Inflammation of the meninges or meningitis in newborn toddlers and infants is not the most common condition. However, parents should not forget about this disease at all. Meningitis in a child under one year old can develop with numerous severe complications. Only timely treatment will help the baby recover and even save his life.
Causes
Among the various forms of meningitis, most are infectious. Often they are caused by various viruses or bacteria. Meningococcal infection is the undoubted leader among the causative agents of the inflammatory process of the meninges. It occurs in 70-80% of cases in patients with meningitis.
Bacterial meningitis, which is severe enough and becomes purulent, is caused by various types of bacteria. Most often in newborns and infants, meningococcal and streptococcal forms of meningitis are found. Such diseases are characterized by a severe course and frequent development of complications.
Serous meningitis is caused in 80-85% of viruses. Often the causative agents of rubella, chickenpox, measles, herpes viruses and Epstein-Bara are the culprits. In debilitated babies, meningitis can also be caused by a common flu infection. In such cases, the child usually has impaired functioning of the immune system or even immunodeficiency.
For children with diabetes mellitus or taking glucocorticosteroids from birth, infection with candidal meningitis is possible. In this case, a conditionally pathogenic fungus, Candida, quickly spreads in a weakened child's body. Getting into the meninges with the blood stream, the microorganism quickly multiplies there and causes severe inflammation. Treatment of such forms of the disease is usually longer than that of bacterial forms.
The most rare forms of meningitis in babies of the first year of life include the tuberculous variant or a disease caused by protozoa. Such forms of the disease occur only in 2-3% of all cases.
The traumatic variant occurs after a birth injury. It usually develops within a few days or months after the baby is born. Traumatic meningitis is difficult. Numerous complications can also occur. For the treatment of a child with a traumatic form of meningitis, it is necessary to consult a neurosurgeon and monitor a neurologist.
At-risk groups
Babies of all ages are not immune to meningitis. Features of the structure and functioning of the nervous and immune systems of babies in the first months after birth make them quite vulnerable to various inflammatory diseases.
Not all babies are equally at risk for meningitis. To control and monitor babies who have a high probability of illness, doctors identify risk groups for the development of meningitis. These include:
Newborn babies with very low birth weight and premature babies. These babies have not yet fully formed the nervous and immune systems. The blood-brain barrier of newborns does not function at all the same as in adults. Microorganisms that are small in size easily penetrate this barrier and can cause inflammation.
Children with congenital or acquired immunodeficiency. The imperfection of the cells of the immune system does not allow a timely response to an external pathogenic factor. The leukocyte link of immunity is not yet capable of effectively eliminating any infectious agents from the body. In such children, the risk of a severe course of any, even the most harmless infection, increases many times.
Birth trauma. Have adverse effects on the nervous system. Damage to the nerve trunks and membranes of the brain during traumatic external influences also contributes to the development of meningitis in babies.
Chronic congenital diseases. Weakened babies with many comorbidities are not able to fight the infection to the proper extent. The presence of congenital heart disease, diabetes mellitus, cerebral palsy affect the possible prognosis for meningitis.
What are the main signs in newborns and infants?
Determining the first manifestations of meningitis in infants is a difficult enough task for any mother. The behavior and well-being of the child during the incubation period practically does not suffer. Usually this period is 3-5 days to two weeks. Attentive mothers may pay attention to the fact that the child becomes more lethargic, tries to rest more often.
Signs characteristic of meningitis usually manifest as:
Temperature rise... Usually fast. In a few hours, the temperature rises to 38-39 degrees. Babies may be shivering or have a fever. Taking paracetamol and other antipyretic drugs does not bring relief. The temperature remains high for 4-5 days of illness. In severe cases - more than a week.
- Severe headache. Babies still cannot tell what worries them. If the child becomes more lethargic, cries, tries to tilt his head below the level of the pillow - you should definitely be alert! This symptom is often a manifestation of high intracranial pressure and requires immediate medical attention.
- Change in child behavior. Babies refuse to breast, become lethargic. When touching the head and neck, the baby may cry or avoid contact. Any attempts to pull the legs to the stomach or to pull them to the sides can cause the baby severe discomfort and even lead to increased pain.
- Frequent regurgitation. Despite the usual feeding, the baby can constantly regurgitate food. This is a manifestation of severe nausea. Some babies may even vomit once, but severely.
- In severe cases, the appearance of seizures. Usually this symptom occurs in babies with congenital diseases of the nervous system or episyndrome. The appearance of this manifestation of the disease is an unfavorable prognostic sign of the disease and requires urgent hospitalization of the baby in the intensive care unit.
