Meningitis is a neurological disease that causes inflammation in the membrane covering the brain and spinal cord. Meningitis in toddlers can be caused by viruses, bacteria, fungi, or parasites. If this condition is not treated on time, it could result in alarming symptoms and long-lasting complications. Therefore, early detection of the symptoms is important to begin the treatment promptly. Moreover, you should follow preventive measures to keep your children safe from this disease. Read the post for more information on meningitis, including its causes, symptoms, complications, diagnosis, and treatment options.
What Is Meningitis?
Meningitis is the acute inflammation (swelling) of the membrane called meninges that covers the brain and the spinal cord. The swelling results from an infection caused by a pathogen, which affect the meninges. The swollen meninges interferes with the functions of the brain and spinal cord, making meningitis a central nervous system disease (1). Let’s take a look at the causes of meningitis.
What Causes Meningitis In Toddlers?
There is no single cause for the disease, and there are many pathogens that can lead to it. Meningitis can be classified based on the cause of the condition.
1. Viral meningitis
It is the leading cause of meningitis among toddlers, but less severe than bacterial meningitis. Milder forms of viral meningitis resolve without treatment, and there are several viruses that infect meninges, causing the problem. Following are the most common ones (2):
Non-polio enteroviruses Herpes virus Varicella-zoster virus (chickenpox and shingles virus) Mumps virus Influenza virus Measles virus West Nile virus Lymphocytic choriomeningitis virus
2. Bacterial meningitis
Bacterial meningitis is less common than viral meningitis, but is more severe and disabling. Severe infection leads to death, and damage to certain parts of the brain is common among those who survive. The most common bacteria that cause bacterial meningitis are (3):
Streptococcus pneumoniae (pneumonia bacteria) Neisseria meningitidis (also called meningococcus) Group B Streptococcus (strep bacteria) Type B Haemophilus influenzae (causes meningitis type b) Listeria monocytogenes (also causes gastroenteritis)
3. Fungal meningitis
It is caused by fungus, which spreads from the bloodstream into the cerebrospinal fluid or brain/spinal cord tissue. The fungus enters the bloodstream through a cut in the body. This happens when the toddler already suffers from a fungal infection such as that of the skin. Fungal meningitis is rare and most common in toddlers with a suppressed immune system such as those suffering from cancers and HIV. This form of meningitis is non-contagious (4). Some of the common fungi that cause fungal meningitis are:
Cryptococcus (most common cause of fungal meningitis) Candida (yeast fungus) Histoplasma (found in bird and bat droppings) Blastomyces (found in decaying organic matter) Coccidioides (naturally found in soil)
4. Parasitic meningitis
Some parasites cause meningitis as a collateral effect of their invasion of the central nervous system. Parasitic meningitis is highly incidental and only occurs when a person ingests the parasite, its eggs, or active larvae. Just three parasites have been associated with meningitis (5):
Angiostrongylus cantonensis (a type of roundworm) Gnathostoma spinigerum (a parasite common in tropical climate) Baylisascaris procyonis (also called raccoon roundworm)
5. Non-infectious meningitis
When meningitis happens as an indirect result of a condition, then it is called non-infectious meningitis. The following cases have been associated with this type of meningitis (6):
Drug reaction Brain injury Brain surgery Cancer Autoimmune diseases
Non-infectious meningitis can be chronic, which means it can come and go regardless of treatment (7). These cases can go on for a long duration, ranging from months to years.
How Does A Toddler Get Meningitis?
A toddler can get meningitis if he contracts a bacteria, virus, or parasite. The pathogen’s primary target could be another organ, such as lungs in pneumonia, but it would eventually find its way into the nervous system (generally through the blood stream) causing meningitis. Following are the scenarios that can lead to meningitis in toddlers (8):
Sneeze and cough of an infected person release hundreds of tiny droplets of mucus and saliva into the air. Inhaling these droplets can spread the bacteria and virus to the blood stream and then to the brain. The pathogens cause meningitis.
Touching any contaminated surfaces such as doorknobs, toilet seats, toys, and floor can transfer the microbes from these surfaces to the toddler. Poor personal hygiene can exacerbate the contraction of the pathogen from inanimate objects.
Sharing utensils with an infected person while eating and drinking can spread infections. Toddlers can be susceptible to it at playschools and daycare where preschoolers could eat snacks from the same plate.
Eating contaminated food transmits bacteria, virus, and parasites, which are potential agents for meningitis infection.
Breathing contaminated dust with fecal matter of bats and birds may contain spores of fungi that could cause meningitis.
Overall poor hygiene, such as not washing hands, playing in contaminated soil, and not covering the mouth while coughing and sneezing increase the risk of developing meningitis.
Head injury, cancers, autoimmune diseases such as allergies, certain types of tumors in the brain, can all cause inflammation of the meninges.
While any toddler can be at risk of getting meningitis, some are more susceptible than others.
What Are The Risk Factors For Contracting Meningitis?
The following conditions can increase the risk of meningitis among toddlers (9) (10):
Immunodeficient toddlers, who suffer from diseases such as cancers, HIV, sickle cell anemia or immunoglobulin deficiency are at a higher risk of meningitis due to the weak immune system.
Toddlers who have deformities and defects in the nervous system, and those who develop spontaneous defects such as a cerebrospinal fluid leak are at a higher risk.
Recurrent sinus infections increase the risk of meningitis. It is not known what exactly causes it, but it could be due to the proximity of the sinuses to the eye from where the bacteria can travel upwards to the brain through the optic nerve.
Brain injury and skull fracture or open concussion expose the brain to pathogens that can cause meningitis.
Toddlers who undergo brain surgery, or toddlers with cochlear implants for hearing and shunt insertion in the brain are at a greater risk since such devices are prone to accidental bacterial contamination.
