnerable to infection and inflammation, because it is penetrated by a network of blood vessels, directly covering the substance of the cerebral hemispheres and the spinal cord.

Meningitis – what kind of disease, how does it occur?

This pathology is an inflammation of the pia mater of the brain and spinal cord. The condition is accompanied by fever, severe general intoxication, disorders of consciousness.

Meningeal syndrome is supplemented by high intracranial pressure, unbearable headaches, and a rapid increase in the severity of pathological symptoms. There are specific changes in the characteristics of the cerebrospinal fluid, inflammation quickly spreads throughout the body, passes to other organs and systems.

Attention! Knowing what meningitis is, a person should take timely measures to prevent the disease in himself and his loved ones.

If you experience anxiety symptoms, you should immediately seek medical help!

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Symptoms of meningitis in adults and children, meningeal syndrome

Often the first signs of meningitis resemble the onset of a respiratory viral illness.

The so-called triad of symptoms of meningitis in an adult or a child is characteristic: high body temperature, vomiting not associated with eating, severe headaches.

Meningeal syndrome includes:

• Stiff neck, back muscles.
• Hyperesthesia – increased sensitivity to light, sounds, smells, tactile, cold factors.
• Triad of intoxication.
• The patient may experience emotional arousal or drowsiness, hallucinations, convulsions.

Different types of meningitis have different symptoms:

• Viral. Symptoms are similar to those of the flu, intoxication is growing rapidly.
• Bacterial. The rapid increase in symptoms and deterioration of the patient’s condition; body temperature up to 40 degrees, disorders of consciousness.
• Purulent. Very pronounced intoxication with indomitable vomiting, loss of consciousness, an epileptic seizure.
• Meningococcal. Signs of severe intoxication, fever, hallucinations, hemorrhagic skin rashes.
• Protozoan. Aches in muscles and joints, rash on the skin, swollen lymph nodes.
• Fungal. Fever, sudden weight loss, lack of appetite, temperature, drowsiness, lethargy.

Symptoms and signs of meningitis in children

In infants, symptoms may include:

• Constant crying.
• Lack of appetite, vomiting at meals.
• Skin rash.
• Redness and swelling in the area of ​​the fontanel.
• Convulsions.
• Cold hands and feet.
• Difficulty breathing, wheezing.
• The baby is difficult to wake up.
• The infant assumes a forced posture with the head thrown back.
• Symptoms of meningitis in children 3-7 years:
• Digestive disorders, diarrhea.
• Severe headache.
• Lethargy.
• Hypersensitivity to light, sounds, smells.
• Vomiting, nausea, loss of appetite.
• Signs of intoxication, high temperature.
• The child is uncomfortable with tactile contact.

The symptoms of meningitis in school-age children and adolescents do not differ from those of adults.
Attention! Parents should listen to what the child says about their well-being, and respond in time, seeking medical help.
For example, a child of the school age category can already tell about headaches, weakness, nausea, etc. Meningitis in children can proceed at lightning speed, self-treatment is unacceptable!

Causes of meningitis

Often the causes of meningitis are seen as hypothermia, linking the disease with epidemiologically dangerous seasons – autumn and spring. Indeed, some cases begin precisely as a seasonal viral infection, this is associated with a decrease in immunity, viral load as a result of SARS, influenza, beriberi.

However, meningitis often occurs during the warm season, in an environment favorable for the rapid reproduction and transmission between people of fungi, bacteria, viruses. The most susceptible to the disease are weakened people with a low immune response of the body to the pathogen – newborns, the elderly, pregnant women, frequently ill children and adults with serious systemic chronic diseases.

How is meningitis transmitted?

Ways of transmission of the infectious agent:

• Airborne.
• Lymphogenic.
• Through the blood.
• Through contaminated fruits, objects, toys, dishes, water, unwashed hands, water bodies.
• Intrauterine infection of the fetus from the mother through the placenta.
• Through insect vector bites.

Risk groups:

• Infants under 2 years of age.
• Newborns with birth trauma, sepsis, prematurity, middle ear defects.
• Elderly over 60 years old.
• Having chronic diseases of organs and systems.
• Immunocompromised persons, HIV.
• Persons with spleen removed.
• Persons with malnutrition, beriberi.
• Pregnant women.
• Patients receiving chemotherapy treatment.
• Persons taking immunosuppressants, cytostatics.
• Received hypothermia.
• Persons with chronic fatigue, stress, excessive loads.
• Persons with back and head injuries.
• People with toxic nicotine, alcohol, drug addiction.

Bacterial meningitis in Russia and European countries is 3 times less common than viral meningitis. This was formed as a result of the widespread use of vaccination.

