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Meningitis at Birth

Meningitis is inflammation of the meninges (or membranes surrounding the brain tissue) which is usually caused by a bacteria or virus.  In the United States two-thirds of all neonatal meningitis cases are caused by group B strep or E.coli strains (see table below).1  Additional bacterial causes such as Listeria monocytogenes are less common causes.  Rarely, other microorganisms such as protozoa can cause meningitis.  Occasionally, the cause cannot be determined.  In the United States the incidence of bacterial meningitis is 0.3/1000 live.3  Mortality rates associated with bacterial meningitis, when treated, are now under 10% in the United States.

Meningitis is a serious medical condition.  The long term effects of meningitis run the spectrum from complete recovery to hearing problems to developmental delays to death.  Significant long-term neurological damage can result from meningitis.  In a recent study of children who were assessed at 5 years after their illness it was found that 65% who had group B strep and 41.5% who had E.coli completely recovered.  However, significant disability was found in many of the children. In this study 8.1% of children had cerebral palsy, 7.5% had learning disabilities, 7.3% had seizures and 25.8% had hearing problems.2  In addition, the long term effects of neonatal meningitis may be more subtle and present as visual, cognitive or behavioral problems later in life.3 

General signs and symptoms common to meningitis include:

• temperature changes
• poor feeding
• lethargy
• vomiting
• diarrhea
• stiff neck
• bulging soft spot (fontanelle)
• seizures
• strange body posturing (opisthotonos)

Delays in treatment of suspected meningitis can cause significant harm.  Such delays are the basis for many malpractice lawsuits.  In general, a neonate with mild fever and non-specific clinical findings needs to be assessed for meningitis by cerebrospinal fluid analysis (spinal tap or lumbar puncture).3

Table 1: Bacteria Causing Meningitis in the Neonatal Period

Bacteria or virus                                         % total cases

References:

1. Kimberlin, D.W. (2002) Meningitis in the Neonate. Current Treatment Options in Neurology 4(3):239-248.
2. Bedford H, de Louvois J, Halket S, et al. (2001)0 Meningitis in infancy in England and Wales: follow up at age 5 years. British Medical Journal 323(7312):533-36.
3. http://www.emedicine.com/neuro/topic239.htm
4. Heath, P.T., Yusoff, N.K.N., Baker, C.J. (2003) Neonatal meningitis. Archives of Disease in Childhood Fetal and Neonatal Edition 88:F173.
5. Lee, W.S., Puthucheary, S.D., Omar, A. (1999) Salmonella meningitis and its complications in infants. Journal of Paediatrics and Child Health 35(4):379-382.

Fitzgerald & Fitzgerald has successfully handled hundreds of birth injury malpractice cases, including cases involving meningitis.  If you would like a free consultation regarding your infant’s injuries, please contact Fitzgerald & Fitzgerald.  You may call toll-free at 1-800-323-9900 or submit the firm’s online contact form.