Neonatal Infections and Meningitis: Symptoms and Treatment

Newborns are much more susceptible to infections and meningitis than adults or older children. This is due to their immature immune systems: their systems aren’t yet equipped to fight the bacteria, viruses, fungi, and parasites that can cause infections.

As a result, babies born with infections may become very sick and require significant recovery time in the hospital. Most babies recover without significant long-term damage when the appropriate diagnosis and treatment is timely. A delay or misdiagnosis can mean serious and permanent mental and physical damage to the child and can even be fatal.

What Are The Common Types of Neonatal Infections?

Babies can get infections from bacteria, viruses, or parasites. Viral infections include herpes simplex virus, chickenpox (varicella virus), Rubella virus and the hepatitis virus. Bacterial infections include Group B Streptococcus, Listeria, E. coli, and syphilis. Parasitic infections include toxoplasmosis, among numerous others.

If a baby is born with one of these infections, it is often due to a maternal infection for which the mother was not properly treated. This undetected maternal infection is transmitted to the fetus when the baby is being delivered.

How Are Neonatal Infections and Meningitis Diagnosed?

Newborns that are infected will have a variety of symptoms. These may include inactivity, apnea, respiratory problems, decreased or elevated body temperature, poor feedings, irritability, odd skin color, low blood pressure, and seizures. Doctors will usually test fluid samples and run blood tests and cultures from the infant (and often the mother) to diagnose the infection. Treatment for most infections includes antibiotics or antiviral medications as well as supportive care (respiratory assistance, fluid replenishment, other medicines).

What Happens When Neonatal Infections and Meningitis Are Not Diagnosed Early or Treated Properly?

There can be severe consequences if infections in a newborn are not diagnosed and treated in a timely fashion. Infection can quickly spread, becoming a much more serious acute infection. When an infection spreads to multiple parts of the body, it is classified as a ‘generalized infection.’ An infection of the blood is called sepsis; infection that settles around the brain is meningitis; infection of the brain is called encephalitis; and infection of the lungs is pneumonia.

• Sepsis: This is a serious infection that involves the spread of germs throughout the blood and tissues. The most common microorganisms associated with sepsis include Group B Streptococcus, E. coli, Listeria, C-negative Staphylococcus and H. influenzae. Blood tests and sometimes a test of cerebrospinal fluid are necessary for diagnosis. If the tests are positive, antibiotics are prescribed and the baby is monitored very closely in the neonatal intensive care unit (NICU). The prognosis for properly treated newborns is good with little to no residual physical or mental problems. If untreated or not effectively treated the mortality rate may be as high as 50%. Pre-term infants with sepsis are noted to have higher rates of cognitive deficits, cerebral palsy, and other neurological disabilities.
• Meningitis: This is inflammation of the membranes around the brain and spinal cord and is a very serious infection in newborns. The most common cause of meningitis in the Unites States is Group B Streptococcus. According to the U.S. Centers for Disease Control and Prevention, 10-30% of pregnant women carry Group B Strep which can potentially lead to neonatal meningitis. Listeria and E. coli are also common causes of meningitis in newborns. A spinal tap is performed to diagnose and determine the nature of the meningitis. Depending on the cause, antibiotics or antiviral medications are given. Intense supportive care in the NICU is required.
• Encephalitis: Encephalitis is an inflammation of the brain caused by a virus, most often herpes simplex virus. If a mother has the virus, she can pass it to her baby through the infected birth canal. To diagnose encephalitis, doctors will typically run blood tests, do a CT scan, MRI, an EEG and sometimes a spinal tap. Herpes encephalitis is extremely dangerous to a newborn and so doctors will generally begin medication without waiting for confirmatory results. An IV of an antiviral medication called acyclovir is given to newborns with encephalitis for 2-3 weeks. The prognosis for infants with encephalitis depends on the severity of the case, the strength of the newborn’s immune system and the timing of the diagnosis and treatment. Those with mild cases recover without any problems while more severe cases can result in lifelong mental and physical disabilities such as cerebral palsy, cognitive impairments, and seizures.
• Pneumonia: This bacterial lung infection can cause pulmonary changes, destruction of bronchopulmonary tissue, respiratory distress, respiratory failure and can develop into sepsis. Diagnosis is done through blood cultures, tracheal aspirate, chest x-ray and pulse oximetry. Treatment includes initial broad-spectrum antibiotics changed to organism-specific drugs once identified.

Neonatal infections require immediate care from doctors or other healthcare providers. Early identification is critical for a favorable outcome. If your child has sustained permanent physical or mental injuries as a result of a neonatal infection, call the birth injury attorneys at Reiter & Walsh ABC Law Centers. We can help determine if your doctor or healthcare provider was negligent in diagnosing and treating maternal or neonatal infection.