Meningitis in newborns: Long term effects, survival rate, and more - Medical News Today

Meningitis is the inflammation of the tissues covering the brain and spinal cord. It can affect anyone, including newborns within the first month of life.

In developed countries such as the United States, experts estimate that the incidence is 0.3 per 1,000 live births. Viral infections are the most common cause, and infants can usually recover from these at home.

In contrast, bacterial infections cause meningitis less often, but they can be very serious and are sometimes fatal. They lead to death in up to 40% of cases within the first month.

Bacterial meningitis requires aggressive treatment in the hospital, where the newborn will receive antibiotics intravenously. Of those who recover, about 50–60% develop long-term effects such as seizures and vision impairments.

Keep reading to learn more about the outlook, causes, symptoms, long-term effects, diagnosis, and treatment of meningitis in newborns.

Meningitis is the inflammation of the thin membrane that covers the brain and spinal cord. This membrane is called the meninges. Sometimes the inflammation can extend beyond the meninges and affect the brain itself.

Meningitis in newborns can be either early or late onset. Early onset occurs within the first week after birth for babies born at term, and in the first 72 hours of life for those born preterm. Late onset happens after this. Newborn is a term for an infant during the first 28 days of life.

In treated cases of bacterial meningitis, the death rate may be as high as 40% in the first month of life and up to 10% after that.

Viral meningitis rarely leads to death. Most children recover fully, although the recovery process can be slow.

A review article published in 2021 explains that newborns are more susceptible to infections for several reasons. For example, their immune system and blood-brain barrier have not fully developed. The immune system is responsible for fighting infections, and the blood-brain barrier helps prevent infections from entering the brain through the bloodstream.

In addition, infants do not receive immunizations until they reach 2 months of age. During this time, they have a high risk of developing a bacterial infection in the blood, which can lead to meningitis.

Viral infections are the most common cause of meningitis in newborns, but such cases are less severe than the meningitis that bacterial infections produce. Bacterial meningitis is often very serious.

A parasite or fungus may also cause meningitis, but these infections tend to occur only in infants with weak immune systems.

An older 2014 study notes that the main cause of transmission of early onset meningitis is the birth process. When infants pass through the birth canal they are exposed to an array of pathogens, which are infection-causing microbes.

Late onset meningitis involves exposure to pathogens while in the hospital. Causes of transmission can include:

• contact with pathogens from medical devices, such as a feeding tube, ventilator, or catheter
• poor hand hygiene among medical staff, which transmits infections from infants with meningitis to infants who do not have meningitis
• taking a prolonged course of antibiotics

Learn more about the types of meningitis here.

Symptoms may include:

• bulging or tense soft spot on the head
• sleepiness
• high temperature, although temperature may be low or typical in infants under 3 months old
• fast breathing
• extreme shivering
• poor feeding or vomiting
• blotchy, pale, or bluish skin
• irritable with a moaning or high-pitched cry
• floppiness and stillness, or stiffness with jerky movements
• cold hands and feet
• unusual grunting sounds
• diarrhea
• pinprick rash or purple bruises anywhere on the skin

Some symptoms may develop before the rash appears.

Up to 60% of infants who survive meningitis develop chronic neurological complications, such as:

• seizures
• movement problems
• cognitive (thinking) issues
• vision and hearing impairments

Evidence suggests that children in the first 5 years of life who survive meningitis have a 10-times higher risk of developing disabilities than those who have not had meningitis.

Learn more about the long-term effects of meningitis here.

In addition to a physical examination and history, doctors base a diagnosis on the following:

• Lumbar puncture: Another term for this is a spinal tap. This is the test that confirms the diagnosis of meningitis. It involves withdrawing a small amount of fluid from the spinal cord in the lower back to test for microbes.
• Blood cultures:These are blood tests that can help grow and identify the specific pathogen causing meningitis.
• MRI or CT scan: These imaging tests do not diagnose meningitis, but they provide additional information. For example, an MRI may reveal inflammatory changes in the meninges, and a CT scan may show other conditions that can cause symptoms similar to those of meningitis.
• Throat, nose, and rectal swabs: These help identify specific viruses that can cause meningitis.

Meningitis progresses rapidly, so doctors treat it aggressively. As soon as symptoms start to appear, an infant needs immediate medical care.

Treatment of bacterial meningitis requires hospitalization. Infants receive antibiotics intravenously, which may be necessary for 14–21 days depending on the bacteria that has caused the infection.

Most infants with viral meningitis do not require hospitalization. They usually recover at home within 7–10 days. Doctors do not treat them with antibiotics because these drugs are not effective against viral infections. Instead, practitioners advise rest and fluids. An exception involves viral meningitis due to a herpes simplex infection, which requires treatment with intravenous antiviral medication.

If neurological complications develop, treatment will include cognitive therapy, physical therapy, medications, and social support over the course of the child's life. The primary pediatrician may coordinate therapies and specialist consultations, such as those with a neurologist.

Meningitis in newborns can happen because infants are more susceptible to infections for several reasons. Their immune system and blood-brain barrier have not fully developed, and they have not yet received immunizations.

Symptoms may include fever, irritability, a pinprick rash, and a bulging soft spot on the head. Because bacterial meningitis is very serious, a caregiver should not wait for a rash to develop before getting the infant medical attention.

Early diagnosis and treatment are very important. Doctors may be able to diagnose the condition with a lumbar tap, which involves withdrawing a small amount of spinal fluid to test for microbes. When the cause is a bacterial infection, treatment requires hospitalization, where an infant will receive intravenous antibiotic therapy for 14–21 days depending on the bacteria.