Neurology

Nerves are like messengers. They’re in constant touch with the body’s organs and muscles, delivering commands from the brain and bringing information back to it. When something goes wrong with the flow of information between the brain and the rest of the body, either because of an injury or a health condition, your child might need to see a pediatric neurologist (“nu-ROL-o-jist”) – a doctor who treats neurological disorders in children.

Meningitis

What Is Meningitis?

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord.

People of any age can get meningitis, but because it can spread easily among those living in close quarters, teens, college students, and boarding-school students are at higher risk for infection.

If dealt with quickly, meningitis can be treated successfully. So it's important to get routine vaccinations, know the signs of meningitis, and get medical care right away if you think that your child has the illness.

What Causes Meningitis?

Most cases are caused by bacteria or viruses, but some can be due to certain medicines or illnesses.

Many of the bacteria and viruses that cause meningitis are fairly common and cause other routine illnesses. Both kinds of meningitis spread like most other common infections do — someone who's infected touches, kisses, or coughs or sneezes on someone who isn't infected.

Bacterial Meningitis

Bacterial meningitis is rare, but is usually serious and can be life-threatening if not treated right away.

In some cases of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis).

Many different types of bacteria can cause bacterial meningitis. In newborns, the most common causes are group B strep, E. coli, and less commonly, Listeria monocytogenes. In older kids, Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are often the causes.

Viral Meningitis

Viral meningitis (also called aseptic meningitis) is more common than bacterial meningitis and usually less serious.

Many of the viruses that cause meningitis are common, such as those that cause colds, diarrhea, cold sores, and the flu.

What Are the Signs and Symptoms of Meningitis?

Meningitis symptoms vary, depending on the person's age and the cause of the infection. The first symptoms can come on quickly or start several days after someone has had a cold, diarrhea, vomiting, or other signs of an infection.

Common symptoms include:

  • fever
  • lack of energy
  • irritability
  • headache
  • sensitivity to light
  • stiff neck
  • skin rashes

Meningitis in Infants

Infants with meningitis might have different symptoms. Babies might be very irritable, feed poorly, and be sleepy or difficult to wake up. It may be hard to comfort them, even when they're picked up and rocked. They also may have a fever or bulging fontanelle (soft spot on head).

Other symptoms of meningitis in infants can include:

  • jaundice (a yellowish tint to the skin)
  • stiffness of the body and neck
  • a lower-than-normal temperature
  • a weak suck
  • a high-pitched cry

How Is Meningitis Diagnosed?

Bacterial meningitis can be very serious. So if you see symptoms or think that your child could have meningitis, it's important to see the doctor right away.

If meningitis is suspected, the doctor will order tests, probably including a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of inflammation and whether the infection is due to a virus or bacteria.

How Is Meningitis Treated?

Most cases of viral meningitis end within 7 to 10 days. Some people might need to be treated in the hospital, although kids usually can recover at home if they're not too ill. Treatment to ease symptoms includes rest, fluids, and over-the-counter pain medicine.

If bacterial meningitis is diagnosed — or even suspected — doctors will start intravenous (IV) antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.

What Problems Can Happen?

Complications of bacterial meningitis might require further treatment. Someone with shock or low blood pressure might get more IV fluids and medicines to increase blood pressure. Some kids may need extra oxygen or mechanical ventilation if they have trouble breathing.

Bacterial meningitis complications can be severe and include neurological problems, such as hearing loss, visual impairment, seizures, and learning disabilities. Because impaired hearing is a common complication, those who've had bacterial meningitis should have a hearing test after they recover.

The heart, kidneys, and adrenal glands also might be affected, depending on the cause of the infection. Although some kids develop long-lasting neurological problems, most who receive prompt diagnosis and treatment recover fully.

Can Meningitis Be Prevented?

Vaccinations

Routine immunization can go a long way toward preventing meningitis. The Hib, measles, mumps, polio, and pneumococcal vaccines can protect against meningitis caused by those germs.

Kids also should get the meningococcal conjugate vaccine when they're 11 or 12 years old, with a booster shot at age 16. Kids older than 11 who haven't been vaccinated also should be immunized, particularly if they're going to college, boarding school, camp, or other settings where they'll live in close quarters with others.

A newer type of meningococcal vaccine called MenB (which protects against a type of meningococcal bacterium not covered by the older vaccine) can be given to teens and young adults at the discretion of their doctor.

Avoiding Germs

Kids and adults should wash their hands well and often, particularly before eating and after using the bathroom, and if they work closely with kids (as in a daycare). Avoid close contact with someone who's obviously ill and don't share food, drinks, or eating utensils to also help stop the spread of germs.

In some cases, doctors may give antibiotics to anyone who has been in close contact with a person who has bacterial meningitis to help prevent infection.

When Should I Call the Doctor?

Get medical care right away if you think that your child has meningitis or you see symptoms such as vomiting, headache, lethargy or confusion, neck stiffness, rash, and fever. A baby who has a fever, is irritable, and isn't feeding well also should be seen right away by a doctor.

If your child has been near someone who has meningitis, call your doctor to ask whether preventive medicine is recommended.

Reviewed by: Mary L. Gavin, MD
Date reviewed: September 05, 2017