Acute bacterial meningitis must be treated immediately with intravenous antibiotics and sometimes corticosteroids. Practice guidelines for the management of bacterial meningitis. Initiate treatment as soon as bacterial meningitis is suspected. Therefore, meticulous attention must be paid to appropriate treatment and monitoring of patients with this disease. Treatment for bacterial meningitis usually involves intravenous iv antibiotics. Chqgdl60008 meningitis emergency management in children 2 in the older child, the rates of meningitis are much lower with an estimated incidence of 1 per 5,901 febrile children aged 2 to 24 months. Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. Although debated, corticosteroids should be considered in certain cases. The initiation of empirical therapy for the management of bacterial. The bacterial form of meningitis can be lifethreatening and needs to be treated quickly. The management and epidemiology of bacterial meningitis in the. The epidemiology, management, and outcomes of bacterial. Over recent decades new vaccines have led to a change in epidemiology of the disease.
Meningitis is a life threatening illness caused by infection and inflammation of the meninges. But now with prompt antibiotic treatment, the vast majority of patients with bacterial meningitis survive, says lise nigrovic, md, attending physician in pediatric emergency medicine at. This may require a transfer to a pediatric hospital or large general hospital. Principles and practice of pediatric infectious diseases revised reprint. The healthcare provider will give your child iv intravenous antibiotics, which kill bacteria. Acute bacterial meningitis abm continues to be associated with high mortality and morbidity, despite advances in antimicrobial therapy. This guideline is written for all clinicians involved in diagnosis, treatment and followup of bacterial meningitis in adults and children with communityacquired bacterial meningitis in the context of hospital care, including infectious disease specialists, neurologists, intensive care. Committee on infectious diseases, american academy of pediatrics. Csf analysis in cns infections management of suspected meningitis in children prevalence of hsv vs bacterial meningitis in neonates etiology aseptic meningitis related topics. The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. The earlier the treatment is initiated, the better your childs outcome. Meningitis is a swelling inflammation of the thin membranes that cover the brain and the spinal cord.
Meningitis is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid csf. Meningitis treatment with antibiotics meningitis center. Diagnosis and management of bacterial meningitis in the paediatric. The infection can be caused by bacteria, a virus, fungus or other rare organisms such as parasites and amoeba.
If the childs condition is rapidly deteriorating, call 911 for transport. In addition to antibiotics, dexamethasone a steroid may also be given to children over six weeks of age who have acute bacterial meningitis. Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. Understand the indications for neuroimaging, adjunctive corticosteroids, and repeat lumbar puncture in children with bacterial meningitis. Recognize the common acute complications of meningitis. Consult a paediatric intensivist, anaesthetist, or intensivist. Pediatric bacterial meningitis is a medical emergency requiring immediate initiation of treatment. Management of pediatric aseptic meningitis is primarily supportive. Meningitis, especially bacterial caused, can be a rapidly progressing, lifethreatening disease, so immediate medical care is important if meningitis is suspected in a child. Nursing management of meningitis royal childrens hospital. Early diagnosis and treatment of bacterial meningitis is critical, and a high. Management of bacterial meningitis in children and young people.
Describe the causes, clinical manifestations, and general approach to the diagnosis, treatment, and prevention of the different types of meningitis in children of various ages. Guidelines for the management of suspected and confirmed. What are the goals of drug treatment for pediatric bacterial meningitis. However, the use of conjugate vaccines has reduced the incidence of bacterial meningitis in children and adults. Consultation with a pediatrician, an infectious disease specialist, a critical care specialist, or combinations thereof may be needed. Prevention and treatment of bacterial meningitis in. Pediatric bacterial meningitis is a medical emergency, and its appropriate treatment depends on the causative organism. People with suspected meningitis will usually need to have tests in hospital and may need to stay in hospital for treatment. Meningitis in children beyond the basics acute disseminated encephalomyelitis adem in children. In large european studies of adults with bacterial meningitis, risk of death or lasting disability increases by 10%30% per hour of treatment delay. The treatment of bacterial meningitis depends on the suspected or known.