Vaccination forms the body’s resistance to a dangerous bacterial agent that causes the most severe type of purulent meningitis.

Attention! Parents who refuse childhood vaccinations put their children at high risk!

Features of diagnosis

Diagnosis begins with a visual examination of the patient and a detailed history taking. The doctor needs to determine when the malaise began, under what conditions. Further, the following examinations are carried out:

Neurological examination

helps to evaluate the functionality of muscles and nerve endings.

General and biochemical blood tests

to determine the level of hemoglobin, ESR, antigens, antibodies of pathogens.

Complete urinalysis

if kidney damage is suspected; to evaluate their functionality.

PCR blood test

for pathogen detection.

Cerebrospinal puncture

to determine the infectious agent, the nature of the course of the disease, the presence of pus.

Electroencephalography

to assess the state of the brain.

Chest x-ray

to detect foci of inflammation in the lungs, heart conditions, tuberculosis.

Computed tomography

to assess the condition of the tissues of the head and spine.

If the test results are questionable, the doctor will prescribe an additional examination or repeated diagnostic measures.

The diagnostic results obtained are evaluated in conjunction with the clinical picture, symptoms of meningitis in a child or adult. Sometimes consultations of doctors of other specialties are required.

The diagnosis is made on the basis of all data.

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Methods of treatment

Treatment is usually carried out in a hospital setting. The patient is prescribed etiotropic, pathogenetic and symptomatic therapy. This allows you to destroy the infection, minimize the risk of complications for the brain, and improve well-being.

Each type of infection requires the use of a specific set of drugs:

• Bacterial meningitis – Levomycetin, Meropenem, Ceftriaxone, Benzylpenicillin.
• Tuberculous – “Ftivazid”, “Isoniazid”, “Streptomycin”.
• Protozoan – “Sulfadimezin”, “Chloridine”.
• Viral – “Acyclovir”.
• Fungal – Fluorocytosine, Amphotericin B.

As a symptomatic treatment, vitamin complexes, diuretics, painkillers, antipyretics are used.

If meningitis is accompanied by convulsions, anticonvulsant therapy is given.

Patients who are admitted to the hospital are immediately given oxygen therapy.

Types, stages of the disease

Although in the vast majority of cases the disease has an infectious origin, sometimes there is a non-infectious lesion of the spinal membranes. There can be many reasons for triggering a pathological process, so understanding the types, stages, and mechanisms of pathology can help a specialist accurately diagnose the condition.

Inflammation of the pia mater may be:

Purulent . As a rule, purulent meningitis occurs when infected with meningococcus. This is the most severe form of the disease, characterized by the accumulation of purulent masses in the brain tissues, cerebrospinal fluid with melting of the membranes, sepsis. Often fatal, with 75% of the victims being babies under 2 years of age.

Serous . This is a fungal, viral or bacterial meningitis, as well as a non-specific pathology. The disease is not as malignant as the previous type, but still has a certain danger to the life of the patient. It is characterized by a high concentration of serous fluid in the tissues of the membranes, cerebrospinal fluid.

The origin of the disease is:

• Primary.
• Secondary, arising as a complication of an inflammatory, infectious process in the body, or another disease.

According to the type of pathogen, it is divided into:

• Bacterial meningitis (meningococcus, streptococcus, mycobacterium tuberculosis, Escherichia coli, Haemophilus influenzae).
• Viral (enterovirus, herpes, cytomegalovirus, HIV, Mengo virus).
• Fungal (candida).
• Protozoan (Toxoplasma).
• Mixed (two or more agents at the same time).

According to the area involved in the pathological process:

• Basal, with damage to the deep structures of the brain.
• Spinal, localized in the spinal structures.
• Convexital, affecting the superficial tissues of the brain.
• Total, extensive, involving the entire brain and spinal cord in the process.

By the rate of progression, the course of the process:

• Lightning current.
• Spicy.
• Subacute.
• Chronic.
• Recurrent.
• Disease severity:
• Lightweight.
• Medium.
• Heavy.

Serous meningitis of non-infectious etiology may be caused by other damaging factors: for example, the action of a drug, vaccine, autoimmune diseases, an allergic reaction.

A non-infectious cause is extremely rare, therefore, more often under this name they mean a disease of an infectious origin.

Prevention and treatment programs for meningitis at the Hadassah Clinic

The prognosis of meningitis depends on the cause of its occurrence, as well as the timeliness of treatment. Patients with a previous disease may have headaches, hearing and vision impairments.

If you delay, there is a high probability of death.

