Meningitis is the medical term for inflammation of the tissues (meninges) that surround the brain and spinal cord. The inflammation is most commonly caused by a virus or a bacterium, which travels from an infection in another part of the body through the bloodstream to the meninges. The treatment and long-term outlook of meningitis differ considerably based upon the cause.
There are two main types of meningitis: viral and bacterial.
Bacterial meningitis — There are many types of bacteria that can cause bacterial meningitis. The most likely type depends upon the child's age, history of vaccinations, and current or past medical problems. The two most common causes of bacterial meningitis in older infants and children in the United States are bacteria called Streptococcus pneumoniae or pneumococcus and Neisseria meningitidis or meningococcus.
Certain factors can increase a child's risk of developing bacterial meningitis, including recent exposure to someone with bacterial meningitis, recent infection (eg, ear or sinus infection), travel to areas where bacterial meningitis is common (eg, sub-Saharan Africa), serious head injury, problems with the immune system, cochlear implants, and certain anatomic abnormalities.
Bacterial meningitis is a medical emergency that must be treated quickly to minimize the risk of serious illness or even death. Even when treated appropriately, children who recover from bacterial meningitis sometimes have long-term complications.
Viral meningitis — The most common cause of viral meningitis is a family of viruses called enterovirus. In the United States, enteroviral meningitis is seen more frequently from June to October. Enteroviruses are spread by direct contact with feces during activities such as diaper changing or indirectly through contaminated water, food, and surfaces.
Other viruses that cause meningitis can be spread by airborne droplets, direct contact, during birth, or through the bite of an animal (eg, rabies) or bug (eg, mosquito, tick).
In developed countries, viral meningitis is more common than bacterial meningitis and is generally less severe. Children with viral meningitis usually recover completely with supportive treatment.
MENINGITIS TREATMENT
The treatment for meningitis depends upon whether the meningitis is caused by a virus or a bacterium. However, this distinction may not be clear until the culture results are available (usually 48 to 72 hours after they are obtained). In many cases, children are treated as if they have bacterial meningitis until bacterial meningitis is definitively excluded. The reason for this is that there is a significant risk of serious illness or even death if the child has bacterial meningitis and treatment is delayed for a prolonged period of time.
Bacterial meningitis — Bacterial meningitis is a life-threatening illness that requires hospitalization and treatment with intravenous antibiotics. The child will be monitored closely for signs of complications. Depending upon the severity of the illness, the child may also need supportive treatments to aid breathing, maintain blood pressure, prevent excessive bleeding, and keep the child hydrated.
Antibiotics — Treatment with antibiotics is usually started immediately after the blood tests and lumbar puncture are performed. Treatment is administered intravenously. Oral antibiotics are not recommended. The concentration of antibiotics necessary to treat bacterial meningitis cannot be achieved with oral administration.
Length of treatment — The length of antibiotic treatment depends upon the results of the bacterial cultures.
If the cultures are negative and the child has improved, antibiotics may be discontinued after 48 to 72 hours.
If the cultures are positive, the length of treatment depends upon the bacteria that is identified and whether there are complications. The treatment course may range from several days to several weeks.
Viral meningitis — In most cases, there is no medication that can eliminate the virus causing viral meningitis. Instead, treatment is supportive, meaning that it is given to support the child while he or she recovers. This generally includes rest, encouraging the child to drink an adequate amount of fluid (when alert enough to do so), providing intravenous fluids (if unable to drink enough fluid), and medications to treat fever and/or headache (eg, acetaminophen or ibuprofen). These medications should be dosed according to weight, not age.
There are two main types of meningitis: viral and bacterial.
Bacterial meningitis — There are many types of bacteria that can cause bacterial meningitis. The most likely type depends upon the child's age, history of vaccinations, and current or past medical problems. The two most common causes of bacterial meningitis in older infants and children in the United States are bacteria called Streptococcus pneumoniae or pneumococcus and Neisseria meningitidis or meningococcus.
Certain factors can increase a child's risk of developing bacterial meningitis, including recent exposure to someone with bacterial meningitis, recent infection (eg, ear or sinus infection), travel to areas where bacterial meningitis is common (eg, sub-Saharan Africa), serious head injury, problems with the immune system, cochlear implants, and certain anatomic abnormalities.
Bacterial meningitis is a medical emergency that must be treated quickly to minimize the risk of serious illness or even death. Even when treated appropriately, children who recover from bacterial meningitis sometimes have long-term complications.
Viral meningitis — The most common cause of viral meningitis is a family of viruses called enterovirus. In the United States, enteroviral meningitis is seen more frequently from June to October. Enteroviruses are spread by direct contact with feces during activities such as diaper changing or indirectly through contaminated water, food, and surfaces.
Other viruses that cause meningitis can be spread by airborne droplets, direct contact, during birth, or through the bite of an animal (eg, rabies) or bug (eg, mosquito, tick).
In developed countries, viral meningitis is more common than bacterial meningitis and is generally less severe. Children with viral meningitis usually recover completely with supportive treatment.
MENINGITIS TREATMENT
The treatment for meningitis depends upon whether the meningitis is caused by a virus or a bacterium. However, this distinction may not be clear until the culture results are available (usually 48 to 72 hours after they are obtained). In many cases, children are treated as if they have bacterial meningitis until bacterial meningitis is definitively excluded. The reason for this is that there is a significant risk of serious illness or even death if the child has bacterial meningitis and treatment is delayed for a prolonged period of time.
Bacterial meningitis — Bacterial meningitis is a life-threatening illness that requires hospitalization and treatment with intravenous antibiotics. The child will be monitored closely for signs of complications. Depending upon the severity of the illness, the child may also need supportive treatments to aid breathing, maintain blood pressure, prevent excessive bleeding, and keep the child hydrated.
Antibiotics — Treatment with antibiotics is usually started immediately after the blood tests and lumbar puncture are performed. Treatment is administered intravenously. Oral antibiotics are not recommended. The concentration of antibiotics necessary to treat bacterial meningitis cannot be achieved with oral administration.
Length of treatment — The length of antibiotic treatment depends upon the results of the bacterial cultures.
If the cultures are negative and the child has improved, antibiotics may be discontinued after 48 to 72 hours.
If the cultures are positive, the length of treatment depends upon the bacteria that is identified and whether there are complications. The treatment course may range from several days to several weeks.
Viral meningitis — In most cases, there is no medication that can eliminate the virus causing viral meningitis. Instead, treatment is supportive, meaning that it is given to support the child while he or she recovers. This generally includes rest, encouraging the child to drink an adequate amount of fluid (when alert enough to do so), providing intravenous fluids (if unable to drink enough fluid), and medications to treat fever and/or headache (eg, acetaminophen or ibuprofen). These medications should be dosed according to weight, not age.
