Meningitis occurs when an infection causes the meninges (the tissue that connects the brain and spine) to become inflamed and swollen. Symptoms in children include prominent fontanel, fever, rash, body stiffness, rapid breathing, weakness, and crying. If you suspect your baby has meningitis, take him to the ER immediately. If you're not sure if he has meningitis or other symptoms, go to the ER immediately.
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Part 1 of 4: Checking for Signs in Babies
Step 1. Look for early symptoms
Early symptoms of meningitis include vomiting, fever, and headache. In infants, the way to detect the signs and symptoms of meningitis is somewhat different because babies cannot express pain and discomfort with words. Symptoms sometimes develop rapidly between 3 and 5 days from the initial infection. Therefore, you should immediately take him to the doctor.
Step 2. Examine the baby's head
Examine and palpate the baby's head for lumps and tender spots that are firm. The protruding soft spot tends to appear on the side of the head around the fontanelle, which is the space in the skull when the baby's cranium develops.
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A bulging fontanel is not always an indication of meningitis. But whatever the cause, a bulging fontanel is always an emergency and you should take your baby to the ER immediately. Some other conditions that cause fontanelles to bulge are:
- Encephalitis, which is swelling of the brain, is usually caused by an infection.
- Hydrocephalus, caused by a buildup of fluid in the brain. This occurs due to obstruction or narrowing of the ventricles that help drain fluid out.
- Increased intracranial pressure, caused by fluid buildup. This condition can restrict blood flow to the brain.
Step 3. Check the baby's temperature
Use an oral or rectal thermometer to check for fever. If the baby's temperature is between 36 and 38 degrees Celsius, it is likely that he has a fever.
- For babies under 3 months of age, be aware of temperatures above 38°C.
- For babies over 3 months of age, be aware of temperatures above 39°C.
- Don't rely entirely on body temperature to know if you should take your baby to the ER. Meningitis babies under 3 months of age usually do not have a fever.
Step 4. Listen to the baby's cry
If the baby is sick, he will show discomfort such as crying, groaning, or moving restlessly. He will show this reaction when carried because his muscles and joints are sore and sore. It may be calm in its stillness, but will cry loudly when picked up.
- Listen for changes in your baby's crying that may indicate pain or discomfort. The baby may whine and moan loudly or make a louder cry than usual.
- He may also cry out in pain or extreme pain when you hold him or touch his neck area.
- Bright light can also trigger crying due to photophobia.
Step 5. Watch for signs of stiffness in the baby's body
If you suspect your baby has meningitis, check and watch for signs of stiffness in the body, especially in the neck. The baby may not be able to bring his chin down to his chest, and he may move wildly and jerkily.
Step 6. Check for discoloration and rashes on the baby's skin
Pay attention to the color of the skin. Maybe the skin is very pale or blotchy, or starting to turn bluish.
- Look for a rash that's pink, purplish-red, or brown, or a rash made up of dots that look like bruises.
- If you're not sure if the patches on your baby's skin are a rash, you can verify by using the thermos/cup test. You do this by gently pressing the drinking glass on the skin area. If the rash or red patches don't go away with the pressure of the glass, it's probably a rash. If you can see the rash through a clear glass, go to the ER immediately.
- If the baby's skin is a little dark, the rash may be difficult to see. In this case, examine areas such as the palms of the hands, soles of the feet, stomach, or around the eyelids. These areas may also show red dots or pinholes.
Step 7. Pay attention to the baby's appetite
He may not seem as hungry as usual. He may refuse if you feed him and regurgitate the food he swallowed.
Step 8. Pay attention to the baby's energy level and activity
Look for signs that his body is weak. He may appear lethargic, have no energy, be tired, or appear always sleepy even when he is well rested. This occurs because the infection spreads throughout the meninges.
Step 9. Listen to the baby's breathing pattern
Observe for any irregular breathing patterns. The baby may be breathing faster than normal or he may have difficulty breathing.
Step 10. Feel if the body is cold
Observe if your baby continues to have extreme chills and unusual chills, especially in the hands and feet.
Step 11. Know what meningitis is
Meningitis occurs when an infection causes the meninges or the tissue that connects the brain and spine to become inflamed and swollen. Infection usually occurs due to the invasion of certain bacteria or viruses into the baby's body system. The causes of meningitis are:
- Viruses: This is the number one cause of meningitis in the world, and is self-limiting. However, the baby should still be examined by a doctor because the effects of the infection can be fatal if not given supportive care. In the case of infants and young children, parents or guardians must adhere to the immunization protocol. Mothers infected with herpes simplex virus or HSV-2 can pass the virus to their babies during delivery if the mother has active genital sores.,
- Bacteria: This type is common in newborns and infants in general.
- Fungal: This type of meningitis is uncommon and usually affects AIDS patients and people with weakened immune systems (for example, transplant recipients and patients undergoing chemotherapy).
- Other: Other types of meningitis caused by chemicals, drugs, inflammation, and cancer.
Part 2 of 4: Getting a Diagnosis from a Doctor
Step 1. Tell the doctor immediately if your baby shows severe symptoms such as seizures or loss of consciousness
You should tell the doctor if your baby shows any of these signs. This must be kept in mind so that the doctor can proceed with appropriate diagnostic tests.
Step 2. Tell the doctor if your baby is exposed to certain bacteria
There are several types of bacteria that cause meningitis. If exposed to people with stomach or respiratory problems, your baby may be exposed to the following categories of bacteria:
- Strep B: In this category, the most common bacterium that causes meningitis in infants under 24 months of age is Strep agalactiae.