As a prophylaxis you need:

• Get vaccinated against chicken pox, measles, pneumococcus, Haemophilus influenzae, meningococcus.
• Eat right and balanced.
• Avoid contact with insects.
• Constantly strengthen the immune system.
• Observe the rules of personal hygiene.
• Treat any pathologies in time and consult a doctor in a timely manner.

Meningitis is a serious disease with dangerous consequences. The sooner you see a doctor, the higher the chance of recovery without complications.
If you begin to notice possible symptoms of meningitis, contact the Hadassah clinic in Moscow.

#DavidovNR

Davidov
Natan Rashbilovich

Neurologist, Ph.D.

Work experience: 10 years

Published: 06/17/2023

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

SOURCES

• Yuldasheva D. R. et al. Meningitis // Miasto Przyszłości. – 2022. – S. 102-103.
• Simonova NV Recurrent meningitis // Universe of the brain. – 2021. – V. 3. – No. 1. – S. 53-55.
• Elistratova TA et al. Pneumococcal meningitis in adults: clinical, epidemiological and diagnostic aspects // Epidemiology and vaccine prevention. – 2018. – T. 17. – No. 3 (100). – S. 63-67.
• Borshcheva P. E., Yushkevich E. A. Meningococcal meningitis. – 2020.
• Beloshitsky GV, Koroleva IS, Koroleva MA Staphylococcal meningitis in the Russian Federation // Epidemiological surveillance of topical infections: new threats and challenges. – 2021. – S. 83-84.
• Belikova VD, Oleinik AA Purulent meningitis in children // Bulletin of the Northern State Medical University. – Issue. – 2019. – S. 30.
• Baibulanova A. A., Zhumabekkyzy A. Meningitis. Causes, symptoms, diagnosis and treatment // Bulletin of Science. – 2021. – T. 4. – No. 4 (37). – S. 180-186.

