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Meningitis and septicaemia in children

Published by Bupa's health information team, April 2008.

This factsheet it for people who would like more information about meningitis and septicaemia in babies and toddlers.

Meningitis is an infection of the meninges - the membranes that cover the brain and spinal cord. Babies and young children are most at risk of getting meningitis, but it can affect anyone. Meningitis sometimes causes a serious type of blood poisoning called septicaemia.

About meningitis
About septicaemia
Symptoms
Complications
Causes
Diagnosis
Treatment
Prevention
Further information
Questions and answers
Related topics
Sources

About meningitis

Meningitis is usually caused by a bacterial or viral infection.

Everybody carries bacteria and viruses harmlessly in the nose and throat. But occasionally, specific types can overcome the body's immune system and cause meningitis. The infections can be spread through close contact, for example, kissing, coughing and sneezing.

These bacteria and viruses are very common and only cause meningitis rarely. No one knows exactly why babies and young children are more likely to get meningitis, but it's probably because their immune systems are less developed. For more information on meningitis in adults, please see Related topics.

Sometimes meningitis can be a complication of another infection, or a head injury or brain surgery. Very rarely, it can be caused by a fungal infection or amoeba.

About septicaemia

Bacterial meningitis sometimes causes a type of blood poisoning called septicaemia, which happens if bacteria or their toxins enter the bloodstream and the rest of the body. Septicaemia is a very serious condition that can be fatal.

Symptoms

It can be very difficult to recognise meningitis and septicaemia, because at first the symptoms look like flu. However, you should seek urgent medical advice if you think that your child has meningitis.

Symptoms of bacterial meningitis and septicaemia can develop very quickly, over the course of a few hours. Viral meningitis may occur suddenly or develop gradually over a number of days.

The symptoms of viral and bacterial meningitis are similar, although the viral form of the disease is generally far less severe.

Meningitis and septicaemia in babies

Symptoms can appear in any order, and may include some, but not necessarily all, of the following:

fever and vomiting
high pitched crying
the baby may be difficult to wake or lethargic
the baby may be floppy, may dislike being handled, be irritable
the baby may have a rigid body with jerky movements
cold hands and feet
blank, staring expression
pale, blotchy complexion
the fontanelle - the soft area on the top of the babies head - may bulge out
a rash (see Septicaemic rash)

Meningitis symptoms in toddlers

The symptoms of meningitis and septicaemia in children are similar to those in adults. They can also appear in any order, and may include some, although not necessarily all, of the following:

fever
vomiting
severe headache
confusion or irritability
fits (seizures)
stiff neck (more common in older children)
not eating
being irritable
drowsiness
sensitivity to light (more common in older children)

Septicaemia symptoms in toddlers

Septicaemia can occur with or without meningitis. The symptoms in young children are similar to those seen in adults, and include:

fever
shivering, or having cold hands and feet
pale, blotchy complexion
drowsiness
confusion
fast breathing
aching limbs or joints
a rash (see Septicaemic rash)

Septicaemic rash

If your child develops septicaemia, he or she may also get a rash. This looks like tiny bright red spots that may join together to give the appearance of fresh bruises. If the spots don't disappear when a glass is pressed against the skin you should seek medical help immediately. This is known as the "tumbler test".

Complications

Recovery usually takes two to three weeks, but this varies from person to person.

However, meningitis can have serious complications - sometimes it can even be fatal. However, these days people are more aware of the symptoms, and there are more effective treatments available.

Although most children have no after effects from meningitis, severe cases can sometimes cause lasting complications, including:

learning difficulties, memory loss, coordination problems or paralysis of parts of the body - often these are temporary
loss of sight or vision problems
deafness or hearing problems
skin scarring from septicaemia
liver or kidney damage

Causes

Bacterial meningitis

Over 50 different types of bacteria can cause meningitis.

In the UK, the most common form of meningitis is meningococcal meningitis, which is caused by the bacterium Neisseria meningitidis. This occurs in several different strains, but most cases in the UK are caused by strain B. Strain C used to be common, but vaccination now prevents most cases (See Prevention). The risk for meningococcal meningitis is highest among children under the age of 5. It is also more common in teenagers and young adults between the ages of 15 and 24.

