Meningitis happens when the membrane covering the brain and the spinal cord, called the meninges, becomes infected and swollen or inflamed. Meningitis is usually caused by either bacterial or viral infections.
Meningitis is not common, but it can be very serious and requires urgent medical treatment. There are many viral and bacterial infections that can cause meningitis, and sometimes meningitis happens because of a complication from another illness such as measles or
chickenpox.
Bacterial meningitis can get worse very quickly. One in five children infected is left with permanent disabilities, such as deafness or cerebral palsy. In a small number of cases, bacterial meningitis can cause death. Viral meningitis is more common, but it is less serious than bacterial
meningitis.
Most children will make a full recovery after meningitis, but it can take time.
Signs and symptoms of meningitis
The signs and symptoms of meningitis can be different depending on the age of your child, and whether the disease is caused by a virus or bacteria. Signs and symptoms may include:
- fever
- vomiting
- seizures (fits)
- headache
- irritability and high-pitched cry (especially in babies)
- the soft spot on the top of a baby’s head (the fontanelle) may bulge and look very full
- tiredness, drowsiness (lethargy) or hard to wake
- a stiff neck
- dislike of bright lights (photophobia)
- babies may hold their head back or arch their back.
When to see a doctor
If your child has a skin rash of small bright red spots or purple spots or bruises that do not turn white (blanch) when you press on them, this may be a sign of meningitis caused by the meningococcal bacteria. See our fact sheet
Meningococcal infection.
If your child is showing signs of meningitis or meningococcal infection, take them to the nearest doctor or hospital emergency department immediately.
To diagnose meningitis, your child will need a lumbar puncture (see our fact sheet Lumbar puncture). This is a safe test performed by an experienced doctor, to take a sample of the fluid around the spine. A diagnosis of meningitis is made by examining this fluid and doing blood tests.
Treatment for meningitis
If your child has meningitis, they will be admitted to hospital. Their treatment and care will depend on the type of meningitis they have and how unwell they are.
The results from the lumbar puncture can take two to three days to come back. In the meantime, your child will be given antibiotics directly into a vein through a drip (intravenous or IV therapy), in case they have bacterial meningitis.
Viral meningitis
Generally, viral meningitis is not as severe as bacterial meningitis. The treatment does not include antibiotics because antibiotics do not work on viruses. Children with viral meningitis will continue to be watched closely during their hospital
stay.
Bacterial meningitis
Bacterial meningitis can be more severe, and your child will need ongoing antibiotics. Your child will be watched closely throughout their hospital stay for any changes in their condition. The regular checks made on your child during their stay in hospital may include checking your child's
vital signs (such as heart rate, temperature and blood pressure) and the state of their neurological system (brain and nerves).
Your child may also receive:
- fluids and medicines through a drip
- additional blood tests
- steroid medicines to reduce the swelling in their brain.
If meningococcal meningitis is suspected, it may be necessary for people who have had close contact with your child to receive antibiotics – your child’s doctor will advise you if this is needed.
Depending on the age of your child, the type of bacteria and other factors, intravenous (through a drip) antibiotic treatment may be required for up to three weeks. In some cases, some children may be able to finish their antibiotic therapy at home, under the supervision of a nurse.
Follow-up
Most children will make a full recovery after meningitis, but it can take time. There are some possible after-effects of meningitis, which may include:
- general tiredness
- frequent headaches
- difficulty in concentration and short-term memory lapses
- clumsiness or problems with balance
- hearing problems
- mood swings.
After your child goes home from hospital, they may need check-ups to monitor their recovery. They may need a hearing test, as a small number of children who have had meningitis develop problems with their hearing.
Some children may be left with permanent damage and disability following meningitis. Your doctor will be able to give you more information about your child's long-term outlook.
How is meningitis spread?
Many people carry the bacteria that causes bacterial meningitis in their noses and throats without getting sick. These people are called healthy carriers. Healthy carriers can spread the bacteria to other people, who may become sick.
The bacteria or virus causing meningitis can be spread from person to person by coughing, sneezing, kissing or sharing cups, drink bottles or cutlery.
Prevention of meningitis
- Several of the bacteria that cause meningitis can be largely prevented by the routine childhood immunisations. Making sure your child is fully up to date with these immunisations is the best way to prevent meningitis.
- Children who are exposed to cigarette smoke are at a greater risk of getting meningitis. Do not allow anyone to smoke in your home or around your child.
Good hygiene reduces the chance of getting viruses or bacterial infections, or passing them onto others. Good hygiene includes:
- regularly washing hands thoroughly
- not sharing drink bottles, cups or cutlery
- encouraging children to cough or sneeze into their elbow
- teaching your child to throw tissues into the bin as soon as they have used them and to wash their hands afterwards.
Key points to remember
- Meningitis is an inflammation of the meninges (the membrane covering the brain and spinal cord).
- Meningitis is caused by either a bacterial infection or a viral infection. Bacterial meningitis can get worse very quickly.
- If your child is showing signs of meningitis, seek immediate medical attention.
- Most people recover from meningitis, although it may take a long time.
- Keeping your child's immunisations up to date is the best way to prevent meningitis.
For more information
Common questions our doctors are asked
When will someone with meningitis stop being
contagious?
As long as a person with meningitis is coughing or sneezing
droplets into the air, they will be contagious.
If tests show my child has viral meningitis, will the
antibiotics cause any problems?
There are risks associated with all medicines, including antibiotics.
But the risk of leaving bacterial meningitis untreated is far greater than the
risk of a reaction to one of the antibiotics. The safest option is to
administer antibiotics immediately, before losing valuable time while we wait
for test results.
Developed by The Royal Children's Hospital General Medicine department. We acknowledge the input of RCH consumers and carers.
Reviewed April
2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.