The treatment and prognosis of bacterial meningitis in infants and children. Prehospital care of children with bacterial meningitis usually is confined. Diagnosis and management of bacterial meningitis in the. If tb meningitis in the differential diagnosis, refer to nice ng33 before administering steroids. Given the importance of early antibiotic treatment, it is safest to assume a bacterial cause until proven. Division of infectious diseases, children s mercy hospitals and clinics, kansas city, mo. Meningitis about bacterial meningitis infection cdc. For a more complete discussion concerning diagnosis and management of meningitis, the reader is referred to a recently published report by a task force appointed by the american academy of pediatrics. Your child will also get a corticosteroid medicine.
The objective was to determine the optimal empirical antibiotics for bacterial meningitis in early infancy. For additional guidance, please contact pediatric infectious. Meningitis in children what is meningitis in children. A children s health queensland statewide paediatric guideline about meningitis emergency management in children. The epidemiology of bacterial meningitis in children is changing. The treatment depends on the type of meningitis you or your child has. Pediatric bacterial meningitis is a lifethreatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. Acute bacterial meningitis in infants and children. Routine neuroimaging is not necessary for the initial medical evaluation of children with suspected bacterial meningitis who do not have clinical signs of brain herniation. There is no home treatment for bacterial caused meningitis. A general intravenous antibiotic with a corticosteroid to bring down the inflammation may be prescribed even. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. Children with bacterial meningitis can become seriously ill very quickly. Bacterial meningitis is very serious and can be deadly.
Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Clinical practice guideline summary clinical practice guidelines for the acute management of infants and children with bacterial meningitis. Children with bacterial meningitis and encephalitis should be admitted to a hospital capable of managing critically ill children. If tb meningitis in the differential diagnosis, refer to nice cg117 before administering steroids. Tests in hospital several tests may be carried out to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection. Diagnosis, initial management, and prevention of meningitis. The role of steroids in the management of acute bacterial meningitis in. This issue provides evidencebased recommendations for the early identification and appropriate management of bacterial meningitis in pediatric patients.
Overview diagnosis and tests management and treatment prevention outlook prognosis resources. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures. Traditionally, initial antimicrobial treatment consists of ampicillin plus an aminoglycoside ampicillin plus cefotaxime is also appropriate. Practice essentials pediatric bacterial meningitis is a lifethreatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. The pathogenesis, epidemiology, clinical features and diagnosis of acute bacterial meningitis and the treatment and prognosis of bacterial meningitis in neonates treatment of bacterial meningitis in pediatrics community or intrapartumacquired common. One in five children infected is left with permanent disabilities. Meningitis in children symptoms, warning signs, treatment. Acyclovir 20mgkgdose iv q8h for infants bacterial pathogen identified or hsv pcr negative. Although the united states and other developed countries have seen a decline in pediatric meningitis, bacterial meningitis continues to cause high morbidity and mortality globally.
Refer to pediatric antimicrobial dosing guideline for further guidance on dosing in children, and neonatal dosing guideline for infants pediatric pharmacist for individualized renal or hepatic dose adjustment. Bacterial meningitis in children older than one month. Pediatric bacterial meningitis is a severe, lifethreatening infection of the. Bacterial meningitis management and treatment cleveland. Add ampicillin 300mgkgday divided q46h max 2g q4h if patient immunocompromised for listeria for suspected bacterial meningitis in children 6 weeks old, consider. Treat seizures with appropriate emergency therapies. Management of bacterial meningitis in children and young. Table 1 shows the common causes of bacterial meningitis in different age groups and recommended treatment schedules. Endorsed by management of bacterial meningitis in children and young people incorporates nice bacterial meningitis and meningococcal septicaemia guideline cg102. The incidence of bacterial meningitis in infants and children has decreased since the. Paediatric bacterial meningitis is a neurological emergency which, despite advances in medical management, still has a significant morbidity and mortality. Management of bacterial meningitis in children and young people incorporates nice bacterial meningitis and meningococcal septicaemia guideline cg102.
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