Pregnant women who have a certain kind of bacteria (group B streptococci) are given antibiotics during delivery to prevent spreading the bacteria to the newborn.
Antibiotics are given intravenously to treat the infection.
(For an overview of meningitis, see Introduction to Meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be... read more . See also Overview of Infections in Newborns Overview of Infections in Newborns Infections occur at all ages but are a great cause for concern in newborns because newborns, especially preterm ones, have an underdeveloped immune system and are more susceptible to infection... read more , Meningitis Acute Bacterial Meningitis Acute bacterial meningitis is rapidly developing inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid... read more in adults, Meningitis in Children Meningitis in Children Bacterial meningitis is a serious infection of the layers of tissue covering the brain and spinal cord ( meninges). Bacterial meningitis in older infants and children usually results from bacteria... read more , and Viral Meningitis Viral Meningitis Viral meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space) when it is caused... read more .)
Meningitis that is caused by bacteria is life-threatening at any age but is of special concern in newborns.
Bacterial meningitis in newborns usually results from an infection of the blood (sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have... read more ). The infection is most commonly caused by the following bacteria:
Group B streptococci
Escherichia coli
Listeria monocytogenes
A number of other bacteria may cause meningitis as well.
Sometimes bacterial meningitis occurs in newborns when the bacteria enter the body through cuts or punctures in the scalp. The cuts or punctures can be caused by instruments that are used for delivery or by probes that are stuck to the scalp.
Symptoms of Bacterial Meningitis in Newborns
Older children with bacterial meningitis usually develop a stiff neck and have a headache. Newborns rarely develop a stiff neck and are unable to communicate specific discomfort. In newborns, important signs of illness that should alert hospital staff or parents to a possibly serious problem include
Signs of sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have... read more (for example, temperature too high or too low, trouble breathing, yellowing of the skin and eyes [ jaundice Jaundice in the Newborn Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more
], and pauses in breathing [apnea])Abnormal drowsiness (lethargy)
Seizures Seizures in Children Seizures are a periodic disturbance of the brain’s electrical activity, resulting in some degree of temporary brain dysfunction. When older infants or young children have seizures, they often... read more
Vomiting
Unusual fussiness and irritability (particularly a newborn who does not calm down when held)
In some newborns with meningitis, increased pressure of the fluid around the brain may make the fontanelles (the soft spots between the skull bones) bulge or feel firm.
Diagnosis of Bacterial Meningitis in Newborns
Spinal tap
Blood tests
Polymerase chain reaction (PCR) test
Sometimes ultrasonography or computed tomography (CT) or magnetic resonance imaging (MRI) of the brain
A doctor diagnoses bacterial meningitis by removing a sample of spinal fluid obtained through a procedure called a (lumbar puncture). The fluid is analyzed, and if there are any bacteria in that sample, they are examined and grown ( ) in a laboratory for identification. Doctors also take a sample of blood to be cultured and analyzed.
Doctors may also do the test on a sample of spinal fluid. The PCR test looks for the genetic material of the bacteria and enables doctors to rapidly identify the bacteria.
A doctor may do an imaging test such as or CT Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more
Prognosis for Bacterial Meningitis in Newborns
Without treatment, nearly all newborns with bacterial meningitis die.
With treatment, the risk of death is 5 to 20%. Of the newborns who survive, 20 to 50% develop serious brain and nerve problems, such as an accumulation of extra fluid in the normal open spaces within the brain (hydrocephalus Hydrocephalus Hydrocephalus is an accumulation of extra fluid in the normal spaces within the brain (ventricles) and/or between the inner and middle layers of tissues that cover the brain (the subarachnoid... read more
Prevention of Bacterial Meningitis in Newborns
While pregnant, women are typically screened for group B streptococci (GBS) in their genital tract. Pregnant women who have GBS may be given antibiotics at the time of delivery to prevent passing the bacteria to the newborn.