With a deterioration in the general condition and an increase in signs of the inflammatory process - clouding of consciousness or even coma... Be sure to pay attention to the child's gaze. If he becomes "absent" - urgently call your doctor! This can be one of the manifestations of meningitis.
Diagnostics
The doctor performs special tests to establish a diagnosis. Usually, the doctor presses the baby's legs against the stomach or torso and evaluates the reaction. Increased pain syndrome is a positive meningeal sign and requires additional diagnostics.
One of the most affordable tests is a complete blood count. Its result provides doctors with information about the specific cause of the disease. Most often, a viral or bacterial etiology of the disease can be established. The leukocyte formula in the general blood test shows how difficult the inflammatory process is.
It is possible to more accurately determine the causative agent of the disease using bacteriological tests. They allow you to identify various types of viruses, bacteria, fungi and even protozoa. The undoubted advantage of such a test is that it is possible to carry out an additional determination of the sensitivity of the microbe to various drugs. This allows doctors to prescribe the correct and effective treatment and eliminate the cause of the disease.
In difficult cases, doctors resort to puncture. The doctor makes a puncture in the spine with a special needle and takes some cerebrospinal fluid for examination. With the help of laboratory analysis, it is possible to determine not only the pathogen, but also the nature of the inflammatory process and the form of the disease.
What consequences?
In many children, who received adequate treatment for meningitis on time, the disease ends with a complete recovery. However, this result is not guaranteed in all cases. If the child had aggravating factors, then the course of the disease becomes quite severe. In this case, the risk of developing an unfavorable latter increases significantly.
The most common complications in babies in the first year of life are:
Nervous system disorders. These include: decreased concentration and attention, some lag in mental and even physical development. After rubella meningitis - hearing impairment and poor speech perception.
The appearance of an episyndrome. Some babies may experience seizures. This symptom is often temporary. To eliminate adverse manifestations, a mandatory consultation with a neurologist and additional diagnostic tests are required. Babies are given EEG, neurosonography, and other tests to assess the level of damage to the nervous system.
Heart rhythm disturbances. Transient arrhythmias are more common. They usually appear several months or even years after the infection has recovered. Babies with such complications require compulsory observation by a cardiologist or an arrhythmologist.
How to treat?
All babies with suspected meningitis must be hospitalized in a hospital. Newborn babies are delivered to hospitals equipped with all necessary resuscitation equipment. The child must be monitored by medical personnel around the clock.
Treatment of the disease is carried out in a comprehensive manner. The leading role in therapy is played by the elimination of the underlying cause that caused the disease. For infectious meningitis, large doses of antibiotics are prescribed. All antibacterial agents are administered parenterally. Intravenous administration of drugs allows you to quickly achieve the desired clinical effect and accelerate recovery.
To relieve symptoms of headache and nausea, diuretics are used. Diuretics reduce high intracranial pressure resulting from inflammation and help to improve your baby's well-being.
To restore the nervous system, the introduction of B vitamins is used. Such injection forms of drugs can reduce the toxic effect of bacterial agents on the nerve trunks. Vitamins are usually prescribed for a long time, in courses of 10 days.
In order to eliminate the symptoms of intoxication, various detoxification drugs are used. Often, babies are given large doses of 5% glucose solution or isotonic sodium chloride solution. When seizures or movement disorders appear, electrolyte solutions are added to the treatment. With this introduction of drugs, the baby's well-being is normalized quickly enough.
After stabilization of the condition, the babies are prescribed immunostimulating drugs. They activate the immune system and help the immune system fight infection. Such drugs are quite effective for newborns and babies in the first year of life. They are generally well tolerated and do not cause adverse side effects.
Prevention
Compliance with the rules of personal hygiene for babies of the first year is also a prerequisite for the prevention of meningitis and other inflammatory diseases. In order to prevent contamination by a contact-household method, it is imperative to monitor the cleanliness of all objects that touch the skin and mucous membranes of the child. Towels should be washed daily. Iron the textiles with a hot iron on both sides.
Babies in the first year of life should have their own dishes and cutlery. The use of adult plates and mugs is prohibited. All cutlery should be free of chips and cracks, as pathogenic bacteria can easily accumulate in them. For newborn babies, be sure to remember to sterilize feeding bottles. The processing of dishes for babies is carried out using special products that are approved for children.
Treatment of meningitis in babies in the first year of life should be started as soon as possible. This will not only prevent possible adverse complications of a dangerous disease, but also preserve life and health.
All about meningitis in a child, see the next video of Dr. Komarovsky.
