How Does A Newborn Get Bacterial Meningitis

The Glass Or Tumbler Test

Above: It doesn’t fade if you press the side of a clear glass firmly against the skin

Where Can I Get More Help And Support

Having a baby who is unwell with meningitis in intensive care or special care can be a challenging and stressful experience. We have some information about how you might be feeling and the different types of support available.

If you are not sure about any part of your baby’s illness, treatment or care, the staff looking after your baby will help in any way they can. It is ok to ask again if you need information repeated or made clearer. The team will understand and want to support you.

We have included some links below to charities and organisations that provide information and support around meningitis. Our website also has other links to charities and organisations to a range of medical conditions and disabilities.

Group B Strep Support they work to stop group B strep infection in babies. They provide support and information to families about GBS. You can call their helpline on 0330 120 0796, and they also provide email support.

Meningitis Research Foundation for information and support with meningitis at any age, including babies. Their helpline number is 080 8800 3344, and you can also use email or livechat.

Meningitis Now also for information and support with meningitis at any age, including babies. Their helpline number is 0808 80 10 388, and they also provide email support.

If you need someone to talk to, you can also contact us via email on or arrange a video call with one of our volunteers.

If you have any feedback about this page, please email:

Is There A Clinical Algorithm

Major Recommendations

• Perform a lumbar puncture on all clinically stable infants with suspected sepsis and meningitis
• Begin empiric antibiotics in all cases of suspected sepsis and meningitis
• âFor suspected early-onset meningitis, consider ampicillin and gentamicin or cefotaxime in infants
• âFor suspected late-onset meningitis, consider vancomycin in addition to ampicillin and gentamicin or cefotaxime

Bibliographic Source

Heath, P.T., I.O. Okike, and C. Oeser, Neonatal meningitis: can we do better? Adv Exp Med Biol. 2011 719:11â24.

Heath, P.T. and I.O. Okike, Neonatal bacterial meningitis: an update. Paediatr Child Health. 2010 20:526â530.

Verani, J.R., L. McGee, and S.J. Schrag, Prevention of perinatal group B streptococcal disease–revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010 59:1â36.

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Treating Meningitis In Babies

Bacterial meningitis is treated with antibiotics that are typically given intravenously in the hospital through an IV.

According to the AAP, most babies who receive prompt antibiotic treatment will recover completely. However, about 20 percent may be left with lifelong effects, including hearing problems, learning disabilities, seizures, and paralysis.

Viral meningitis does not respond to antibiotics. It is usually not as serious as bacterial meningitis , and many babies will recover completely without complications.

However, both types of meningitis require prompt medical attention. Babies may need extra hydration with IV fluids, pain relief, monitoring, and rest in order to make a full recovery.

Meningitis can be spread easily from person to person. Although it cannot be prevented completely, some precautions can significantly reduce the risk of a baby getting it.

What Is The Difference Between Bacterial Meningitis And Viral Meningitis

Symptoms:

• viral meningitis: fever, headache, stiff neck, sensitivity to light, drowsiness, confusion
• bacterial meningitis: high fever, severe headache, stiff neck, sensitivity to light, drowsiness, confusion. A rash, nausea, vomiting, and sore throat can also occur.

Effects:

• viral meningitis: temporary, flu-like symptoms, headache, and stiff neck.
• bacterial meningitis: possibility of varying degrees of brain damage, including hearing loss and mental retardation. Can be fatal if not treated in time.

Severity:

• viral meningitis: goes away on its own usually within three to 10 days.
• bacterial meningitis: life-threatening medical treatment is needed immediately

Treatment:

• viral meningitis: bed rest, Tylenol
• bacterial meningitis: hospitalization and antibiotics

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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 places where they’ll live in close quarters with others.

Kids 2 months to 11 years old who are at higher risk for infection also should get MenACWY. This includes kids who:

• live in or travel to countries where infection is common
• have some types of immune disorders
• are present during an outbreak

A newer type of meningococcal vaccine called MenB protects against a type of meningococcal bacterium not covered by the older vaccine. Kids 10 years and older who have a higher risk for infection should get this vaccine. Others who are not at increased risk may also get it between the ages of 16 and 23 . The decision to get the MenB vaccine should be made together with their parents and the 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 . Avoid close contact with someone who looks ill and don’t share food, drinks, or eating utensils.

