Meningitis in Premature Babies

Giving birth to a baby even before the mother completes 37 weeks of gestation will result in a premature baby.  Preemies born too early and with low birth weight are more prone to developing a condition of the brain and spinal cord referred to as meningitis.

What is Meningitis?

The human brain and spinal cord is enveloped in three layers of membranes collectively referred to as meninges.  Infections caused by either the bacteria, virus, fungus or other micro-organisms can lead to inflammatory conditions of the meninges, termed medically as meningitis.

Symptoms of Meningitis

-       High body temperatures, but feet and hands may feel cold to touch

-       Vomiting leading to feed refusals

-       Increased breathing rate and/or breathing difficulties

-       Easily irritated when being handled

-       High pitched cries

-       Blank gaze

-       Bulging fontanel

-       Skin rash or pale complexion

-       Abnormal drowsiness leading to difficulty in waking up the child

Causes

-       A preemie is generally born with an immature immune system.  Because of this, they are prone to recurrent viral, bacterial, or fungal infections that can lead to inflammation of the membranes surrounding the brain and the spinal cord.

-       Congenital anatomical defects, like a fractured skull, will allow the microorganisms to penetrate into the preemie’s nervous system and trigger meningitis.

Types

-       Viral meningitis is a common type that is not known to seriously affect the health of a preemie.  The virus may have entered the baby’s body via a mosquito bite or may be air borne and is not considered to be very harmful.  The inflammation will often resolve on its own causing no major health complications for the baby.

-       Bacterial meningitis caused by the group B streptococcus bacteria.  This bacteria type commonly resides in the vaginal area of women, and during the time of vaginal delivery, a possible bacterial transfer can occur between the mother and child resulting in this type of meningitis during the first week of a preemie’s life.

Treatment

The treatment plan will depend on –

-       the severity of the illness

-       gestational age of the preemie

-       the type of meningitis, and

-       are there other medical conditions present in the preemie

If the meningitis is caused by a virus, then this will not warrant any medical treatment for they are known to resolve on their own.

However, severe cases of meningitis (be it viral or bacterial) will require a course of –

-       Antibiotic/antiviral administered via the intravenous route

-       Medicines to bring the body temperature down.  The room that the preemie is placed in should be adequately ventilated and cool sponge baths may also be given to get their fever under control.

-       Feeds and plenty of fluids to be provided for the baby to prevent dehydration.  In case the preemie has persistent vomiting and diarrhea, the feedings should be done via the tube route.

-       In situations where the baby has breathing difficulties, then the preemie will need to be placed in an oxygen tent or a tube be inserted into their trachea for adequate oxygen supply.

-       If the preemie is restless, irritable, or crying persistently, then sedatives may be administered to give them good rest.

While the baby can get vaccinated against certain types of bacterial infections that can lead to meningitis, there seems to be no preventive vaccine yet available to fight against meningococcus group B bacteria, which is the common cause for bacterial meningitis in infants.