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Bacterial Meningitis in Childhood

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Hot Topics in Infection and Immunity in Children VIII

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 719))

Abstract

A wide variety of pathogens cause childhood meningitis and clinical features and ­outcomes vary according to the organism. Bacterial meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) is of particular importance as it has a high mortality and morbidity, has been relatively common and is treatable with antibiotics. In the last two decades widespread introduction of highly effective conjugate vaccines against these pathogens in many industrialised countries has led to a significant reduction in the incidence of bacterial meningitis, although there is still a substantial global burden of disease, predominantly occurring in resource-poor countries, where case-fatality rates are higher and long-term sequelae are more common.

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References

  1. Saez-Llorens X, McCracken GH, Jr. Bacterial meningitis in children. Lancet. 2003;361:2139–48.

    Article  PubMed  Google Scholar 

  2. Rorabaugh ML, Berlin LE, Heldrich F, Roberts K, Rosenberg LA, Doran T, et al. Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications. Pediatrics. 1993;92:206–11.

    PubMed  CAS  Google Scholar 

  3. Ramsay M, Fox A. EU-IBIS Network. Invasive Neisseria meningitidis in Europe 2006. London: Health Protection Agency; 2007.

    Google Scholar 

  4. McIntosh ED, Fritzell B, Fletcher MA. Burden of paediatric invasive pneumococcal disease in Europe, 2005. Epidemiology and Infection. 2007;135:644–56.

    Article  PubMed  CAS  Google Scholar 

  5. Watt JP, Levine OS, Santosham M. Global reduction of Hib disease: what are the next steps? Proceedings of the meeting Scottsdale, Arizona, September 22–25, 2002. The Journal of Pediatrics. 2003;143:S163-87.

    Article  PubMed  Google Scholar 

  6. Hsu HE, Shutt KA, Moore MR, Beall BW, Bennett NM, Craig AS, et al. Effect of pneumococcal conjugate ­vaccine on pneumococcal meningitis. The New England Journal of Medicine. 2009;360:244–56.

    Article  PubMed  CAS  Google Scholar 

  7. Watt JP, Wolfson LJ, O’Brien KL, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates. Lancet. 2009;374:903–11.

    Article  PubMed  Google Scholar 

  8. Harrison LH, Trotter CL, Ramsay ME. Global epidemiology of meningococcal disease. Vaccine. 2009;27 Suppl 2:B51-63.

    Article  PubMed  Google Scholar 

  9. O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374:893–902.

    Article  PubMed  Google Scholar 

  10. Heath PT, Nik Yusoff NK, Baker CJ. Neonatal meningitis. Archives of Disease in Childhood. 2003;88:F173-8.

    Article  PubMed  CAS  Google Scholar 

  11. Baker RC, Kummer AW, Schultz JR, Ho M, Gonzalez del Rey J. Neurodevelopmental outcome of infants with viral meningitis in the first three months of life. Clinical Pediatrics. 1996;35:295–301.

    Article  PubMed  CAS  Google Scholar 

  12. Baethgen LF, Weidlich L, Moraes C, Klein C, Nunes LS, Cafrune PI, et al. Epidemiology of meningococcal disease in southern Brazil from 1995 to 2003, and molecular characterization of Neisseria meningitidis using multilocus sequence typing. Trop Med Int Health. 2008;13:31–40.

    Article  PubMed  CAS  Google Scholar 

  13. Cohn AC, MacNeil JR, Harrison LH, Hatcher C, Theodore J, Schmidt M, et al. Changes in Neisseria meningitidis disease epidemiology in the United States, 1998–2007: implications for prevention of meningococcal disease. Clin Infect Dis. 2010;50:184–91.

    Article  PubMed  Google Scholar 

  14. Lapeyssonnie L. La méningite cérébro-spinale en Afrique. Bull World Health Organ. 1963;28:449–74.

    Google Scholar 

  15. Mayer LW, Reeves MW, Al-Hamdan N, Sacchi CT, Taha MK, Ajello GW, et al. Outbreak of W135 meningococcal disease in 2000: not emergence of a new W135 strain but clonal expansion within the electophoretic type-37 complex. J Infect Dis. 2002;185:1596–605.

    Article  PubMed  Google Scholar 

  16. Djibo S, Nicolas P, Alonso JM, Djibo A, Couret D, Riou JY, et al. Outbreaks of serogroup X meningococcal meningitis in Niger 1995–2000. Trop Med Int Health. 2003;8:1118–23.

    Article  PubMed  CAS  Google Scholar 

  17. Ramsay ME, Andrews NJ, Trotter CL, Kaczmarski EB, Miller E. Herd immunity from meningococcal serogroup C conjugate vaccination in England: database analysis. BMJ (Clinical research ed.) 2003;326:365–6.

    Article  PubMed  Google Scholar 

  18. MacNeil J, Cohn AC, Mayer R, Zell ER, Clark TA, Messonnier NE, et al. Interim analysis of the effectiveness of quadrivalent meningococcal conjugate vaccine (MenACWY-D): a matched case-control study. 17th International Pathogenic Neisseria Conference. Banff, Canada 2010.

