Meningitis, or inflammation of the protective membrane that surrounds the brain or spinal cord, ranges in severity from mild to a life-threatening emergency. Because of this wide range, it’s important to recognize the early symptoms of meningitis and understand how your child’s doctor will diagnose the disease.
There are two main causes of meningitis in infants: viral and bacterial. Viral meningitis tends to be mild, but bacterial meningitis can act fast and often with devastating results. If you suspect any type of meningitis, it’s important to seek out medical help immediately.
Symptoms of meningitis
Classic symptoms of viral and bacterial meningitis are similar and easily mistaken for the flu. Symptoms may come on quickly, over the course of several hours, or more slowly, over a day or two. In general, meningitis is marked by severe headache, high fever, confusion, nausea, sensitivity to light, a stiff neck and back pain, but children of different ages can have different symptoms.
- Infants less than 2 months old—Look for fever, decreased appetite, irritability, lack of alertness, listlessness, excessive crying, vomiting, and stiffness in the body and neck. Your baby may be inconsolable and may cry harder when picked up. If you bring your baby to the doctor, he or she may look for a bulging soft spot (the fontanelle on the baby’s head) or abnormal reflexes.
- Children ages 2 months to 2 years—Look for vomiting, fever, decreased appetite, rash, increased fatigue or sleepiness that makes it difficult to wake your child, extreme irritability and seizures.
Diagnosis of meningitis
The doctor will examine your child’s head, throat, ears, and spine, looking for signs of infection. The doctor may also order X-rays or computerized tomography (CT) scans of your child’s head, chest, or sinuses to look for swelling. If the doctor suspects viral meningitis, he or she may also order a polymerase chain reaction (PCR) test to look for antibodies against various viruses. A blood test may be used to determine whether a bacterial infection is present.
A spinal tap, or lumbar puncture, is also typically used to collect samples of cerebrospinal fluid. During a spinal tap, a needle is inserted into your child’s lower back. Fluid is removed from the bottom of the sac surrounding the spinal cord (not the spinal cord itself). If the fluid shows signs of infection (doctors look for low blood sugar and increased protein and white blood cell count), your child will likely be diagnosed with bacterial meningitis. The spinal tap may also give your doctor a clue as to which strain of bacteria is to blame for the infection.
Treatment depends on the type of infection.
Reviewed by Dr. Sara Connolly, February 2019
- Symptoms of meningitis are often mistaken for the flu, and can come on all of a sudden or over the course of a day or two.
- Newborns may experience fever, decreased appetite, listlessness, excessive crying, vomiting, stiffness and a bulge in the soft spot.
- A doctor will do a physical exam and may order several tests, including X-rays, a blood test and a spinal tap.
- Routine infant immunizations protect against some of the most common deadly causes of bacterial meningitis.