What Are The Signs And Symptoms Of Meningitis

• She’s developed a rash that doesn’t disappear when you press a glass onto it. The rash starts as a few small red pinpricks that increase in number and size and turn dark purple. On darker skin the rash can be more difficult to see but you may notice spots on paler areas of her body, such as the soles of her feet and the palms of her hands.
• She’s agitated and restless, and seems unhappy if you pick her up.
• She has a bulging soft spot on her head .
• She’s drowsy, floppy or unresponsive.
• Her crying is unusually high-pitched.
• She is vomiting, and refusing to feed
• She has cold hands and feet.
• Her neck and body are stiff.
• She appears to dislike bright lights.
• Her breathing has changed, either faster or slower than normal, and/or she’s making a grunting noise.
• She’s arching her back.
• Her tummy is swollen.
• She has a seizure. There is a particular type of seizure called convulsive status epilepticus that can be caused by meningitis.

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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 antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.

Who Gets Bacterial Meningitis

Children between the ages of 1 month and 2 years are the most susceptible to bacterial meningitis.

Adults with certain risk factors are also susceptible. You are at higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia.

You are also at higher risk if you have a weakened immune system, have had your spleen removed, are on corticosteroids because of kidney failure or have a sickle cell disease.

Additionally, if you have had brain or spinal surgery or have had a widespread blood infection you are also a higher risk for bacterial meningitis.

Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks.

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When To Get Medical Help

You should get medical advice as soon as possible if you’re concerned that you or your child could have meningitis.

Trust your instincts and do not wait until a rash develops.

Call 999 for an ambulance or go to your nearest A& E immediately if you think you or your child might be seriously ill.

Call NHS 111 or your GP surgery for advice if you’re not sure if it’s anything serious or you think you may have been exposed to someone with meningitis.

What Causes Meningitis In Newborns

A newborn babys immune system is not fully developed, so they are more likely to get infections. The immune systems of babies born prematurely are less developed than babies born at full term, so they are more vulnerable.

Meningitis in newborn babies may be either early onset or late onset. Early onset means it happens in the first three days after birth. Late onset means the infection starts after at least three days, and is most likely to develop within 28 days after birth.

Early onset meningitis is usually caused by bacteria that the baby picks up from the mother during birth. Bacteria that are living harmlessly on the mother can sometimes cause serious infections in a newborn baby. Rarely, early onset meningitis is caused by bacteria that have infected the mother from food she has eaten.

Late onset meningitis is usually caused by bacteria from the environment around the baby. This type of meningitis is more likely to happen in premature babies, and most likely in babies who are in intensive care.

Bacteria can get into places where your baby is attached to equipment such as tubes into their veins, or ventilation tubes which help support their breathing, although this is rare.

The bacteria can get into the babys blood and travel to the meninges around their brains. The meninges can then become inflamed and cause damage to the brain.

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Common Symptoms In Children And Adults

• Sleepiness or trouble waking up from sleep
• Lack of appetite

Most people with mild viral meningitis usually get better on their own within 7 to 10 days.

Initial symptoms of viral meningitis are similar to those for bacterial meningitis. However, bacterial meningitis is usually severe and can cause serious complications, such as brain damage, hearing loss, or learning disabilities. The pathogens that cause bacterial meningitis can also be associated with another serious illness, . Sepsis is the bodys extreme response to infection. Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.

See a doctor right away if you think you or your child might have meningitis. A doctor can determine if you have the disease, what is causing it, and the best treatment.

Duration Of Antimicrobial Therapy

For uncomplicated meningitis, the minimum recommended treatment durations are the following:10, 61, 64

• 14 days for GBS, L. monocytogenes, and S. pneumonia
• 21 days for Pseudomonas and gram-negative enteric bacteria such as E. coli

Longer treatment courses are recommended for infants with meningitis with delayed clinical improvement after beginning therapy or with complications such as brain abscesses, ventriculitis, or brain infarctions.62

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How Is Meningitis Diagnosed In A Child

The healthcare provider will ask about your childs symptoms and health history. He or she may also ask about your familys health history. He or she will give your child a physical exam. Your child may also have tests, such as:

• Lumbar puncture . This is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain is measured. A small amount of cerebral spinal fluid is removed and sent for testing to see if there is an infection or other problems.

• Blood tests. These can help diagnose infections that cause meningitis.

• CT scan or MRI. These are tests that show images of the brain. A CT scan is sometimes done to look for other conditions that may cause similar symptoms as meningitis. An MRI may show inflammatory changes in the meninges. These tests give more information. But meningitis cant be diagnosed using these tests alone.

• Nasal, throat, or rectal swabs. These tests help diagnose viral infections that cause meningitis.

