Neonatal Meningitis

Meningitis is a very serious and often life-threatening infection that involves inflammation of the membranes surrounding the brain and spinal cord. It is especially likely to occur during the neonatal period (i.e. the first month of a baby’s life). The most common causes of meningitis in the United States are Group B Streptococcus (GBS) and Escheria coli (E. coli), but there are many other pathogens that can lead to this condition. Meningitis is such a serious threat to newborn health that medical professionals will begin treatment in suspected cases before an official diagnosis is made (1). If treated quickly and appropriately, infants with meningitis should make a full recovery. However, if treatment is delayed or improper, neonatal meningitis can result in serious disabilities such as cerebral palsy, seizure disorders, and developmental issues such as vision and hearing impairments (2).

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Group B Strep is the most common cause of neonatal meningitis

The causes of meningitis are mostly bacterial, although there are some cases of viral and fungal meningitis (1). In the U.S., 50% of all neonatal bacterial meningitis cases are due to group B Streptococcus (GBS). Other bacterial causes include E. coli (which accounts for about 20% of cases) and Listeria monocytogenes (which accounts for 5-10% of cases) (2).

Perhaps the reason that so many meningitis cases are attributed to GBS is the prevalence of the infection. According to the U.S. Centers for Disease Control and Prevention, about 1 in 4 pregnant women carry GBS in their rectum or vagina. If the mother is not diagnosed prenatally and properly treated, there is a much higher risk of transmitting GBS – and ultimately meningitis – to the infant during the birthing process. Because of this, all pregnant women should be tested for GBS in the third trimester. If the tests come back positive, healthcare providers must administer antibiotics during labor to minimize the risk of transmission (3).

Symptoms and treatment of meningitis in newborns

The following signs indicate that a newborn may have meningitis:

  • Any signs of sepsis (the clinical features are similar)
  • Poor feeding or refusal to feed
  • Bulging fontanelle (the soft spot at the top of the baby’s head)
  • Abnormal muscle tone, e.g. nuchal rigidity (inability to flex neck forward) (1)
  • Trouble breathing/respiratory distress
  • Diarrhea or vomiting
  • Temperature instability (fever or hypothermia)
  • Seizures
  • Irritability or lethargy
  • Apnea or bradycardia
  • Hypotension
  • Poor perfusion
  • Jaundice
  • Hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) (2)

Because meningitis can be fatal, once it is suspected doctors must begin treatment with broad-spectrum antibiotics immediately. If the meningitis is later attributed to an unusual type of bacteria, virus, or another pathogen, a different treatment may be needed. Delays in treatment may cause significant, irreversible brain damage.

A lumbar puncture (spinal tap) and a culture of cerebrospinal fluid (CSF) are typically done to confirm meningitis (1).

In addition to antibiotics and other drugs, babies with meningitis require supportive care in the neonatal intensive care unit (NICU) and close monitoring by medical professionals. They will also need to be treated for any associated complications. For example, if a baby shows signs of neonatal seizures, they may need anticonvulsant medications.

Magnetic resonance imaging (MRI) should be performed before antibiotics are discontinued (4).

Prognosis

Outcomes following a meningitis infection vary greatly depending on timing and quality of treatment. Approximately 7-18 percent of newborns with meningitis do not survive. About 20 percent of survivors go on to develop severe disabilities, and 35 percent develop mild-moderate disabilities.

Survivors of neonatal meningitis should be carefully monitored to see whether they are reaching developmental milestones or showing signs of health complications (4).  If treatment is timely and appropriate, most newborns do very well.

If GBS – or any other infection – is not diagnosed and properly treated in a pregnant woman, it can be transmitted to the infant. It may then progress to neonatal meningitis and a variety of resultant complications such as cerebral palsy and seizure disorders. If pregnant women are timely diagnosed and properly treated, the infection will likely not be transmitted to newborns.  

If your child was diagnosed with meningitis at birth, the attorneys at ABC Law Centers: Birth Injury Lawyers can help. We have the knowledge and professional experience to thoroughly examine the complex medical records of your child’s case, determine whether there was an error or negligence, and help you obtain the monetary compensation your child deserves. Free of charge and obligations, we will answer your questions and inform you of your legal options. In fact, you pay nothing throughout the entire legal process unless we win or settle in your favor. Our team is available to speak with you to set up an appointment in any of the following ways:

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Sources

  1. (n.d.). Retrieved January 8, 2019, from https://www.uptodate.com/contents/bacterial-meningitis-in-the-neonate-clinical-features-and-diagnosis
  2. Neonatal Meningitis. (2018, August 09). Retrieved January 8, 2019, from https://emedicine.medscape.com/article/1176960-overview#a7
  3. GBS | Fast Facts and Statistics | Group B Strep | CDC. (n.d.). Retrieved May 28, 2024, from https://www.cdc.gov/group-b-strep/about/index.html
  4. (n.d.). Retrieved January 8, 2019, from  https://www.uptodate.com/contents/bacterial-meningitis-in-the-neonate-treatment-and-outcome

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