Bacterial meningitis (Pediatrics - PEDS)

This is an infection of the layers that surround and protect the brain and spinal cord called the meninges. The bacterium responsible will vary depending on the child's age and geographic location. The most common are Streptococcus agalactiae, E. coli, meningococcus, pneumococcus and H. influenzae. It generally presents with fever, headache, vomiting, seizures and a stiff neck. In small children, it may manifest with prostration, irritability, rejection of food or bulging fontanelle. Diagnosis is clinical and is confirmed by analyzing the cerebrospinal fluid. Treatment is with antibiotics administered early, which are combined with corticosteroids if meningitis due to pneumococcus or H. influenzae is suspected. It is a serious condition that generally requires admission to an ICU.