Infantile and childhood bacterial meningitis

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Published on: October 29, 2014

Philippe Lepage1, Bernard Dan

  • 1Department of Paediatrics, Université Libre de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.

Handbook of Clinical Neurology
|April 30, 2013
PubMed

Insights

Bacterial meningitis (BM) is a serious global health threat, primarily caused by Hib, S. pneumoniae, and N. meningitidis. Early diagnosis and prompt antimicrobial therapy are crucial for managing this infection and preventing severe neurological complications.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Bacterial meningitis (BM) is a significant global health challenge, particularly in children.
  • Key pathogens include Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis, responsible for ~90% of cases beyond the neonatal period.
  • Pathogenesis involves upper respiratory tract colonization, epithelial invasion, bloodstream survival via complement evasion, and rapid multiplication within the cerebrospinal fluid (CSF).

Purpose of the Study:

  • To outline the epidemiology, pathogenesis, clinical presentation, diagnosis, and management of bacterial meningitis.
  • To highlight the importance of timely diagnosis and appropriate antimicrobial therapy.
  • To emphasize the monitoring of potential complications in affected children.

Main Methods:

  • Review of clinical features, diagnostic procedures, and management strategies for bacterial meningitis.
  • Discussion of common pathogens and their mechanisms of invasion and survival.
  • Inclusion of information on neurological findings, complications, and diagnostic tools like lumbar puncture and CSF examination.

Main Results:

  • Clinical manifestations vary based on age, pathogen, and host response, often including meningeal signs, altered consciousness, seizures, and increased intracranial pressure.
  • Complications can include prolonged fever, seizures, subdural effusions, empyema, and brain abscesses.
  • Diagnostic confirmation relies on history, physical examination, lumbar puncture, and CSF analysis; clinical scores are emerging for risk prediction.

Conclusions:

  • Prompt diagnosis through clinical evaluation and laboratory tests, followed by appropriate antimicrobial therapy, is critical for favorable outcomes in bacterial meningitis.
  • Vigilant monitoring for and management of complications are essential components of patient care.
  • Understanding the pathogenesis and clinical spectrum aids in effective disease control and treatment strategies.

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