    Google Scholar 

  19. Sadarangani M, Pollard AJ. Serogroup B meningococcal vaccines-an unfinished story. Lancet Infect Dis. 2010;10:112–24.

    Article  PubMed  CAS  Google Scholar 

  20. Ruckinger S, van der Linden M, Reinert RR, von Kries R, Burckhardt F, Siedler A. Reduction in the incidence of invasive pneumococcal disease after general vaccination with 7-valent pneumococcal conjugate vaccine in Germany. Vaccine. 2009;27:4136–41.

    Article  PubMed  Google Scholar 

  21. Kumar P, Sarkar S, Narang A. Role of routine lumbar puncture in neonatal sepsis. Journal of Paediatrics and Child Health. 1995;31:8–10.

    Article  PubMed  CAS  Google Scholar 

  22. National Collaborating Centre for Women’s and Children’s Health. Bacterial meningitis and meningococcal ­septicaemia: management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care. London, UK: Royal College of Obstetricians and Gynaecologists. Available at http://www.nice.org.uk/CG102; 2010.

  23. Kirkpatrick B, Reeves DS, MacGowan AP. A review of the clinical presentation, laboratory features, antimicrobial therapy and outcome of 77 episodes of pneumococcal meningitis occurring in children and adults. The Journal of Infection. 1994;29:171–82.

    Article  PubMed  CAS  Google Scholar 

  24. Riordan FA, Thomson AP, Sills JA, Hart CA. Bacterial meningitis in the first three months of life. Postgraduate Medical Journal. 1995;71:36–8.

    Article  PubMed  CAS  Google Scholar 

  25. Valmari P, Peltola H, Ruuskanen O, Korvenranta H. Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician. European Journal of Pediatrics. 1987;146:515–8.

    Article  PubMed  CAS  Google Scholar 

  26. Miner JR, Heegaard W, Mapes A, Biros M. Presentation, time to antibiotics, and mortality of patients with ­bacterial meningitis at an urban county medical center. The Journal of Emergency Medicine. 2001;21:387–92.

    Article  PubMed  CAS  Google Scholar 

  27. De Cauwer HG, Eykens L, Hellinckx J, Mortelmans LJ. Differential diagnosis between viral and bacterial ­meningitis in children. Eur J Emerg Med. 2007;14:343–7.

    Article  PubMed  Google Scholar 

  28. Casado-Flores J, Aristegui J, de Liria CR, Martinon JM, Fernandez C. Clinical data and factors associated with poor outcome in pneumococcal meningitis. European Journal of Pediatrics. 2006;165:285–9.

    Article  PubMed  Google Scholar 

  29. Kornelisse RF, Westerbeek CM, Spoor AB, van der Heijde B, Spanjaard L, Neijens HJ, et al. Pneumococcal meningitis in children: prognostic indicators and outcome. Clin Infect Dis. 1995;21:1390–7.

    Article  PubMed  CAS  Google Scholar 

  30. Rothrock SG, Green SM, Wren J, Letai D, Daniel-Underwood L, Pillar E. Pediatric bacterial meningitis: is prior antibiotic therapy associated with an altered clinical presentation? Annals of Emergency Medicine. 1992;21:146–52.

    Article  PubMed  CAS  Google Scholar 

  31. Molyneux E, Riordan FA, Walsh A. Acute bacterial meningitis in children presenting to the Royal Liverpool Children’s Hospital, Liverpool, UK and the Queen Elizabeth Central Hospital in Blantyre, Malawi: a world of difference. Annals of Tropical Paediatrics. 2006;26:29–37.

    Article  PubMed  Google Scholar 

  32. Walsh-Kelly C, Nelson DB, Smith DS, Losek JD, Melzer-Lange M, Hennes HM, et al. Clinical predictors of bacterial versus aseptic meningitis in childhood. Annals of Emergency Medicine. 1992;21:910–4.

    Article  PubMed  CAS  Google Scholar 

  33. Kallio MJ, Kilpi T, Anttila M, Peltola H. The effect of a recent previous visit to a physician on outcome after childhood bacterial meningitis. JAMA. 1994;272:787–91.

    Article  PubMed  CAS  Google Scholar 

  34. Ostergaard C, Konradsen HB, Samuelsson S. Clinical presentation and prognostic factors of Streptococcus ­pneumoniae meningitis according to the focus of infection. BMC Infectious Diseases. 2005;5:93.

    Article  PubMed  Google Scholar 

  35. Lee BE, Chawla R, Langley JM, Forgie SE, Al-Hosni M, Baerg K, et al. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. BMC Infectious Diseases. 2006;6:68.

    Article  PubMed  Google Scholar 

  36. Michos AG, Syriopoulou VP, Hadjichristodoulou C, Daikos GL, Lagona E, Douridas P, et al. Aseptic meningitis in children: analysis of 506 cases. PloS One. 2007;2:e674.

