In this section
This guideline has been adapted for statewide use with the support of the Victorian Paediatric Clinical Network
Fluids in Meningitis guidelineLumbar Puncture GuidelineCSF InterpretationMeningococcal infection Febrile Child under 3 yearsAfebrile convulsion guideline
The commonest organisms causing bacterial meningitis in children over 2 months of age are:
As a result of immunisations Hib meningitis is now rare and there has been a reduction in the incidence of pneumococcal meningitis.
Organisms to consider in infants less than 2 months of age include those listed above and the following:
Consider other pathogens in those who have anatomical abnormalities of the CNS, ventricular shunts, immunosuppressed children and those who have a history of travel.
Encephalitis can be caused by:
Features on history:
Features on examination:
Cefotaxime 50 mg/kg (max 2g) iv 6H ANDBenzylpenicillin* 60 mg/kg iv 12H (wk 1 of life) 6-8H (wk 2-4 of life) 4H (>4 weeks of life)
> 2 months
Ceftriaxone 50 mg/kg/dose
(2g) iv 12H
Dexamethasone 0.15mg/kg IV 6 hourly for 4 days
If encephalitis is suspected on examination then give:
Aciclovir 20 mg/kg iv 8H (age <3m ) 500 mg/m2 iv 8H (age 3m-12y) 10 mg/kg iv 8H (age >12y). Surface area calculator
Benzylpenicillin 60mg/kg/dose (max 3g), iv 4 hourly for 7 days
S. pneumoniae (Penicillin sensitive)
Benzylpenicillin 60mg/kg/dose (max 3g), iv 4 hourly for minimum of 10 days
Haemophilus influenzae type b
Ceftriaxone 50 mg/kg/dose (2g) iv 12H
For advice or ICU level transfer ring the Sick Child Hotline: (03) 9345 7007
Information Specific for RCH
Parent information sheets:
Last updated September 2012
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