Meningitis in the baby

definition

In case of meningitis (meningitis) is an infectious disease that affects the meninges of the central nervous system (brain, spinal cord). A transfer to the brain matter (Meningoencephalitis) is possible.
In small children and infants, meningitis is often severe. Especially with a bacterial infection, the rapid spread of the inflammation can pose an acute danger to life.

The diagnosis of meningitis is often very difficult. In contrast to meningitis in adults, these occur in small children and infants classic symptoms do not always appear immediately. Often the detection of all symptoms is already a sign of advanced disease.

causes

The cause of meningitis is one Infection with bacteria or viruses. These pathogens often lead to another disease (e.g. otitis media) before they spread to the central nervous system and affect the meninges.

The spectrum of pathogens that can trigger meningitis differs between children and adults. Frequent triggering bacteria Newborn are Streptococci (Group B), Listeria and E. Coli. With increasing age, meningitis is increasingly caused by pneumococci, meningococci and Haemophilus influenzae. The spectrum of viral pathogens is very broad. The cause of meningitis can be infection with Herpes viruses, TBE viruses, mumps viruses, influenza and enterovirusesn be.

The bacteria and viruses are mainly transmitted through close contact between infected people and infants. Kissing, sneezing, coughing or sharing dishes or, for example, a toothbrush can transmit the pathogen to the toddler and should be avoided in any case.

Meningitis caused by herpes viruses

A common cause of meningitis is infection with Herpes viruses (especially Herpes Simplex 1, Herpes Zoster). This is a virus that is transmitted by small droplets of secretion through breathing and saliva. It can spread along nerve fibers in the body. Besides the typical vesicle formation in the area served by the nerves, the virus can also spread along the nerves to the central nervous system, where it has a Meningitis can trigger. A viral meningitis is usually milder than a bacterial one and often heals spontaneously after a few days to weeks.

diagnosis

The diagnosis of meningitis is particularly difficult in newborns. The symptoms that occur in adults can include fever, headache, and stiff neck occur only weakly in small children or do not occur at the beginning. Often these symptoms do not appear until the disease is advanced. Especially the typical neck stiffness (Meningism) rarely occurs in young children and is difficult to diagnose.

To confirm the diagnosis, a doctor removes cerebrospinal fluid from the baby's lumbar spine (lumbar puncture). If bacterial meningitis is suspected, antibiotic therapy should be started before the diagnosis is confirmed.

What are the signs?

The first signs of meningitis in babies vary greatly. Often it can be seen in babies in the early stages of the disease high fever measure up. The high fever often occurs with an abrupt one Behavior change of the baby on. The babies appear tired and absent and stand out constant crying and screaming and a whimpering behavior.

If meningitis is suspected, a doctor should be consulted as soon as possible so that a reliable diagnosis can be made. The earlier therapy can be started, the lower the risk of possible complications caused by the disease.

Symptoms

The spectrum of symptoms that can occur with meningitis is very broad. The individual symptoms can partly also only weakly pronounced be or not occur at all. The order in which these symptoms are recognized in the newborn also varies from child to child. Because the baby's immune system is not yet fully developed, meningitis symptoms can be more severe than in an adult.

Classic symptoms of meningitis are Fever and headache. The fever is usually accompanied by cold hands or feet. Neck stiffness, which is typical in adults, does not usually occur in newborns or is difficult to diagnose. The babies are characterized by a general malaise from - unusual crying or whimpering (constant and uninterrupted screaming), one Refusal of food and grouchy behavior when touched are typical.

In addition, the babies show one increased tiredness and the associated difficulty in waking up. Since the cranial bone is not yet completely ossified in newborns, meningitis can lead to Bulging of the fontanel come. In addition, typical skin changes are possible, especially if the disease is very advanced. While in some babies the whole Skin pale and blotchy appears, typical punctiform rashes can occur in other babies.

skin rash

When the bacteria from the meninges spread through the body through the bloodstream and multiply rapidly (sepsis), it can get in the skin too small, punctiform hemorrhages come. Without treatment, this rash will develop into a kind of bruise that turns increasingly purple and finally completely discolored.

This rash occurs mostly in babies advanced stage of meningitis on and is life threatening. The rapid deterioration in health is possible after these symptoms appear. An emergency room should be visited quickly.

treatment

The treatment of meningitis depends on the pathogen (bacteria or viruses). One through bacteria meningitis is caused with Antibiotics treated. Treatment is usually done inpatient in the hospital in an intensive care unit. It should be started as soon as possible after diagnosis and, depending on the stage of the disease, lasts from several weeks to months.

One through Viruses Meningitis caused cannot be treated with the help of antibiotics. Here special drugs against viruses are given, so-called Antivirals. Usually this, in combination with Peace and quiet of the baby, the symptoms improve and the meningitis subsides within a few days to weeks. In some cases, general malaise and headaches can persist for a long time. A transfer of the viral meningitis to the brain tissue (Encephalitis) is a dreaded complication. This occurs especially when infected with herpes or measles viruses.

Duration

The course and duration of meningitis varies greatly depending on the causative agent. At bacterial infection the disease often takes one more serious and faster progressing course. Symptoms can appear 2 to 5 days after being infected with the bacterium. As a result, the infection often takes a very serious course, which can lead to death within a short time (hours to days).

In the case of a viral infection, the first symptoms appear after approximately 2 to 14 days. This so-called incubation period depends on the pathogen. Meningitis usually heals spontaneously within a few days to weeks through rest and rest.

What can the consequences / long-term consequences be?

Similar to meningitis in adults, consequences can also occur in babies through the inflammation in the area of ​​the central nervous system. These occur mainly with bacterial infections.

Since the nervous system in newborns is not yet fully developed, there is a risk that its development will be disturbed by the inflammation. The following are Mental development impairments possible in rare cases. In addition, disorders of consciousness, movement and hearing can occur when the inflammation spreads to the brain tissue.

Without treatment, the bacteria may spread through the bloodstream (Waterhouse-Friderichsen Syndrome). There is a rapid and strong increase in the blood, which is why blood poisoning (sepsis) speaks. This course is acute due to a disruption of the blood coagulation system life threatening for the baby. Going to an emergency room and receiving intensive medical treatment are urgently needed.

Vaccination against meningitis

A baby can be vaccinated against several pathogens that cause meningitis. As a bacterial meningitis takes a much more serious course, a vaccination against possible bacterial pathogens is indicated.

Read more on the subject at: Vaccinations in the baby

There are already vaccinations against several bacterial strains, which are recommended by the STIKO (permanent vaccination commission). A vaccination against Haemophilus influenzae type B can be carried out in the third, fourth, fifth and twelfth month of life. You can vaccinate against several different types of pneumococci from two months to five years of age. You can also vaccinate against meningococci (type C) in the second year of life.

In addition, a vaccine against meningococci (type B) has existed since 2013. The current data situation is not yet sufficient for a general vaccination recommendation by the STIKO due to studies and investigations carried out. Therefore this vaccination is only recommended for babies with specific underlying diseases.

Find out more about the topic here: Meningococcal vaccination