Meningitis and encephalitis in infants and children

Abstract

Despite the availability of modern therapies, meningitis and encephalitis remain potentially life-threatening infections in children with mortality rates reaching up to 25%. Treated patients are at a high risk of long term sequelae including epilepsy, learning, and behavioral disorders. The golden rule of early diagnosis and treatment to achieve a good outcome has not yet been challenged by the new, often expensive antibiotics or contemporary critical care. In this article, an updated overview of meningitis and encephalitis in infants and children is presented. It is important to note that routine childhood immunization has significantly decreased the number of serious infections. However, meningitis and encephalitis remain problematic particularly in developing countries where immunization rates are suboptimal. The most common viral etiologies include enteroviruses, herpes simplex virus, and arboviruses. However, the causative virus may not be identified in up to 70% of cases. This is not the case for bacterial infections unless the patient had received prior oral antibiotics. The causative bacterial organisms vary with age, and the less common fungal infections occur mainly in immune compromised patients.