Toddlers in overcrowded setups, such as in playschools, daycare or other similar environments, are at a higher risk of contracting meningitis.
These risks can evolve into complications and may bring other problems in the toddler’s health.
What Are The Complications Of Meningitis In Toddlers?
Untreated meningitis can lead to the following complications in toddlers (10).
Neurological disorders, such as cerebral palsy and repeated fits
Intellectual problems such as having low IQ, attention deficit and hyperactivity disorder (ADHD), and limited cognitive abilities.
Chronic weakness, fatigue, and lethargy
Problems ranging from a permanent blurred vision to blindness in one eye Hearing problems
Acute headache, with bouts of dull and sharp pain in the head like a migraine
Poor limb coordination that hampers precision in movements like those needed during running or walking. It hampers the toddler’s ability to participate in sports or vigorous outdoor activities.
Sepsis, also called septicemia and blood poisoning, is an overwhelming immune response to bacteria that causes meningitis (11). Sepsis also multiplies the intensity of meningitis’ symptoms. The complication is most likely to occur in younger toddlers and those suffering from a severe infection. The condition is fatal with 50% of meningitis-induced sepsis cases leading to death (12)
Around one in five people with bacterial meningitis may develop long-lasting side-effects (13). Viral meningitis survivors fare better and suffer only from a chronic headache and weakness. Nevertheless, the condition can be spotted for immediate treatment.
What Are The Symptoms Of Meningitis In Toddlers?
A toddler with meningitis will display the following symptoms (14): Parents may not relate meningitis to these symptoms as they could overlap with several other conditions. Therefore, it is imperative to take the toddler to a doctor when you spot any of the above symptoms.
How Is Meningitis In Toddlers Diagnosed?
Neck rigidity (Kernig’s sign) is one of the diagnostic signs. The doctor uses one or more of the following methods (8):
Blood test determines the presence of infectious meningitis pathogens in the blood.
Stool and urine samples are collected to detect the presence of a pathogen. A stool test is especially useful in identifying parasitic meningitis.
Computed tomography scan or CT scan uses multiple X-rays of the head to detect inflammation. Magnetic resonance imaging or MRI may also be used to determine the extent of infection in the meninges accurately.
Lumbar tap, also called spinal tap, tests a small sample of cerebrospinal fluid that is extracted from the lower section of the spinal cord. The fluid is sent for laboratory analysis to check for anomalies. Lumbar tap is quite invasive and could be preferred when other tests do not yield a conclusive diagnosis. It is useful in cases where there is a suspicion of sepsis (16). Spinal tap also helps in identifying the pathogen responsible for causing meningitis.
The treatment methods are based on the final analysis and could vary as per the severity of the condition.
How Is Meningitis In Toddlers Treated?
The treatment is determined by the type of meningitis. Most forms of viral meningitis have no specific treatment, and the infection usually resolves in ten days. The only exception is herpes virus related meningitis, which is treated with acyclovir injections. The other kinds of meningitis do require extensive therapy through medication (8):
Bacterial meningitis is treated with a combination of several antibiotics, including those administered intravenously. The doctor prescribes a treatment course and the toddler must attend all the IV therapy sessions. Oral antibiotics are prescribed to be taken at home.
High concentration antifungal and antiparasitic medicines treat fungal and parasitic meningitis respectively. These drugs are directly diffused into the bloodstream through intravenous administration.
Antiviral medicines are needed in cases of viral meningitis caused by herpes and influenza virus since they cannot be overpowered by the immune system alone.
Corticosteroids are prescribed to reduce the inflammation of the meninges. Anti-epileptic drugs are given when the toddler suffers from seizures and fits as a result of meningitis (15).
Antihistamine treatment is useful in non-infectious meningitis caused by autoimmune diseases such as allergies (16).Despite complete recovery, a toddler may have to visit a doctor for any remnant effects of meningitis.
Are There Any After-Effects Of Meningitis?
The effects of meningitis may take time to taper away after treatment. As a result, the toddler may display mild after-effects (17):
Lethargy and tiredness Frequent headaches Problems in concentration Brief short-term memory loss Difficulties in body balance and general clumsiness Hearing problems Mood swings and sudden tantrums Paralysis of the limbs or hemiplegia. Vision difficulties
A pediatrician will frequently review the condition of the toddler to ensure these after-effects do not hinder healthy growth.
How To Prevent Meningitis In Toddlers?
Despite being a critical illness, meningitis can be easily prevented through some simple preventive measures (8):
The US Center for Disease Control & Prevention (CDC) and the American Academy of Paediatrics (AAP) recommend immunization against bacterial infections. Vaccines against meningitis bacteria are type b Haemophilus influenzae (causes type b meningitis), Streptococcus pneumoniae (pneumonia bacteria), and Neisseria meningitidis (also called meningococcus) (18) (19) (20). Vaccinations can protect against a dozen and more strains of bacteria. Each vaccine has its dosage and immunization schedule, which is determined by the doctor after considering the toddler’s age. Parents need to stick to the schedule to ensure complete immunity.
Washing hands is a single personal hygiene measure to prevent a host of diseases including meningitis. Teach the toddler the good habit of washing hands before eating, after using the toilet, and returning from outdoors.
Never share utensils as that spreads bacteria from one person to another. Parents and other caretakers may tend to feed toddlers from the same plate but do not do that! The toddler may invariably come in contact with bacteria that would be dormant in adults but may have adverse effects in toddlers.
Consuming hygienically-prepared, well-cooked food prevents the spread of parasites that can lead to parasitic meningitis.
Avoid dusty environments. Fungal meningitis often occurs due to inhalation of soil and dust particles contaminated with bird droppings. Hence, it is best for the toddler to stay indoors when the air outside is excessively dusty.
