Bacterial Meningitis in Newborns
Newborns with bacterial meningitis are usually irritable, vomit, or may have seizures.
The diagnosis is based on the results of a spinal tap and blood tests.
All untreated newborns die from the infection.
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.
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). The infection is most commonly caused by the following bacteria:
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.
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
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.
A doctor diagnoses bacterial meningitis by removing a sample of spinal fluid obtained through a procedure called a spinal tap (lumbar puncture). The fluid is analyzed, and if there are any bacteria in that sample, they are examined and grown (cultured) in a laboratory for identification. Doctors also take a sample of blood to be cultured and analyzed.
Doctors may also do the PCR 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.
Without treatment, nearly all newborns with bacterial meningitis die.
While awaiting culture results, the newborn is given antibiotics (often, ampicillin plus gentamicin, cefotaxime, or both) by vein (intravenously). Once the culture results are available, doctors change the antibiotics, if needed, to ones that are appropriate for the type of bacteria causing the meningitis.