Meningitis in Children
Meningitis is a swelling
(inflammation) of the thin membranes that cover the brain and the spinal cord. These
membranes are called the meninges.
Meningitis is most often caused by
a bacterial or viral infection that moves into the cerebral spinal fluid (CSF). CSF
the fluid that protects and cushions the brain and spinal cord. A fungus or parasite
also cause meningitis. This is more common only in children with a weak immune
Meningitis caused by a virus is
more common and usually less severe. Bacterial meningitis is usually more severe and
lead to long-term complications or death.
Viruses that can cause meningitis
include the herpes simplex virus, the mumps virus (paramyxovirus), the flu virus,
West Nile virus.
Bacteria that can cause meningitis
include group B streptococcus, E. coli, Haemophilus influenzae type b (Hib), and
bacteria that cause pneumonia. Syphilis, tuberculosis, and Lyme disease bacteria can
also cause meningitis.
The bacteria, viruses, and fungi
that cause meningitis usually grow in a person’s respiratory tract. A child may have
symptoms at all but may carry the organism in their nose and throat. They may be spread
- Close contact with someone carrying
- Touching infected objects, such as
doorknobs, hard surfaces, or toys, and then touching nose, mouth, or eyes
- Droplets from a sneeze, close
conversation, or kissing
An infection usually starts in the
respiratory tract. In a child, it may first cause a cold, sinus infection, or ear
infection. It can then go into the bloodstream and reach the brain and spinal cord.
A child is more at risk for
meningitis if they have an infection caused by a number of viruses, bacteria, or fungi.
Children with a weakened immune system are at great risk.
The symptoms of meningitis vary
depending on what causes the infection and the age of the child. The symptoms may
several days after your child has had a cold and runny nose, or diarrhea and vomiting.
Symptoms can occur a bit differently in each child. Symptoms may appear suddenly.
they may develop over several
In babies, symptoms may include:
- Sleeping more than usual
- Poor feeding
- Crying that can’t be soothed
- High-pitched cry
- Arching back
- Bulging soft spots on the head (fontanelles)
- Changed temperament
- Purple-red splotchy rash
In children age 1 or older, symptoms may include:
- Neck pain
- Back pain
- Refusing to eat
- Reduced level of consciousness
- Eyes sensitive to light (photophobia)
- Nausea and vomiting
- Neck stiffness
- A purple-red splotchy rash
The symptoms of meningitis can be
like other health conditions. Make sure your child sees their healthcare provider
The healthcare provider will ask
about your child’s symptoms and health history. They may also ask about your family’s
health history. They will give your child a physical exam. Your child may also have
tests, such as:
Lumbar puncture (spinal tap). This is
the only test that diagnoses meningitis. A needle is placed into the lower back, into
the spinal canal. This is the area around the spinal cord. The pressure in the spinal
canal and brain is measured. A small amount of CSF is removed and sent for testing
see if there is an infection or other problems.
Blood tests. These can help diagnose infections that cause meningitis.
CT scan or MRI. These are tests that
show images of the brain. A CT scan is sometimes done to look for other conditions
that may cause symptoms like those of meningitis. An MRI may show inflammatory
changes in the meninges. These tests give more information. But meningitis can’t be
diagnosed using these tests alone.
Nasal, throat, or rectal swabs. These tests help diagnose viral infections that cause meningitis.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Treatment varies by type of meningitis. The treatments by type include:
Bacterial meningitis. Treatment is started as quickly as possible. The healthcare provider will give your
child IV (intravenous) antibiotics, which kill bacteria. Your child will also get
a corticosteroid medicine. The steroid works by decreasing the swelling (inflammation)
and reducing pressure that can build up in the brain. Steroids also reduce the risk
for hearing loss and brain damage.
Viral meningitis. Most children get better on their own without treatment. In some cases, treatment
may be done to help ease symptoms. There are no medicines to treat the viruses that
cause viral meningitis. The only exception is herpes simplex virus, which is treated
with IV antiviral medicine. Babies and children with a weakened immune system may
need to stay in the hospital.
Fungal meningitis. Your child may get IV antifungal medicine.
Tuberculous (TB) meningitis. Your
child will be treated with a course of medicines over 1 year. Treatment is done with
several medicines for the first few months. This is followed by other medicines for
the remaining time.
While your child is recovering from
meningitis, they may also need:
- Bed rest
- Increased fluid intake by mouth or IV fluids in the hospital
- Medicines to reduce fever and
headache. Don’t give aspirin or medicine that contains aspirin to a child younger
than age 19 unless directed by your child’s healthcare provider. Taking aspirin can
put your child at risk for Reye syndrome. This is a rare but very serious disorder.
It most often affects the brain and the liver.
- Supplemental oxygen or breathing machine (respirator) if your child has trouble breathing
Talk with your child’s healthcare providers about the risks, benefits, and possible
side effects of all treatments.
Bacterial meningitis is usually more severe and may lead to long-term complications.
Some children may have long-term problems with seizures, brain damage, hearing loss,
and disability. Bacterial meningitis can also cause death.
Several vaccines are available to prevent some of the bacterial infections that can
cause meningitis. These include:
H. influenzae type b vaccine (Hib). This is given as a 3- or 4-part series during your child's routine vaccines starting
at 2 months old.
PCV13 pneumococcal vaccine. The American Academy of Pediatrics recommends this vaccine for all healthy children
younger than age 2. PCV13 can be given along with other childhood vaccines. It is
recommended at ages 2 months, 4 months, 6 months, and 12 to 15 months. One dose is
also advised for older children who did not get the 4-dose series, and for those at
high risk for pneumococcal disease.
pneumococcal vaccine. This vaccine is also recommended for older children at high risk for pneumococcal
Meningococcal vaccine. This vaccine is part of the routine vaccine schedule. It is given to children ages
11 to 12, with a booster given at age 16. It is given to teens entering high school
if they were not vaccinated at age 11 or 12. A booster is also given at age 16 to
18, or up to 5 years later. Babies and young children at increased risk may also have
this vaccine. Ask your child's healthcare provider about the number of doses and when
they should be given.
Vaccines that protect against
viruses, such as measles, mumps, chickenpox, and the flu, can prevent viral
Talk with your child’s healthcare provider if you have questions about the vaccines.
You and your child can do other
things to prevent the spread of infections. Correct handwashing and staying away from
people who are sick can help prevent meningitis.
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Not received vaccines
- Contact with someone who has meningitis
- Symptoms that don’t get better, or get worse
- New symptoms
- Meningitis is an inflammation of the thin membranes that cover the brain and the spinal
- It is most often caused by a bacterial or viral infection that moves into the cerebral
spinal fluid. A fungus or parasite may also cause meningitis.
- Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis
is usually more severe and may lead to long-term complications or death.
- An infection usually starts in the respiratory tract. In a child, it may first cause
a cold, sinus infection, or ear infection. It can then go into the bloodstream and
reach the brain and spinal cord.
- A lumbar puncture (spinal tap) is the only test that diagnoses meningitis. A needle
is placed into the lower back, into the spinal canal.
- Several vaccines are available to prevent some of the bacterial and viral infections
that can cause meningitis.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.