How do newborns acquire spinal meningitis and what are its after effects and treatments?
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Meningitis, also called spinal meningitis is the inflammation of the meninges or membranes covering the brain and spinal cord. Most often meningitis results from infections caused by micro-organisms like bacteria, viral, fungi and others. This infection can commonly occur in newborns and babies up to 3 months, usually called as neonatal meningitis.
Although there may be several causes, meningitis in newborns and babies can be serious and life threatening if appropriate treatment is not provided in time. As the immune system in newborns is still developing, they are at greater risk of infections.
What Are The Causes Of Spinal Meningitis In Newborns?
Newborns can have increased chances of meningitis due to infection of the blood or sepsis. This is often a bacterial infection acquired from the birth canal. The common causative organisms include group B streptococci, Escherichia coli and sometimes Listeria monocytogenes.
Other causes of meningitis in infants and young children include infections caused by Pneumococcus bacteria, Meningococcus bacteria and Haemophilus influenzae B (Hib).
Babies who are at an increased risk of spinal meningitis include preterm babies, low birth weight babies and complicated deliveries.
How Do Newborns Acquire Apinal Meningitis?
Pregnant women carrying streptococci can potentially pass the infection to their babies while giving birth. Another infection called listeriosis caused by Listeria can affect pregnant women. This infection spreads through contaminated food like luncheon meats, soft cheese and hot dogs and presents with flu-like symptoms in pregnant women. This can infect the baby by passing through amniotic fluid or placenta.
Infants and babies can acquire infection from contact with respiratory and oral secretions of infected persons. These commonly spread by sharing personal items, kissing and prolonged contact with infected person.
What Are The Symptoms Of Spinal Meningitis In Newborns?
Newborns with an infection during birth often begin to seem unwell during initial weeks after birth. Some may show an early onset of infection. The hallmark signs of spinal meningitis are high fever, stiff neck and headache. However, in case of newborns and babies, some symptoms may be difficult to appreciate.
Symptoms in newborns and infants need to be properly evaluated, and as neonatal meningitis can be fatal; it needs immediate medical attention and care.
Some of the Signs of Neonatal Meningitis Include
- Fever and excessive crying
- Poor feeding or refusal of food
- Vomiting or diarrhea
- Increased irritability and oversensitivity
- Dislike being carried or handled
- Breathing difficulty
- Arching of back and neck
- Body floppiness or jerky movements
- Excessive sleepiness and lethargy
- Rash or spotty appearance of skin
- Bulging fontanel or soft spot on the head
Newborns may not clearly show neck stiffness or confusion; their discomfort is often presented with crying and irritability. Some may have seizures, uncontrolled facial or body movements. Older children may have complaints of headache, confusion, altered mental status.
How Is Spinal Meningitis Diagnosed In Newborns?
If there is a suspicion that a baby may be suffering from spinal meningitis, immediate medical attention should be sought. The physician will have a thorough clinical examination to detect meningitis specific signs and record the history.
In suspected cases, a procedure called spinal tap or lumbar puncture may be performed. In this, a needle is inserted into the back and the cerebrospinal fluid (CSF) is collected for analysis. Diagnosis is confirmed by CSF analysis.
How is Spinal Meningitis in Newborns Treated?
Spinal meningitis in newborns and babies is treated with antibiotics for bacterial infection and intravenous fluids. Based on the symptoms and the severity of the infection, other symptomatic treatment may be given. These include medicines to control fever and seizures.
Additionally, monitoring of intracranial pressure is required. In some cases, assessment and treatment of cerebral abscess and hydrocephalus caused due to bacterial infection may be necessary.
What Are The After Effects Of Spinal Meningitis In Newborns?
In some newborns surviving spinal meningitis, there may be after effects like hearing difficulties, brain or nerve damage, intellectual disability or sometimes seizures and learning difficulties may be seen.
Prevention Of Spinal Meningitis In Newborns
Infection control in pregnant women can play an important role in prevention of meningitis in newborns. Pregnant women can be given prophylactic antibiotics before labor to avoid streptococcal infection and to avoid transmission to the newborn. Women, who particularly need to be considered, include those who carry streptococcal bacteria, have streptococcal urinary tract infection or those with a history of previous baby with streptococcal infection.
Listeriosis is another infection, which can be controlled in pregnant women by practicing appropriate personal and food hygiene like washing vegetables and fruits thoroughly under running water, consuming well cooked meat or animal food and boiling or treating milk and drinking water. Appropriate pregnancy care should be taken and medical advice should be obtained in case of complications, high fever or early delivery.
Vaccinations are available to prevent some types of meningitis and those should be taken with medical advice. The recommended immunization schedule for children should be appropriately followed.