Prices for neurology services

Neurology

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9053 7

9 0512

Reflexology session for diseases of the central nervous system (45 minutes)	7 200 ₽
Reflexology session for diseases of the peripheral nervous system (45 minutes)	7 200 ₽
Reflexology session for diseases of the musculoskeletal system (45 min) )	8 000 ₽
Vertebral therapy session for joint diseases (60 minutes)	8,000 ₽
Vertebral therapy session for diseases of the central nervous system (60 minutes)	8,000 ₽
Vertebral therapy session for diseases of the peripheral nervous system (60 minutes)	513 Treatment of migraine with the drug Irinex 70 mg/ml	24 400 ₽
Drug treatment Xeomin, 50 u.	10 100 ₽
Treatment with the drug Xeomin, 100 units.	Rs. 7 Focused shock wave therapy (up to 2000 shocks) $100 Focused shock wave therapy (up to 4500 shocks) $94 Focused shock wave therapy (over 4500 strokes) 10 100 ₽ Focused shock wave therapy for myofascial pain syndrome, spine (up to 4500 shocks) 11 500 ₽ Focused shock wave therapy for myofascial pain syndrome, spine (over 4500 shocks) 12 900 ₽ Focused shock wave therapy in the treatment of diseases of the shoulder joint treatment of diseases of the hip joint 11 500 ₽ Focused shock wave therapy in the treatment of diseases of the elbow joint (epicondylitis) 10 100 ₽ Focused shock wave therapy in the treatment of diseases of the knee joint 10 100 ₽ Focused shock wave therapy for plantar fasciitis 10 100 ₽ Focused shock wave therapy for bilateral plantar fasciitis 14,300 RUB Focused shock wave therapy for the treatment of Achilles tendon disease 10,100 RUB Focused shock wave therapy therapy for delayed union of bone fractures and stress fractures 10 100 ₽ Focused shock wave therapy for loading periosteopathy, aseptic necrosis (up to 3000 shocks) 10 100 ₽ Focused wavelength therapy during postoperative restoration (removal of edema, pain, up to 3000 strikes) 10 100 ₽ Focused shock wave therapy for postoperative recovery (removal of swelling, pain, over 3000 strokes) 11 500 ₽ Focused shock wave therapy in the treatment of trophic skin lesions (one segment) 10 100 ₽ Focused shock wave therapy in the treatment of trophic skin lesions (two segments) 12 900 ₽ 9000 3 Other diseases we treat By clicking on the button, you agree to the terms of use and processing of personal data causes, symptoms, diagnosis, complications, treatment This disease is treated by Neurologist The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment. Article content: Causes Classification Symptoms Complications Diagnostics Treatment Forecast Prophylaxis What is purulent meningitis? Purulent meningitis is an inflammation of the soft lining of the brain caused by the penetration of pathogens into it. bacteria Source: Etiological structure of purulent meningitis in children. Jafarova K.A. Saratov Scientific Medical Journal. 2010. No. 4. pp. 780-782 (meningococci, pneumococci and a number of others). Symptoms of purulent meningitis are high body temperature, severe headaches, uncontrollable vomiting, bringing relief, disorder of consciousness, hyperesthesia, meningeal symptoms. Diagnosis is made on the basis of history, characteristic clinical presentation and confirmed by the results cerebrospinal fluid tests. Treatment is complex and includes the mandatory use of antibiotics, as well as glucocorticosteroids, decongestants, tranquilizers and other symptomatic therapy. Inflammation of the meninges starts after infection. Pathogenic flora can penetrate through airborne, hematogenous, lymphogenous, fecal-oral routes. The main causative agents of the purulent form of the disease in adults and children are bacteria, protozoa, fungi. The likelihood of developing the disease increases with a decrease in the immune defense of the body. There are a number of factors that can trigger the development of the disease. These include: frequent hypothermia; malnutrition; smoking, alcohol abuse; diabetes mellitus; constant stress, nervous tension; abrupt climate change; high physical activity; the patient has a history of chronic diseases. Classification The following forms of pathology are distinguished: mild – the patient has headaches, there are signs of general intoxication of the body, specific (meningeal) symptoms of meningitis are doubtful; moderate – the patient has a high body temperature (39 degrees Celsius and above), there are meningeal symptoms, the person is conscious; severe – body temperature continues to rise, consciousness is disturbed, severe intoxication of the body is observed, meningeal symptoms are pronounced, convulsions appear, cerebral edema develops. Downstream: fulminant – the clinical picture develops rapidly, cerebral edema occurs quickly, the patient’s consciousness is confused; acute – the most common type, manifested by the traditional clinical picture; abortive – the symptoms are erased, mostly there are signs of intoxication of the body; recurrent – observed with improper therapy or in advanced cases, when a focus of chronic purulent infection forms in the body. According to the mechanism of penetration of pathogenic flora: primary – occurs if the pathogen directly enters the brain in case of skull injuries, non-compliance with asepsis rules during operations on the brain, and so on; secondary purulent meningitis – the infection enters the brain with blood or lymph from other pathological foci in the body, most often this occurs with chronic infectious pathologies of the ears or respiratory tract. Symptoms The onset of this form of the disease is acute. The patient’s body temperature rises sharply to 39-40 degrees Celsius. There is a strong chill, headaches, the intensity of which increases rapidly, nausea, vomiting, which does not bring relief. Confusion occurs, the patient may become delirious. Approximately 40% of patients develop convulsive syndrome. In the first hours of the disease, stiff neck muscles develop, which intensifies every hour. In addition, there is an increased sensitivity of the teeth, a decrease in abdominal reflexes. A hemorrhagic rash may appear on the skin. In the purulent form of the disease, the functioning of the cranial nerves is disturbed. Most often, the nerves of the eyes are affected, which is manifested by the development of strabismus, double vision, ptosis of the upper eyelid can be observed. Source: Bacterial purulent meningitis in children: is there light at the end of the tunnel? Vilnits A.A., Skripchenko N.V., Gorelik E.Yu., Astapova A.V., Markova K.V., Egorova E.S. Children’s infections. 