13 June, 2017
A Newborn With Meningitis
Meningitis is an inflammation of the meninges, the membranes that surround and protect the brain and spinal cord. In babies, especially newborns, meningitis can be a serious condition that can lead to death if left untreated. In babies younger than 2 to 3 months, the disease is called neonatal meningitis. A newborn believed to have meningitis should be taken to a doctor immediately, because prompt care may be able to control the infection and prevent severe complications.
Neonatal meningitis can be caused by either a virus or a bacterial infection. Viruses that can cause meningitis in a newborn include the Coxsackie and the herpes simplex. Newborn bacterial meningitis may be the result of group B streptococcus, E. coli, Listeria or Haemophilus influenzae type B, also known as HiB. Bacterial neonatal meningitis may be contracted through the placenta before birth or during passage through the birth canal. Bacterial meningitis in a newborn is sometimes associated with sepsis, a bacterial infection of the blood that spreads throughout to many organs.
Symptoms of meningitis in a newborn may be subtle at first and can include irritability, lethargy or a loss of appetite. Neonatal meningitis can proceed rapidly and result in symptoms such as vomiting, a high fever, a bulging or pulsing soft spot, a rash, jaundice, shivering and difficulty breathing. Some babies with meningitis develop seizures. Babies with meningitis may exhibit unusual behavior, such as becoming irritated rather than consoled when held.
Neonatal meningitis is a medical emergency requiring hospitalization. In infant patients, broad-spectrum antibiotics are typically delivered via IV immediately while the doctor awaits test results that indicate the specific cause of the meningitis. If the cause is determined to be bacterial, antibiotics specific to that bacterial strain will be used. Viral meningitis caused by the herpes virus is treated with the anti-viral medication acyclovir. Other sources of viral meningitis do not respond to antibiotics or anti-virals, so treatment only involves alleviating the symptoms and keeping the infant warm and hydrated.
According to Merck Manuals, up to 25 percent of newborns with meningitis who receive treatment still die and more than 50 percent have long-term complications such as learning disabilities or brain and nerve damage. Without treatment, almost all neonatal meningitis patients die.
Prevention of meningitis in a newborn hinges on good prenatal and postnatal care and an avoidance of foods that may be infected with Listeria bacteria or E. coli while pregnant. Doctors typically test for Group B strep in the last weeks of pregnancy and place a mother-to-be on antibiotics before delivery and the baby on antibiotics after birth if the bacteria are present in the birth canal. Pregnant women with a herpes simplex infection may be put on anti-virals before birth or may opt for a Cesarean section to avoid infecting the baby during delivery.
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