Meningitis is a serious disease, especially in newborns and infants below the age of 1 year. Human brain and spinal cord is covered by a membrane. This membrane is called meninges. Meningitis is a medical term used when there is inflammation of meninges. The disease is caused due to bacterial and viral infection.
In infants it is life threatening condition and its prognosis is heavily influenced by early diagnosis and institution of specific treatment with appropriate antibacterial agents. Usually meningitis occurs in epidemics, but sporadic cases are not altogether ruled out.
Meningitis Symptoms In Infants
Meningitis in infants is not as easy to detect as it is identifiable in adults and children.
This is because, the symptoms in infants are not very obvious compared to adults and older children. In children and adults there are classical symptoms of high fever, projectile vomiting, neck stiffness, toxic appearance, loss of appetite, chills and headache.
The more obvious symptoms and signs in infants are crankiness, high pitched cry, bulging fontanels, lethargy, vomiting and convulsion and fever. While many of these symptoms are also present in other diseases, meningitis should always be considered first. Especially when an infant is crying in a high pitch, there is bulging of soft spot in head with lethargy, diminished sucking reflex, parents should consult their pediatric physician immediately.
Different Types Of Meningitis In Infants
- Meningococcal meningitis: It is caused by gram negative bacteria. At least 15 % of infants below one year may be infected with menigococal infection. The inset is abrupt with general malaise, lethargy and irritability. Repeated projectile vomiting, fever, and convulsion are frequent among infants. The temperature is high with rapid pulse rate. The neck becomes stiff, and attempts to flex the neck causes the infant to flex his knee and hip. This is also called Brudzinski’s sign. If the leg is fled at hip, it cannot be straightened at the knee. This sign is called Kernig’s sign. However, in very young infants, the rigidity of neck and back is frequently absent.
- Streptococcal meningitis: Hemolytic streptococcus infection is now a relatively infrequent cause of meningitis, except in early infancy. In newborn infant, the germs may gain entry into the blood through a superficial umbilical cord infection. It may also reach the meninges directly through an infected meningocele.
- Pneumococcal meningitis: It is more prevalent in infants than in older children. It usually occurs in epidemics just as pneumococcal pneumonia. In fact one of the complications of pneumococcal pneumonia is pneumococcal meningitis. The symptoms are similar to those of other forms of meningitis.
- Influenzal meningitis: Hemophilus influenzae is a common cause for meningitis in infants. The peak of its occurrence is between six and twelve months of age. It is rare in first two months of life. The clinical symptoms are similar to those of other types of meningitis. Nowadays liberal availability of HIB vaccine in immunization schedule has restricted the number of cases.
- Viral meningitis: It is comparatively of milder variety. A group of virus called enterovirus is most often responsible for viral meningitis in infants. The infant may have suffered from cold, and respiratory tract infection before getting viral meningitis.
Prevention & Treatment Of Meningitis In Infants
Meningitis in newborn and infants is relatively a high risk of morbidity and mortality. This is because they have low immune resistance power. Not only that, they are exposed to few common bacteria while they are handled. Besides, if they have not received preventive immunization their susceptibility towards the disease increases many folds.
- So, primarily HIB and pneumococcal vaccine should be given to protect against haemophilus form of meningitis.
- If mother is suffering from Group B streptococcus infection, she should take proper antibiotic therapy in order to prevent the organism to get transferred to the infant.
- Once the disease is detected and diagnosed by the pediatrician, the infant is hospitalized. The first line of treatment is to give appropriate antibiotics.
- Infant is closely monitored round the clock, in a PICU (pediatric intensive care unit). He is fed with the help of Ryles tube. His body fluids are maintained adequately.
- Other symptoms such as fever, etc are treated with symptomatic medicines. In most cases the prognosis is favorable if the disease is detected and treated in its early stage.