- E. coli
- Listeria species
- Neisseria meningitidis
- S. pneumoniae
- Haemophilus influenzae
Step 3. Take the baby to the doctor for a complete physical examination
The doctor will examine the vitals as well as the baby's medical history. The doctor will also check your temperature, blood pressure, heart rate, and breathing rate.
Step 4. Let the doctor draw the baby's blood
The doctor will take the baby's blood to do a complete blood count. Blood is drawn by making a small hole in the baby's heel.
A complete blood count will check electrolyte levels, as well as red and white blood cell counts. The doctor will also check for blood coagulation and bacteria in the blood
Step 5. Ask your doctor about a cranial CT scan
Cranial CT scan is a radiological test that checks the density of the brain to see if the soft tissues are swollen or if there is bleeding. If the patient has had seizures or has experienced trauma, CT can help identify this and show whether the patient can undergo the next test, which is a lumbar puncture. If the patient has an indication of intracranial pressure due to the above indications, a lumbar puncture will not be performed until the pressure has decreased.
Step 6. Ask if a lumbar puncture is necessary
A lumbar puncture test removes cerebrospinal fluid from the baby's lower back. The fluid is needed in certain tests to determine the cause of meningitis.
- Know that this test hurts. The doctor will apply an external anesthetic and use a large needle to drain fluid from between the patient's lower spine.
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If there are other health conditions, the doctor will not perform a lumbar puncture. The conditions in question include:
- Increased intracranial pressure or cerebral herniation (brain tissue moves from its normal location)
- Infection in the lumbar puncture area
- Coma
- Spinal abnormalities
- Difficulty breathing
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If a lumbar puncture is necessary, the doctor will use cerebrospinal fluid to perform tests, including:
- Gram stain: After the cerebrospinal fluid is taken, some will be stained with a dye to determine the type of bacteria present in the fluid.
- Cerebrospinal fluid analysis: This test analyzes a sample of fluid to find cells, proteins, and the ratio of glucose to blood. This test can help doctors diagnose meningitis correctly and differentiate between different types of meningitis.
Part 3 of 4: Treating Meningitis
Step 1. Provide appropriate treatment for viral meningitis
Treatment for meningitis is based on the type. Viral meningitis is treated according to the virus that causes it.
For example, HSV-1 or herpes can be passed from mother to baby during delivery if there are active genital sores on the mother. Newborns diagnosed with herpes encephalitis should be treated with intravenous antiviral agents (eg, intravenously administered Acyclovir)
Step 2. Adhere to the treatment plan for bacterial meningitis
Bacterial meningitis is also treated based on the bacteria causing it. The doctor will identify the cause and provide appropriate treatment for the baby. Follow the doctor's instructions. Below are some of the medications and their recommended dosages for treatment:
- Amikacin: 15–22.5 mg/kg/day every 8–12 hours
- Ampicillin: 200–400 mg/kg/day every 6 hours
- Cefotaxime: 200 mg/kg/day every 6 hours
- Ceftriaxone: 100 mg/kg/day every 12 hours
- Chloramphenicol: 75–100 mg/kg/day every 6 hours
- Co-trimoxazole: 15 mg/kg/day every 8 hours
- Gentamicin: 7.5 mg/kg/day every 8 hours
- Nafcillin: 150–200 mg/kg/day every 4–6 hours
- Penicillin G: 300,000–400,000 U/kg/day every 6 hours
- Vancomycin: 45–60 mg/kg/day every 6 hours
Step 3. Talk to your doctor about how long the treatment will last
The duration of treatment for infant meningitis depends on the cause. The following is an estimate of the duration of treatment for meningitis in infants:
- N. meningitides: 7 days
- H. influenza: 7 days
- Strep pneumonia: 10 to 14 days
- Group B. strep: 14 to 21 days
- Gram negative aerobic bacillus: 14 to 21 days
- L. meningitis: 21 days or more
Step 4. Provide additional supportive care
Take care of your baby to make sure he receives the right dose of medicine during the treatment period. He should also be encouraged to rest and drink plenty of fluids. It is likely that IV fluids will be provided because of his young age. He will also be guarded to prevent transmission of meningitis to other family members.
Part 4 of 4: Follow-up Care After Treatment
Step 1. Check baby's hearing
One of the most common complications of meningitis is hearing loss. Therefore, all infants should undergo a hearing evaluation after treatment through an auditory evoked potential study.
Step 2. Check the baby's intracranial pressure with an MRI
Bacteria or other pathogens sometimes remain after treatment and can cause complications. One of them is increased intracranial pressure due to fluid buildup between different parts of the brain.
All infants should have a follow-up MRI 7 to 10 days after meningitis treatment ends
Step 3. Immunize your baby
Make sure your child has received all the vaccinations to reduce the chance of contracting viral meningitis.
Reduce your child's risk of developing meningitis again in the future. If you are pregnant and have HSV with genital sores, tell your doctor before giving birth
Step 4. Minimize contact with infectious or sick individuals
Some forms of bacterial meningitis are highly contagious. Keep your child and baby away from contact with sick or infectious individuals.
Step 5. Be aware of the risk factors
Some people have a higher risk of contracting meningitis, depending on the specific circumstances. Some of them are:
- Age: Children under the age of five have a higher risk for viral meningitis. Adults over the age of 20 have a higher risk for bacterial meningitis.
- Living in crowded places: Living in close proximity to many other people, such as boarding houses, military bases, boarding schools, and child care facilities, can increase the risk of meningitis.
- Weakened immune system: People with weak immune systems have a higher risk of contracting meningitis. Among the things that can weaken the immune system are AIDS, alcoholism, diabetes, and use of immunosuppressive drugs.
