Meningitis is a serious and potentially life-threatening disease, and involves an inflammation of the membranes that cover the brain and spinal cord, called the meninges. Some of the more common symptoms of meningitis include fever, lethargy (decreased consciousness), irritability, headaches, photophobia (eye sensitivity to light), and a stiff neck. The inflammation can be caused by a variety of factors, including bacterial infections and viral infections, and also by some species of fungi, protozoa, and other parasites. The vast majority of meningitis cases result from infections that are themselves contagious. Many of the bacteria and viruses that are responsible for meningitis are fairly common. Good personal hygiene is an important means of preventing any infection. In addition, a range of vaccines are now available that protect against various forms of the disease.
To diagnose the cause of illness, a doctor will perform a physical examination of the patient, but, if meningitis is suspected, then laboratory tests will be conducted to make an accurate diagnosis of the exact cause of the disease so that appropriate treatment can be started as soon as possible.
The laboratory tests may include a lumbar puncture (spinal tap) to collect a sample of spinal fluid, which will be examined for signs of inflammation and cultured for the organism(s) that may be causing the infection.
If a child is suspected to have meningitis, then urgent diagnosis is required, and, if the diagnosis is confirmed, urgent treatment must follow. The sooner they are diagnosed and treated, the greater the chance that they will make a full recovery.
It is very important to begin the fight against meningitis, particularly bacterial meningitis, very quickly. If a child is diagnosed with (or strongly suspected to have) bacterial meningitis, doctors will start intravenous antibiotics straight away, even before the laboratory test results have been received back or the exact micro-organism causing the infection has been pinpointed. The disease is so serious, that no delay in treatment can be allowed.
Once the infectious agent has been identified by laboratory tests, then the antibiotics can be changed to something more appropriate to the particular bacteria involved, or even discontinued if the patient turns out to have viral or some other form of meningitis.
Children with bacterial meningitis will almost certainly be hospitalised so that they can be closely monitored around the clock by hospital staff. While in the hospital, the child will continue to receive antibiotics and may require intensive-care treatment. The child will also receive fluids to replace those lost to fever, sweating, vomiting, and poor appetite, and may be given corticosteroids to help reduce inflammation of the meninges.
The complications caused bacterial meningitis may require additional treatments. For example, anticonvulsants can be given for seizures. If the child develops shock or low blood pressure, then additional intravenous fluids and certain medications can be given to increase blood pressure. Some children may need supplemental oxygen or mechanical ventilation if they have difficulty breathing.
A child who has viral meningitis may also be hospitalised, although less serious cases may be allowed to recover at home provided they are closely monitored by their parents. With the exception of medication for the herpes simplex virus, there are no medications to fight viral meningitis, so treatment is usually aimed at relieving the child’s symptoms. This includes getting plenty of rest, drinking lots of fluids, and taking over-the-counter pain medication, such as acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to relieve fever and headache. If the condition of a child recovering at home deteriorates, then they should be rushed to hospital straight away. Recovery from viral meningitis is normally complete, but headaches, tiredness, and depression may persist for weeks or even months.
Some patients who have had meningitis may require longer-term follow-up treatments. For example, one of the most common problems resulting from bacterial meningitis is impaired hearing, and children who have had bacterial meningitis should have a hearing test following their recovery.
Fungal meningitis requires anti-fungal therapy and appropriate management.
