Neonatal meningitis is a serious medical condition in infants that is rapidly fatal if untreated. Meningitis is an inflammation of the meninges, the protective membranes of the central nervous system, is more common in the neonatal period (infants less than 44 days old) than any other time in life, and is an important cause of morbidity and mortality globally. Mortality is roughly half in developing countries and ranges from 8%-12.5% in developed countries. Symptoms seen with neonatal meningitis are often unspecific and may point to several conditions, such as sepsis (whole body inflammation). These can include fever, irritability, and shortness of breath. The only method to determine if meningitis is the cause of these symptoms is lumbar puncture (an examination of the cerebrospinal fluid). The most common cause of neonatal meningitis is bacterial infection of blood, known as bacteremia. Organisms responsible are different; most commonly group B streptococci (i.e. Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes. Although there is a low mortality rate in developed countries, there is a 50% prevalence rate of neurodevelopmental disabilities after meningitis caused by E. coli and Streptococcus agalactiae, and a 79% prevalence after meningitis caused by Gram-negative rods other than E. coli. Delayed treatment of neonatal meningitis may cause cerebral palsy, blindness, deafness, seizure disorders, and learning deficiencies. The following is a list of common signs and symptoms of neonatal meningitis. Fever poor appetite anterior fontanelle bulging seizures jitteriness dyspnea irritability anorexia vomiting diarrhea abdominal distention (increase in abdominal size) neck rigidity cyanosis jaundice sunset eyes (downward gaze of the eyes) abnormal body temperature (hypo-or hyperthermia) change of activity (lethargy or irritability) These symptoms are unspecific and may point to many different conditions. Neuroimaging (X-ray imaging of the brain) is recommended to detect the complications of meningitis.
Jacques Fellay, Alessandro Borghesi