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Amniotic fluid problems

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Mastitis

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Antenatal Classes

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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Meningitis

Meningitis is an inflammation of the meninges or membranes that cover the brain and spinal cord. It is usually caused by a virus or bacteria, but may occur as a result of certain illnesses or medication. Bacterial meningitis is rare and it generally does not occur in children beyond the age of 2, unless it is due to an infection with meningococcus. Bacterial meningitis is serious and can be life-threatening if it is not treated correctly. Viral meningitis, also known as aseptic meningitis, is far less serious, more common, and can occur in children of all ages. It occurs more frequently in the summer months and is sometimes misdiagnosed because it produces symptoms similar to the flu. If dealt with immediately, meningitis can be successfully treated. It is therefore important to know the signs of meningitis and if you suspect that your child has the illness, seek medical assistance immediately. The reason why meningitis is classified as a medical emergency is because of the inflammation’s proximity to the brain and spinal cord (Collins, 2003; The Nemours Foundation, 1996-2010; Leary, 1990; Wikipedia, 2010).

 

Causes

Many of the viruses and bacteria responsible for causing meningitis are relatively common and are associated with other routine illnesses. These viruses or bacteria may initially affect the skin, urinary or gastrointestinal tract or respiratory system but can spread via the bloodstream to the meninges through the cerebrospinal fluid. In some instances, bacterial meningitis may be a result of the bacteria from a severe head injury or severe local infection (e.g. otitis media or sinusitis) that then spreads to the meninges (The Nemours Foundation, 1996-2010).

 

Bacterial meningitis

This type of meningitis is most common in children under the age of 5, but it can occur at all ages. Meningococcal meningitis is most commonly caused by the Neisseria meningitides bacterium and rarely by the Haemophilius influenzae. The neisseria bacteria are normally present in the nose and throat, and can be differentiated from meningitis from other causes by the development of a rapidly spreading rash that precedes other symptoms. The rash consists of small irregular purple or red spots on the trunk, lower extremities, mucous membranes and sometimes on the hands and feet. The rash is typically non-blanching or does not turn white when pressed (Collins, 2003; Wikipedia, 2010).

 

Viral meningitis

Several viruses may lead to viral meningitis, including the enteroviruses such as the coxsackievirus, pollovirus, and hepatitis A virus, the viruses responsible for causing chicken pox, glandular fever and AIDS, as well as the herpes virus. Epidemics of viral meningitis tend to occur during the winter months, most frequently in children over the age of 5 (Collins, 2003; The Nemours Foundation, 1996-2010).

 

Symptoms

The symptoms of meningitis vary, depending on the age of the child and cause of the infection. The early stages of viral and bacterial meningitis are very similar. However, in the case of bacterial meningitis, the symptoms are usually more severe and develop rapidly, sometimes within a few hours.

 

In infants, the early symptoms are often vague in nature and may include:

·         Abnormal drowsiness.

·         Fever or a lower than normal temperature.

·         Vomiting.

·         Poor feeding or a weak suck.

·         Increased crying that is often high-pitched.

·         Restlessness.

·         Jaundice or a yellowish tint to the skin.

·                In infants up to 6 months of age, bulging fontanelle (the soft spot at the top of baby’s head), may be present.

·                Leg pain, cold extremities and abnormal skin colour are also distinguishing features of meningitis in young children.

 

Older children may exhibit the above symptoms, as well as the following:

·         Severe headache.

·         Photophobia or increased sensitivity to light.

·         Dislike of loud noise, or phonophobia.

·         Rigidity of muscles, most notably a stiff neck.

·         Lethargy.

 

As bacterial meningitis progresses, children of all ages, may experience:

·         Increasing drowsiness and occasionally loss of consciousness or convulsions.

·                If meningitis is caused by bacteria such as Neisseria meningitides, your child may develop a skin rash (Collins, 2003; The Nemours Foundation, 1996-2010; Wikipedia, 2010).

 

Diagnosis

If your child is abnormally drowsy or develops at least 2 of the above symptoms, take them to the doctor or emergency room immediately. Bacterial meningitis is always serious and if treatment is delayed, it can leave children with severe handicaps, such as deafness, epilepsy, cerebral palsy and mental retardation (Collins, 2003; Leary, 1990).

 

Your doctor may use several tests to assist him in making an accurate diagnosis:

·                Blood tests are performed for markers of inflammation, as well as blood cultures, to help identify the organism responsible for the illness.

·                Lumbar punctures (spinal tap) are performed under local anaesthetic in order to collect a sample of your child’s cerebrospinal fluid. This test also indicates any signs of inflammation, and whether a virus or bacterium is causing the infection (The Nemours Foundation, 1995-201; Wikipedia, 2010).

 

Treatment

If viral meningitis is confirmed, your child may be hospitalised, but some children are allowed to recover at home if they are not too ill. Treatment involves bed rest, a sufficient intake of fluids and the prescription of painkillers to help relieve the symptoms. Viral meningitis generally lasts for 5-14 days, depending on the virus involved, and rarely has any after effects (Collins, 2003; The Nemours Foundation, 1995-2010).

 

If your doctor suspects bacterial meningitis, your child will be started on a high dosage of antibiotics immediately. As soon as the laboratory test results become available, treatment will either be continued or changed, in order to target the specific bacteria responsible for the illness. Your child may be given his antibiotic intravenously, as well as fluids to replace those lost through fever, sweating, vomiting, and poor appetite. Corticosteroids may help in reducing the inflammation of the meninges, depending on the cause of the disease. Some children may require anticonvulsant treatment if they are experiencing seizures. If a child develops shock or low blood pressure, additional IV fluids and certain medications may be required to increase their blood pressure. Any breathing difficulties that may arise are treated with supplementary oxygen or mechanical ventilation. Treatment may continue for up to 10 days (Collins, 2003; The Nemours Foundation, 1995-2010).

 

Prevention

·                Routine immunisation assists in the prevention of meningitis. Doctors now recommend that children of 11 years of age are vaccinated for meningococcal disease, a serious bacterial disease that may result in meningitis. The meningococcal vaccine or MCV4 is also recommended for children over the age of 11 who have not previously been vaccinated and are going to be living in close quarters to others (college, boarding school, camp), as well as people travelling to countries where meningitis is more prevalent, and children between 2-10, who have certain high-risk medical problems.

·                Some of the viruses and bacteria responsible for meningitis are relatively common. Good hygiene is essential for preventing any kind of infection. Encourage your child to wash his hands thoroughly and frequently, especially before eating and after using the bathroom. Avoid contact with someone who is ill and do not share food, drink and eating utensils.

·                In some cases, your doctor may give antibiotics to anyone who has been in close proximity to the affected individual, especially the family who have been living in close contact, in order to prevent additional cases of the illness (Collins, 2003; The Nemours Foundation, 1995-2010).