Preventing Meningitis In Babies

Vaccines can prevent many, but not all, kinds of meningitis if theyre given as recommended by the CDC . None are 100 percent effective, so even babies that are vaccinated can get meningitis.

Note that although theres a meningitis vaccine, its for one specific type of bacterial meningitis called meningococcal meningitis. Its generally recommended for older children and teens in the United States. Its not used in babies.

In some countries such as the United Kingdom, babies often do receive a meningitis vaccine.

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Which Vaccines Protect My Baby Against Meningitis

• Meningococcal bacteria type B. The MenB vaccine is offered at two months, four months and one year.
• Haemophilus influenzae type B bacteria. The Hib vaccine is offered at two months, three months, and four months.
• Meningococcal bacteria type C. The MenC vaccine is offered at one year, combined with a booster vaccine against Hib.
• Pneumococcal bacteria. Pneumococcal conjugate vaccine is offered at two months and four months.
• Measles, mumps and rubella. The combined MMR vaccine protects against all three infections and is offered at 13 months.

Performing Or Deferring The Lp

Because the LP is an invasive procedure with risks, it is difficult to determine which infant should receive one as part of the septic workup.40, 41 Among infants with positive blood cultures, up to 30% will have a concurrent positive CSF culture.42 However, in infants with confirmed meningitis, 15â38% will have a negative blood culture.27, 43â45 In rare cases, the blood and CSF cultures can be discordant.44 Approaches in which only infants with confirmed bacteremia are evaluated for meningitis will result in missed diagnoses of meningitis.

The incidence of meningitis among asymptomatic infants with risk factors is very low .46, 47 When clinical signs can be attributed to noninfectious causes, such as respiratory distress syndrome or transient tachypnea of the newborn, clinical judgment is required in deciding when to perform an LP.43 Among 238 infants admitted for respiratory distress without other symptoms, 17/238 infants had a positive blood culture, and none were found to have meningitis.48

The current recommendation is to perform an LP on all clinically stable infants suspected to have early- or late-onset sepsis and who are exhibiting signs of infection.20, 39, 43 Whenever possible, the LP should be performed prior to the administration of antibiotics.

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How Can I Help Prevent Meningitis In My Child

Several vaccines are available to prevent some of the bacterial infections that can cause meningitis. These include:

• H. influenzae type b vaccine . This is given as a 3- or 4-part series during your child’s routine vaccines starting at 2 months old.

• PCV13 pneumococcal vaccine. The American Academy of Pediatrics recommends this vaccine for all healthy children younger than age 2. PCV13 can be given along with other childhood vaccines. It is recommended at ages 2 months, 4 months, 6 months, and 12 to 15 months. One dose is also advised for older children who did not get the 4-dose series, and for those at high risk for pneumococcal disease.

• PPSV23pneumococcal vaccine. This vaccine is also recommended for older children at high risk for pneumococcal disease.

• Meningococcal vaccine. This vaccine is part of the routine vaccine schedule. It is given to children ages 11 to 12, with a booster given at age 16. It is given to teens entering high school if they were not vaccinated at age 11 or 12. A booster is also given at age 16 to 18, or up to 5 years later. Babies and young children at increased risk may also have this vaccine. Ask your child’s healthcare provider about the number of doses and when they should be given.

Vaccines that protect against viruses such as measles, mumps, chickenpox, and the flu can prevent viral meningitis.

Talk with your childs healthcare provider if you have questions about the vaccines.

Causes Of Meningitis In Infants

Meningitis in infants is caused when a bacterial, viral, or fungal infection in another part of the body travels to the brain and spinal cord through the bloodstream. While meningitis can develop in people of any age, babies under 2 years old have the highest risk of getting it. Additionally, meningitis in infants happens more in babies with weakened immune systems.

Out of the three main types of meningitis in infants, viral meningitis tends to be the most common. Although they are less common, bacterial and fungal meningitis in infants can pose life-threatening risk.

If treatment for meningitis is delayed, it can cause serious brain damage and even death. Sadly, some of these tragic cases happen because medical professionals did not follow the standard of care for diagnosing and treating sick newborns. In cases of a missed or even delayed diagnosis, medical negligence could be the cause.

• Sleeping more than normal and difficulty waking up

In some cases, infants with meningitis may have seizures, which are often due to high fever, rather than being caused by the meningitis itself.

Symptoms may begin to appear several days after an infant has a cold, runny nose, diarrhea, or vomiting. However, sometimes symptoms occur seemingly out of nowhere and progress very rapidly, making every second in getting your baby treatment critical.

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