Meningitis Explained

Who doesn’t cringe when confronted with the M word?? We’ve feared it, avoided it, and above all, misunderstood it. But the truth is, it’s not always that scary. Here’s what you need to know.

Meningitis is an inflammation (usually, but not always, caused by infection) of the lining of the brain, or meninges.  Viral meningitis (also called aseptic meningitis) is the most common type. It often remains undiagnosed because its symptoms can be similar to those of the common flu.  Bacterial meningitis is rare, but is usually serious and can be life-threatening if it’s not treated right away.

Meningitis of any kind is most common in kids because their infections travel like wildfire.  So it’s important to get routine vaccinations, know the signs of meningitis, and if you suspect that your child has the illness, get to medical care right away.

Symptoms depend on the age of the child and whether the cause is viral or bacterial. Sometimes (particularly in the very young, or when a virus is the cause) it can look a lot like the flu — irritable, achy, feverish, poor appetite. Older kids will often report headache, stiff neck, and sensitivity to light.

Scary warning signs that may mean a bacterial or other serious cause and should send you directly to your doctor or the ER:

Infants — extreme irritability, poor suck or lethargy, fever > 101 in infants under 6 weeks, bulging fontanelles (the soft spot on the top of the head), stiffness of the body and neck.

Toddlers and up — a dramatic change in behavior (decreased alertness, lethargy) with fever, irritability, and/or headache, neck stiffness or light sensitivity.  An accompanying rash that looks like small spots of bleeding under the skin that don’t pale when pressed (called blanching) is an ominous sign, call 911.

Many different viruses can cause meningitis if they manage to reach the membrane that covers the brain, either via blood vessels or contact with sinuses or nasal passages.  The most common of these are the enteroviruses.

Bacterial causes vary by age group.  In newborns the most common causes are group B strep, E. coliand listeria.  In older kids pneumococcus and meningococcus are the major players.

Diagnosis and treatment of meningitis will include blood tests and a lumbar puncture, or spinal tap.  This test sounds scary to most parents, but it’s completely safe and pretty routine to your doctor.  Parents often worry about damage to the spinal cord when the needle is placed to remove spinal fluid, but there is virtually zero risk of this since the cord is protected by a thick cushion of fluid.

A child with viral meningitis may be hospitalized, or may be allowed to recover at home if they are not too ill. Treatment, including rest, fluids, and over-the-counter pain and fever medication, is mostly symptomatic.

If bacterial meningitis is even suspected, the child will be hospitalized and doctors will start IV antibiotics as soon as possible.  Steroids may be added to help reduce inflammation of the meninges.

Complications of bacterial meningitis can require additional treatment. For example, anticonvulsants might be given for seizures.  IV fluids and certain medications may be given to maintain blood pressure. Some kids may need supplemental oxygen or mechanical ventilation if they have difficulty breathing.

Prevention: Routine childhood immunizations are the best first-line defense against meningitis.  Doctors recommend that kids who are 11 or older also get vaccinated for meningococcal disease, a serious bacterial infection that can lead to meningitis, particularly if they’re going to college, boarding school, camp, or other settings where they are going to be living in close contact with other kids. The vaccine may also be recommended for children between the ages of 2 and 10 with special medical problems that put them at risk.

Many of the bacteria and viruses that are responsible for meningitis are pretty common, and the usual common-sense rules apply.  Encourage kids to wash their hands thoroughly and often, particularly before eating and after using the bathroom, and avoid close contact with someone who is ill.

If your child has had contact with someone diagnosed with meningitis, let your doctor know. Preventive treatment may be recommended.

Call your doctor immediately if you suspect meningitis or if your child exhibits symptoms such as vomiting with headache, lethargy or confusion, neck stiffness, rash, and fever. Infants who have fever, irritability, poor feeding, and lethargy should also be seen by a doctor right away.

For more detailed information, go to WebMD for this comprehensive article.  But remember, meningitis is fairly rare, and serious bacterial meningitis is even rarer. Knowledge is power, mamas!

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Ellen and Rachel are two old friends and “expert” mamas—one a pediatrician and one a family therapist—with fifty years of parenting experience between them.


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