As well as infecting the meninges, meningococcal bacteria can also cause septicaemia.

The second most common form of meningitis in the UK is pneumoccocal meningitis, which is caused by the bacterium Streptococcus pneumoniae. Pneumoccocal meningitis is most common in young children, the elderly and people who have a weakened immune system such as those with HIV/AIDS. It can also result in septicaemia. S. pneumoniae usually causes less serious illnesses than meningitis, such as ear infections and sore throats.

Bacterial infections in babies

Group B streptococcal bacteria are the most common cause of meningitis in new-born babies. These bacteria are carried by a third of the population but they are usually harmless. Esherichia coli and Listeria can also cause meningitis in new-born babies.

The bacterium Haemophilus influenzae type b (HiB) also used to be a common cause of meningitis in children under the age of 4. Because babies are routinely immunised against Hib, it's now rare.

Viral meningitis

Viral meningitis doesn't usually cause septicaemia, and most cases are relatively mild. It's more common in the summer.

Enteroviruses, which normally live in the lining of the bowels (intestines), are the most common cause of viral meningitis. Most people infected by these viruses only get a mild cold or flu-like illness. Many other types of virus such as herpes or measles can cause viral meningitis; the mumps virus used to be the most common cause of meningitis, but widespread use of the MMR vaccine means this is now very rare.

Diagnosis

If you think your child has meningitis seek urgent medical advice. If the doctor suspects meningitis he or she will refer him or her to hospital immediately.

Below are some possible tests to confirm meningitis.

A lumbar puncture (spinal tap) - this involves inserting a needle between two bones of the lower spine to take a sample of the spinal fluid for lab tests.
A computerised tomography (CT) scan, which uses X-rays to make a three-dimensional image of part of the body, may be carried out to check for swelling or damage to the brain tissue.
A magnetic resonance imaging (MRI) scan, which uses magnets and radiowaves to produce images, may be performed to look for brain tissue damage.
Other tests may include a blood test, to see if the infection has reached the blood (septicaemia), throat and nose swabs, a chest X-ray, and testing a faeces sample for viruses.

If there has been a recent head injury, an X-ray may be taken to check for damage to the skull.

Treatment

The treatment depends on the type of infection causing the meningitis.

Bacterial meningitis

Bacterial meningitis or septicaemia needs urgent treatment with antibiotics, often given immediately as a "drip" directly into a vein (intravenously).

Oxygen may be given, especially if there are breathing difficulties. Extra fluids may be given intravenously if there are signs of dehydration, poor circulation or shock (when the organs do not receive enough blood).

Viral meningitis

Because viral meningitis is generally less serious, it can usually be managed at home, with rest and over-the-counter painkillers. The symptoms usually clear up within two weeks. Hospital care may be needed for a severe infection, but there is no specific treatment for the virus infection. If you think your child has viral meningitis, go and see your GP.

Prevention

In the UK, babies are offered routine immunisation against some strains of meningitis.

A pneumococcal vaccination, which protects against seven types of pneumococcal bacteria.
A MenC vaccination, which protects against meningococcal group C bacteria.
A HiB vaccination, which protects against H influenzae bacteria.

This has helped to dramatically reduce the number of cases of meningitis, although they don't protect against all types of meningitis. The number of group C meningococcal disease cases has dropped by 90 percent since the MenC vaccine was introduced in the UK.

As well as babies, vaccinations against various strains of bacteria that cause meningitis are offered to other groups such as young adults or the elderly, people who have low resistance to infection such as people with diabetes, and travellers to areas where meningitis is prevalent. However, no single vaccine can prevent all forms of the disease.

If you or your child comes into contact with someone with meningococcal meningitis or septicaemia, you should seek medical advice - you may need to take a preventive course of antibiotics.

Steps to prevent the spread of meningitis include avoiding contact with people known to have possible meningitis. Regular hand-washing also helps stop it spreading from person to person.

Further information

Meningitis Research Foundation
080 8800 3344
www.meningitis.org.uk