Bacterial meningitis in neonates (Paediatrics)

It is an infection of the layers that surround and protect the brain and spinal cord, called the meninges.

Bacterial meningitis is more common in the first month of life than at any other time. The most common causes are Streptococcus agalactiae and E. coli.

In newborns, the most common symptom is unstable temperature, ranging from fever to hypothermia. Neurological symptoms include irritability, lethargy, tremors, seizures and a bulging fontanelle.

The diagnosis is suspected on the basis of clinical history and physical examination. Complementary investigations are required: laboratory tests, lumbar puncture, blood and cerebrospinal fluid cultures, CT-scan and/or MRI scan.

Treatment is based on supportive measures and antibiotics, which must be started as soon as possible. Treatment is given in an intensive care unit. The lumbar puncture will be repeated after one or two days of antibiotic treatment, and an imaging test (such as an MRI) will be done to rule out complications.