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BACTERIAL MENINGITIS AND MENINGOCOCCUS

What is meningitis?

Meningitis is an inflammation of the meninges, the thin membranes that cover the brain and the spinal cord. Infection can be caused by viruses—which is more common—or by bacteria—which is more serious and life-threatening. Bacterial meningitis can occur in any person, but is most commonly seen in childhood, with very young children at the greatest risk.

What is meningococcal meningitis?

A bacterium called Neisseria meningitidis, or meningococcus, can cause a particularly deadly infection, especially in children between birth and 5 years of age and in adolescents and young adults between 15 and 24 years. The germ, which lives naturally in the nose and throat of people, has two main types—B and C. It is spread through close contact with saliva from activities such as kissing and sharing drink bottles, and also by nasal droplets from sneezing or coughing. This infection can take the form of meningitis or septicaemia (severe infection of circulating blood), or both simultaneously. The affected person rapidly becomes sick with fevers and may develop a rash. This red rash can be misleading as it looks like any heat rash at first, but then the deadly sign of purpura (bleeding into the skin) develops. It does not blanch (turn white) when pressed with a finger. Early diagnosis and treatment with antibiotics is critical. Untreated cases may be fatal or result in permanent brain damage.

What are frequent symptoms and signs?

  • Fever

  • Headache

  • Nausea and vomiting

  • Pale skin

  • Skin rash

  • Weakness/tiredness

  • Increasing irritability with high-pitched cry in the young

  • Drowsiness

  • Neck stiffness

  • Sensitivity to light

  • Altered state of consciousness (e.g. confusion or disorientation)

As a general rule the illness seems like the flu at first and this can make it difficult for doctors to diagnose correctly in the early stages.

In infants the signs of meningitis may not be so obvious, but neck stiffness, vomiting and headache are more noticeable in children over 3 years of age. These symptoms may not be obvious if the child is on antibiotics. To arrive at the correct diagnosis, doctors usually need to do a lumbar puncture (sampling of fluid from around the spinal column using a needle), blood tests or brain scans.

When is urgent attention necessary?

If your child develops any of the following ‘red flag’ signs, take the child immediately to your doctor or hospital emergency department:

  • becomes ‘flat’ quite rapidly

  • cold, pale skin especially of the limbs

  • change in state of consciousness

  • drowsiness, confusion or delirium

  • rapid heart rate

  • rapid, difficult or noisy breathing

  • convulsion

  • red rash, especially if it looks like flecks of blood.

Doctors prefer to ...

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