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31 - Neonatal bacterial meningitis

from Section 4 - Specific conditions associated with fetal and neonatal brain injury

Published online by Cambridge University Press:  12 January 2010

By
Alistair G. S. Philip
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

The term meningitis refers to inflammation of the leptomeninges covering the brain. Bacterial infection of the meninges usually produces a suppurative process or “purulent meningitis.” However, it is probably more correct in the newborn infant to consider the condition as bacterial meningoencephalitis, since it is common to have involvement of the cerebral hemispheres as well as involvement of the meninges.

From the clinician's perspective it has been traditional to think of neonatal sepsis (septicemia) and meningitis together, because the clinical manifestations may be indistinguishable. For many years, the proportion of cases of neonatal sepsis that also had documented meningitis was considered to be one-quarter to one-third. For instance, in 1986 it was estimated that one case of neonatal meningitis occurs for every four cases of sepsis. Indeed, this was my personal experience in Vermont between 1975 and 1980, when 12 of 41 cases (29%) with neonatal sepsis in the first week after birth had associated meningitis. However, in the early 1990s the proportion of cases decreased to as low as 5%. This may be less true in other countries, with 32 of 229 (14%) noted in Israel, 107 of 577 (18.5%) in Panama, and 14 of 84 (17.8%) in Kenya. It is also noteworthy that with meningitis due to Group B Streptococcus (GBS), the proportion of cases may relate to the time of onset of the disease.

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Information
Fetal and Neonatal Brain Injury , pp. 347 - 360
Publisher: Cambridge University Press
Print publication year: 2009

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