Meningitis is an inflammation of the protective tissues and fluid surrounding the brain and spinal cord. It commonly occurs in children and adults, though young children are more susceptible to the infection. Many viruses, bacteria, and fungi cause meningitis in children.

With timely medical attention, meningitis in children is fully treatable and curable. A severe infection or delayed diagnosis, however, can be life threatening and cause long-term effects.

As scientists advance in their understanding of meningitis, they have developed several vaccines that offer protection against the disease. Examples include the meningococcal, Haemophilus influenzae type B (Hib), and pneumococcal vaccines.

Keep reading to learn more about meningitis in children, including the causes, symptoms, and treatment options.

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Children can develop meningitis from close contact with a person who has the infection or through surfaces and inanimate objects infected with the germ that causes meningitis.

A simple cold or respiratory tract infection can also lead to meningitis. The type of pathogen that causes meningitis influences its symptoms and the severity of the disease. Several different kinds of meningitis can affect babies, toddlers, and young children:

Viral meningitis

A viral infection is one of the most common causes of meningitis in children. Research shows that over 70% of these infections occur in children under the age of five. Babies younger than 1 month old are more likely to have severe illness from viral meningitis.

In most cases, viral meningitis resolves on its own without treatment within 7–10 days. However, it is best to pay a visit to the doctor since some children can develop complications.

According to the Centers for Disease Control and Prevention (CDC), non-polio enteroviruses are the leading cause of viral meningitis in the United States. Other viruses that can cause the infection include the mumps virus, herpesviruses, the measles virus, and influenza viruses. In areas where vaccines are not available, the mumps virus is responsible for 10–20% of viral meningitis cases.

Bacterial meningitis

Bacterial meningitis is more serious than viral meningitis, and around 250,000 people lose their lives to the illness every year. Unlike in the case of viruses, some bacteria that cause meningitis release a toxin in the body, which can lead to neurological complications.

Bacterial meningitis mostly affects children and young people. It leaves 1 in 5 people with long-lasting effects such as seizures, hearing and vision loss, neurological damage, and cognitive impairment.

According to the International Society for Pediatric Neurosurgery (ISPN), Hib meningitis is the most common form of bacterial meningitis in the period of infancy. The incidence of Hib meningitis decreases after the age of 2 months due to vaccination. Throughout the first year of life, meningococcal and pneumococcal meningitis occur more frequently. In children aged 5 years and above, meningococcal meningitis is the most prevalent type of bacterial meningitis.

Fungal meningitis

Although less common than viruses and bacteria, fungi can also cause meningitis in children.

In most cases, fungal meningitis is an opportunistic infection – that is, it develops when the child’s immune system gets weakened from another infection or treatment. Studies show a higher rate of fungal meningitis in children with a hematological disease such as leukemia or children who have undergone a hematopoietic stem cell or solid organ transplant.

The use of catheters, ventilators, and other invasive devices also increases the risk of fungal meningitis in children.

Learn more about the types of meningitis here.

In children, the first symptoms of meningitis are usually a fever, severe headache, and vomiting. Since these signs are nonspecific, parents may mistake the infection for the flu. This can cause a delay in meningitis diagnosis and allow the disease to become more serious.

Other common symptoms to look out for include:

Although fever is one of the most telling signs of meningitis, it is often absent in babies younger than 3 months old. Babies and toddlers may show other symptoms, including increased irritability, refusing to feed, and a tense or bulging soft spot on their heads.

Learn more about meningitis in babies here.

When diagnosed in time, all forms of meningitis are treatable. That said, children with bacterial meningitis are at a higher risk of developing complications with long-term effects.

According to World Health Organization (WHO) estimates, bacterial meningitis may result in brain damage, hearing loss, or a learning disability in 10–20% of people. Some children can even lose their lives to bacterial meningitis.

A 2014 study looked at the physical and mental effects of bacterial meningitis on people who had the disease in their childhood or adolescence. This study involved a total of 61 people, of whom 36 had a history of bacterial meningitis and 25 never had the infection.

Results suggested that the meningitis group had poorer postural control and struggled with balance and steadiness several years after recovering from the infection. They also reported feelings of dizziness, vertigo, light-headedness, and visual impairments during the course of the study.

The quickest and most reliable way to confirm a case of meningitis is through a laboratory examination. This comprises a series of tests that check for viruses, bacteria, fungi, or other agents that cause meningitis.

A doctor or medical professional will collect a sample from the child for further investigation, such as:

  • a nose or throat swab
  • a sample of the child’s stool
  • a finger prick to draw blood
  • a spinal tap or lumbar puncture to draw fluid from around the spinal cord

Before the diagnostic examination, parents and caregivers must inform the doctor about other prescribed antibiotics or medicines that may cause allergies.

Meningitis treatment depends on whether the meningitis is viral, bacterial, or fungal in origin.

Viral meningitis

Viral meningitis tends to resolve on its own with adequate rest and fluids. However, children with bacterial or fungal meningitis or those at risk of developing severe illness need close observation and treatment in a hospital setting.

Sometimes, a doctor may prescribe an antiviral for children with a type of viral meningitis known as herpes simplex meningitis. They may also provide pain relief medication for headaches and an antiemetic to reduce nausea and vomiting.

Bacterial meningitis

Doctors treat bacterial meningitis with antibiotics. The ISPN lists the following antibiotics to treat bacterial meningitis:

  • cefotaxime
  • ampicillin
  • ceftriaxone
  • gentamicin
  • vancomycin
  • chloramphenicol

The choice of antibiotic will depend on the type of bacteria causing the disease, the child’s age, and the presence of complications, if any. A doctor may prescribe other antibiotics instead of or in addition to the above, depending on the causative organism. They will recommend the best course of treatment while also cautioning on its side effects.

Antibiotic therapy can last for 5–21 days or more depending on the causative organism, the type of antibiotic used, and the severity of the disease.

Fungal meningitis

The treatment for fungal meningitis is a long course of high-dose antifungal medicines. A healthcare professional will usually administer these directly into a vein in the hand through an IV, but sometimes a person can take them orally.

Amphotericin B and fluconazole are the two commonly prescribed antifungal drugs in children. The duration of treatment depends on the type of fungus causing the infection, the child’s symptoms, and the overall health of their immune system.

There are also vaccines for meningitis. Learn about them here.

Meningitis in children is a global health concern, as it carries the risk of long-term effects and complications. Today, several vaccines are available that help prevent the disease.

The cause of meningitis can be viral, bacterial, or fungal. The cause will directly influence its symptoms and the choice and duration of treatment. Viral meningitis is relatively nonserious and self-resolving, but bacterial and fungal meningitis need close observation and often require hospital treatment.

Parents must be vigilant of the signs and symptoms of meningitis and contact a doctor immediately to prevent complications from developing.