meningitis%20-%20acute,%20bacterial%20(pediatric)
MENINGITIS - ACUTE, BACTERIAL (PEDIATRIC)
Acute meningitis is the bacterial infection of the subarachnoid space and cerebrospinal fluid that may cause local and systemic inflammatory response.
Common symptoms in newborns are lethargy, fever, seizures, irritability and bulging fontanelle. While in children the common symptoms are fever, nuchal rigidity (incidence increases with age) and altered consciousness.
Meningeal signs are stiff neck, Kernig's or Brudzinski's signs) are not reliably present in infants <6 months of age.
It may also observe the presence of persistent vomiting, changes in behavior or other psychological/neurologic signs.

Definition

  • Bacterial infection of the meninges and subarachnoid space that is usually caused by bacteria and results in high mortality and morbidity throughout the world
  • The introduction of conjugated vaccines against H influenzae type B, N meningitidis and S pneumoniae has caused decline in the incidence of bacterial meningitis in children thus majority of cases are now present in the adult population

Etiology

Other causes of acute meningitis include the following:

  • Spirochetes (eg Treponema pallidum)
  • Mycobacteria (eg Mycobacterium tuberculosis)
  • Fungi (eg Cryptococcus, Coccidioides, Sporothrix)
  • Viruses [eg herpes simplex virus (HSV), varicella zoster, cytomegalovirus (CMV)]
  • Protozoa and helminths

Signs and Symptoms

  • Symptoms are variable in children, especially in the early stage of the illness
  • Common symptoms may be observed according to age group
    • Newborns: Lethargy, fever, seizures, irritability, bulging fontanelle, poor feeding
    • Children: Fever, nuchal rigidity (incidence increases with age), altered consciousness, seizures
  • Meningeal signs (stiff neck, Kernig’s or Brudzinski’s sign) are not reliably present in infants <6 months of age
  • May also observe persistent vomiting, changes in behavior or other psychological/neurologic signs
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