Topics Discussed: infectious diseases; meningitis; neonatal meningitis; neurology.
Excerpt:"Definition. Neonatal meningitis is an infection of the meninges and central nervous system (CNS) in the first month of life. This is the most common time of life for meningitis to occur.
Incidence. The incidence is ~ 0.16–0.45 per 1000 live births in developed countries. The incidence may be higher in underdeveloped countries.
Pathophysiology. In most cases, infection occurs because of hematogenous seeding of the meninges and CNS. In cases of CNS or spinal anomalies (eg, myelomeningocele), there may be direct inoculation by flora on the skin or in the environment. Neonatal meningitis is often accompanied by ventriculitis, which makes resolution of infection more difficult. There is also a predilection for vasculitis, which may lead to hemorrhage, thrombosis, and infarction. Subdural effusions and brain abscess may also complicate the course.
Most organisms implicated in neonatal sepsis also cause neonatal meningitis. Some have a definite predilection for CNS infection. Group B streptococcus (GBS) (especially type III) and the Gram-negative rods (especially Escherichia coli with K1 antigen) are the most common causative agents. Other causative organisms include Listeria monocytogenes (serotype IVb ), other streptococci (enterococci, Streptococcus pneumoniae), and other Gram-negative enteric bacilli (Klebsiella, Enterobacter, and Serratia spp). In the very..."
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