    Article  PubMed  Google Scholar 

  37. Thompson MJ, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet. 2006;367:397–403.

    Article  PubMed  Google Scholar 

  38. Feigin RD, McCracken GH, Jr., Klein JO. Diagnosis and management of meningitis. The Pediatric Infectious Disease Journal. 1992;11:785–814.

    Article  PubMed  CAS  Google Scholar 

  39. Riordan FA, Cant AJ. When to do a lumbar puncture. Arch Dis Child. 2002;87:235–7.

    Article  PubMed  CAS  Google Scholar 

  40. Blazer S, Berant M, Alon U. Bacterial meningitis. Effect of antibiotic treatment on cerebrospinal fluid. Am J Clin Pathol. 1983;80:386–7.

    PubMed  CAS  Google Scholar 

  41. El Bashir H, Laundy M, Booy R. Diagnosis and treatment of bacterial meningitis. Arch Dis Child. 2003;88:615–20.

    Article  PubMed  Google Scholar 

  42. Nigrovic LE, Kuppermann N, Macias CG, Cannavino CR, Moro-Sutherland DM, Schremmer RD, et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA. 2007;297:52–60.

    Article  PubMed  CAS  Google Scholar 

  43. Pierart J, Lepage P. [Value of the “Bacterial Meningitis Score” (BMS) for the differential diagnosis of bacterial versus viral meningitis]. Revue Medicale De Liege. 2006;61:581–5.

    PubMed  CAS  Google Scholar 

  44. Dubos F, Lamotte B, Bibi-Triki F, Moulin F, Raymond J, Gendrel D, et al. Clinical decision rules to distinguish between bacterial and aseptic meningitis. Arch Dis Child. 2006;91:647–50.

    Article  PubMed  CAS  Google Scholar 

  45. Nigrovic LE, Kuppermann N, Malley R. Development and validation of a multivariable predictive model to ­distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics. 2002;110:712–9.

    Article  PubMed  Google Scholar 

  46. Sudarsanam T, Rupali P, Tharyan P, Abraham OC, Thomas K. Pre-admission antibiotics for suspected cases of meningococcal disease. Cochrane Database of Systematic Reviews (Online). 2008:CD005437.

    Google Scholar 

  47. Prasad K, Singhal T, Jain N, Gupta PK. Third generation cephalosporins versus conventional antibiotics for ­treating acute bacterial meningitis. Cochrane Database of Systematic Reviews (Online). 2004:CD001832.

    Google Scholar 

  48. Bradley JS, Wassel RT, Lee L, Nambiar S. Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events. Pediatrics. 2009;123:e609-13.

    Article  PubMed  Google Scholar 

  49. Swingle HM, Bucciarelli RL, Ayoub EM. Synergy between penicillins and low concentrations of gentamicin in the killing of group B streptococci. J Infect Dis. 1985;152:515–20.

    Article  PubMed  CAS  Google Scholar 

  50. Schaad UB, Nelson JD, McCracken GH, Jr. Recrudescence and relapse in bacterial meningitis of childhood. Pediatrics. 1981;67:188–95.

    PubMed  CAS  Google Scholar 

  51. van de Beek D, de Gans J, McIntyre P, Prasad K. Corticosteroids for acute bacterial meningitis. Cochrane ­Database of Systematic Reviews (Online). 2007:CD004405.

    Google Scholar 

  52. Maconochie I, Baumer H, Stewart ME. Fluid therapy for acute bacterial meningitis. Cochrane Database of ­Systematic Reviews (Online). 2008:CD004786.

    Google Scholar 

  53. Health Protection Agency Meningococcus Forum. Guidance for public health management of meningococcal disease in the UK. London, UK2006.

    Google Scholar 

  54. Ladhani S, Neely F, Heath PT, Nazareth B, Roberts R, Slack MP, et al. Recommendations for the prevention of secondary Haemophilus influenzae type b (Hib) disease. The Journal of Infection. 2009;58:3–14.

    Article  PubMed  Google Scholar 

  55. Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:317–28.

    Article  PubMed  Google Scholar 

  56. Connell T, Curtis N. How to interpret a CSF--the art and the science. Adv Exp Med Biol. 2005;568:199–216.

    Article  PubMed  CAS  Google Scholar 

  57. Shah SS, Ebberson J, Kestenbaum LA, Hodinka RL, Zorc JJ. Age-specific reference values for cerebrospinal fluid protein concentration in neonates and young infants. J Hosp Med. 2011;6:22–7.

    Article  PubMed  Google Scholar 

  58. Ahmed A, Hickey SM, Ehrett S, Trujillo M, Brito F, Goto C, et al. Cerebrospinal fluid values in the term neonate. The Pediatric Infectious Disease Journal. 1996;15:298–303.

    Article  PubMed  CAS  Google Scholar 

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Sadarangani, M., Pollard, A.J. (2012). Bacterial Meningitis in Childhood. In: Curtis, N., Finn, A., Pollard, A. (eds) Hot Topics in Infection and Immunity in Children VIII. Advances in Experimental Medicine and Biology, vol 719. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0204-6_16

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