A bulging fontanelle is not always indicative of meningitis. Regardless of the possible causes, a bulging fontanelle is always an emergency and you must take your baby to an emergency room immediately. Some other conditions that cause a bulging fontanelle include: Encephalitis, which is swelling of the brain, usually caused by an infection. Hydrocephalus, caused by fluid buildup in the brain. This can happen because of an obstruction or narrowing of ventricles that help channel fluid out. Increased intracranial pressure, caused by a build-up of fluid. This can restrict blood flow to the brain. [5] X Research source
Under 3 months of age, always seek medical attention for a temperature above 38°C (100. 4°F). 3–6 months: always seek attention for a fever above 39ºC (102. 2ºF). Older than 6 months: always seek attention for a fever above 40°C (104°F). Do not rely solely on a high temperature to tell you that you should take the baby to an emergency room. Babies younger than three months with meningitis often have no fever. [8] X Research source
Listen for changes in the baby’s crying that may indicate pain or discomfort. The baby may whimper and moan excessively or emit cries that are higher than normal in pitch. The baby might also have pained or extreme crying when you cradle her or touch the neck area. Bright light might also trigger crying due to photophobia. [10] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
Look for rashes that are pink, purple-red, or brown or develop rash clusters of pin-prick dots that resemble bruises. If you are unsure whether the blotchy spots on the baby is a rash, you can verify by using the tumbler/glass test. This is done by gently pressing a clear drinking glass to the affected area of the skin. If the rash or red spots do not disappear because of the glass being pressed against the skin, the baby most likely has a rash. If you can see a rash through the clear glass, go to the emergency room immediately. [13] X Research source If the baby has a darker complexion, a rash may be difficult to observe. In this case, look at areas such as the palms of the hands, the soles of the feet, the stomach, or near the eyelids. These areas may also have what resembles red dots or pinpricks. [14] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
Viral: This is the number one cause of meningitis in the world, and it may resolve on its own. However, the baby still needs to be seen by a medical professional because the effects of the infection can be deadly if supportive care isn’t provided. For children and babies, it is important for the parent or guardian to follow all immunization protocols. Mothers who are infected with herpes simplex virus or HSV-2 can transmit the virus to their baby during labor, if the mother has active genital lesions. [20] X Research source O’Connell, Theodore X. USMLE Step 2 Secrets. Print. 172 ,[21] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source Bacterial: This type is common in newborns and babies. Fungal: This type of meningitis is uncommon and usually affects AIDS patients as well as others who have compromised immune systems (e. g. transplant recipients and patients receiving chemotherapy). Miscellaneous: Other types of meningitis may be chemical, drug, inflammatory and cancer.
Seizures Loss of consciousness Muscle weakness
Strep B: In this category, the most common bacteria causing meningitis in babies under 24 months is strep agalactiae. E Coli Listeria species Neisseria Meningitidis S. Pneumoniae Haemophilus Influenzae
The complete blood count will examine electrolyte levels, as well as red and white blood cell counts. The doctor will also check blood coagulation and will check for bacteria in the blood.
Be warned that this test is painful. The doctor will apply a topical anesthetic and use a large needle to pull fluid out between the bones of the patient’s lower back. If certain conditions are present, the doctor will not perform a lumbar puncture. These conditions may include: Increased intracranial pressure or cerebral herniation (cerebral tissue shifting from its normal location)[26] X Research source Infection at the site of lumbar puncture Coma Abnormalities of the spine Difficulty breathing If the lumbar puncture is necessary, the doctor will use the cerebrospinal fluid to administer tests, which may include:[27] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Gram stain: Once cerebrospinal fluid is removed, some of it will be stained with a dye in order to determine the type of bacteria present in the fluid. Cerebrospinal fluid analysis: This test analyzes the fluid sample for cells, protein and glucose-to-blood ratio. This can help doctor correctly diagnose meningitis and differentiate each type of meningitis from one another.
For example, HSV-1 or herpes may be transmitted from mother to baby during labor if the mother has active genital lesions. Treatment for a newborn diagnosed with herpes encephalitis should be treated with an intravenous antiviral agent (for example, acyclovir administered intravenously).
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
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 Listeria monocytogenes/L. meningitis: 21 days or more
All babies must undergo a follow up MRI 7 to 10 days after treatment for meningitis has ended.
Reduce the risk of future children getting meningitis. If you are pregnant and you have HSV with genital lesions present, inform your doctor before delivery.
Age: Children under five years old may be at higher risk for viral meningitis. Adults over the age of 20 may be at higher risk for bacterial meningitis. Living in close quarters: When people live in close contact with many other people, such as dormitories, military bases, boarding schools and child care facilities, they may be at increased risk of meningitis. Decreased immune system: People with compromised immune systems may have a higher risk of contracting meningitis. AIDS, alcoholism, diabetes, and use of immunosuppressant drugs can compromise immune systems.
