DEAR DR.PAUL: I was just searching your site and found
some very valuable information. Can you please give me some basic
information on Meningitis?
PEDIATRICIAN DR.PAUL Answers: I first heard of meningitis,
a term that terrifies parents, as a medical student and got
to know this potentially devastating disease very well during
my Pediatric training. So I have seen first hand its effects
on children. However, over the last 15 years, there have been
major breakthroughs in not only how we treat meningitis, but
most importantly on how to prevent it.
But first what is meningitis? Meningitis means the infection
of the covering of the brain (or the meninges). Although there
are multiple causes, the two major germ categories are bacterial
and viral. The specific bacteria vary with age. In children
over 3 to 4 months, the bacteria include: Streptococcus pneumoniae(the
most common), Hemophilus Influenzae and Meningococcus. The first
2 bacteria are also the main culprits in ear and other respiratory
infections including pneumonia.
The symptoms of meningitis vary with age. In older children,
there usually is a fever and the child develops a stiff neck.
In younger children especially babies less than 3 months, the
symptoms are very non-specific. For example, irritability and
poor feeding, with or even without fever. As it is sometimes
difficult to tell if a child has meningitis the diagnosis must
be confirmed by a procedure called a lumbar puncture (or spinal
tap).
This relatively safe procedure involves placing a (hollow) needle
between the spinal bones in the middle lower back after the
area is frozen. Spinal fluid is then collected into small test
tubes which are sent for analysis. A positive spinal tap means
that a child has meningitis, and the liquid will then be examined
to see which bacteria is the cause. If no bacteria are found,
but the spinal fluid is abnormal, we test for viruses.
The distinction between a viral meningitis vs. a bacterial one
is important. Viral meningitis, which usually occurs more during
he summer months, goes away on its own, and usually causes no
significant complications. However, bacterial meningitis causes
problems, ranging from brain related infection/damage, (such
as deafness, paralysis, seizures and even mental retardation)
to spread of infection through the blood, to tragically, even
death. Bacterial meningitis is treated by intravenous antibiotics
which fortunately have been able to decrease and/or prevent
these complications.
What has had the biggest impact on decreasing meningitis has
been the introduction of the Hemophilus Influenzae vaccine which
is now given routinely to all children from 2 months of age.
Hemophilus meningitis and other related infections have decreased
significantly since the vaccination was given universally. Unfortunately
this vaccination does not protect children from the other 2
bacteria. There is however a vaccine for meningococcus, and
recently a new Streptococcus pneumoniae vaccine has been developed
and recommended for all children as part of their routine immunization.
This vaccination is good news as we can now also protect children
from this very dangerous bacteria too.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