2021. №4. pp.28-34. Rarely observed inflammation of the facial, trigeminal, optic nerves. Possible hearing loss. If therapy is not started immediately, the inflammatory process spreads to the entire brain and severe inflammation occurs – meningoencephalitis. In this case, to the above symptoms are added a violation of sensitivity, paresis, paralysis, increased nervous excitability, slurred speech. Perhaps the appearance of symptoms such as hyperkinesis, hallucinations, behavioral disorders, memory, sleep disturbances. Complications The bacterial form of the disease is life-threatening! It is difficult to treat and can lead to the development of a number of severe complications, up to death. During the acute period, the following complications may occur: meningoencephalitis; accumulation of pus between the membranes of the spinal cord and brain; abscess between meninges; myocarditis; bleeding disorder; sepsis; renal, hepatic insufficiency; irreversible neuromuscular disorders; convulsive syndrome. Complications that may develop after an illness: persistent headaches that are difficult to manage; speech disorders; epilepsy; formation of adhesions between the meninges; hydrocephalus; blurred vision, memory; chronic renal failure. In particularly severe cases, everything can end in death. The presence of a purulent form of the disease in a patient can be assumed by the characteristic clinical picture, the presence of meningeal symptoms and neurological signs in the form of damage to the spinal nerves Source: On the issue of early diagnosis of purulent meningitis. Ponomareva O.V., Batulina A.R., Karaseva E.A., Ageeva K.A., Martynov V.A. Science and Health. 2020. №4. pp.119-125. If the disease occurs a second time, against the background of other pathologies or has an erased course, then the diagnosis is difficult. Spinal puncture is indicated to confirm the diagnosis and determine the type of pathogen. During the sampling of the material, the increased pressure of the cerebrospinal fluid, its turbidity are determined. Further analysis shows an increase in neutrophils and proteins. To determine the pathogen, liquid is sown on nutrient media, as well as microscopy of smears. In addition to the above studies, a blood test is performed, as well as the contents of a rash on the skin. If the doctor suspects the secondary nature of inflammation of the brain, then additional examinations are carried out to identify the primary focus (X-ray of the sinuses, lungs, otoscopy, consultations of narrow specialists, and so on). Treatment All patients are urgently hospitalized and treated in a hospital setting. To identify the pathogen, a puncture of the cerebrospinal fluid is performed. Based on the results obtained, an appropriate antibiotic therapy is prescribed. If the exact cause of the disease cannot be determined, then initial therapy includes intramuscular administration of aminoglycosides (often in combination with ampicillin). In severe cases, antibiotics can be administered intravenously. Source: Meningitis: diagnostic difficulties, clinic and treatment. Sokolova V.I., Sychev D.A., Vasilyeva E.I., Seredkin E.A. Antibiotics and chemotherapy. 2019. No. 9-10. pp.26-32. To reduce the severity of cerebral edema and hydrocephalus, the patient is prescribed diuretics. To relieve inflammation, glucocorticosteroids are indicated (the dosage depends on the severity of the pathology). Tranquilizers, lytic mixtures are indicated as symptomatic therapy. If the patient has hypovolemia and an infectious-toxic shock develops, then infusion therapy is performed. After stopping the acute phase of the disease, neuroprotectors, nootropics, and multivitamins are indicated. General strengthening therapy is also carried out. Treatment of patients with a secondary form of the disease includes the elimination of the primary purulent focus, including through surgical intervention. The disease is characterized by a severe course, complications often develop, so the prognosis largely depends on how quickly treatment was started. Timely adequate therapy in most cases leads to the recovery of the patient. Source: Actual aspects of the pathogenesis, diagnosis and treatment of bacterial purulent meningitis. Vengerov Yu.Ya., Nagibina M.V., Kovalenko T.M., Matosova S.V., Rusin P.V., Smirnova T.Yu., Mikhalinova E.P., Razdobarina S.E. Infectious Diseases: News. Opinions. Education. 2018. No. 1. pp.78-85. The prognosis is favorable. In the absence of therapy, a fatal outcome is observed in about half of the cases. Prevention To minimize the risk of developing this pathology, the following recommendations should be observed: do not get too cold; do not swim in polluted open waters; stop smoking and alcohol abuse; observe the rules of hygiene; wash fruits and vegetables thoroughly before eating; eat right; strengthen the body’s immune defenses; timely treat acute infectious diseases and exacerbation of their chronic forms; wear a protective mask in crowded places; exclude any contact with patients; regularly sanitize foci of chronic infection; be vaccinated against meningitis; when the first symptoms appear, you should immediately call an ambulance, timely treatment will save the patient’s life and improve the prognosis. On the issue of early diagnosis of purulent meningitis. Ponomareva O.V., Batulina A.R., Karaseva E.A., Ageeva K.A., Martynov V.A. Science and Health. 2020. №4. p.119-125 Etiological structure of purulent meningitis in children. Jafarova K.A. Saratov Scientific Medical Journal. 2010. No. 4. p.780-782 Bacterial purulent meningitis in children: is there light at the end of the tunnel? Vilnits A.A., Skripchenko N.V., Gorelik E.Yu., Astapova A.V., Markova K.V., Egorova E.S. Children’s infections. 2021. №4. p.28-34 Meningitis: diagnostic difficulties, clinic and treatment. Sokolova V.I., Sychev D.A., Vasilyeva E.I., Seredkin E.A. Antibiotics and chemotherapy. 2019. No. 9-10. p.26-32 Actual aspects of the pathogenesis, diagnosis and treatment of bacterial purulent meningitis. Vengerov Yu.Ya., Nagibina M.V., Kovalenko T.M., Matosova S.V., Rusin P.V., Smirnova T.Yu., Mikhalinova E.P., Razdobarina S.E. Infectious Diseases: News. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website