Neonatal meningitis

causative pathogens

in children >6 months

Headline
Etiology see above
N meningitidis, H flu, S pneumoniae - transmitted by resp droplet
Group B Strep - vertical transmission (most common in early neonatal meningitis)
Epidemiology Listeria meningitis is rare in the UK!
Clinical presentation
Pathogenesis inflammatory cascade → ↑ ICP
Diagnostic investigations LP:
Management <3 months:
- Intravenous cefotaxime plus ampicillin or amoxicillin, or
- Intravenous ceftriaxone with or without ampicillin or amoxicillin

3 months - 15 years:
- IV ceftriaxone
- Target to pathogen
- IM benpen is only for community use

Do not give ceftriaxone in: 2

  • In premature babies
  • In babies with jaundice, hypoalbuminaemia, or acidosis because it may exacerbate hyperbilirubinaemia
  • If giving calcium-containing infusions