Meningitis in children is a serious and risky disease that can affect the central nervous system of children and adults. This disease occurs as inflammation of the brain and spinal cord (bacterial meningitis) or inflammation of the brain membrane (viral meningitis). If not diagnosed and treated quickly, meningitis can lead to serious complications such as stroke, permanent neurological disorders and even death. In this article, we will discuss the causes, symptoms, diagnosis and treatment of meningitis in children. When does meningitis occur in children? Meningitis in children can occur at any age, but some age groups are more at risk of this disease: 1. Babies and children less than 2 years old - This age group has the highest incidence of meningitis. - Common causes include Streptococcus pneumoniae, Neisseria meningitidis and Salmonella bacteria. - Symptoms at this age can be non-specific, such as fever, lack of appetite and restlessness. 2. Children from 2 to 18 years old Viral meningitis is more common in this age group. - Bacterial causes include Neisseria meningitidis and Haemophilus influenzae. Symptoms include fever, headache, neck pain and sensitivity to light. 3. Teenagers and young people - This group is also at high risk of meningitis. - The symptoms are similar to the previous age group. Therefore, meningitis can occur at any age, but its prevalence and causes differ with the age of the child. Types of meningitis in children In children, meningitis can occur in different ways. This disease is usually divided into two main categories: ### Bacterial meningitis This type of meningitis is more common than other types of meningitis in children and may progress quickly and cause a serious condition for the child's life. Some types of bacteria are usually the cause of this type of meningitis, for example Haemophilus influenzae and Pneumococcus, which are prevented in routine childhood vaccines. The main symptoms of this type of meningitis include high fever, severe headache, vomiting, neck stiffness, neck pain, convulsions, anorexia, and sleepiness, and its treatment includes the use of antibiotics prescribed by a doctor. Early treatment is very important to prevent serious complications and brain abscess formation. ### Viral meningitis Another type of meningitis in children that occurs mainly due to viral infection is viral meningitis. Various viruses, including herpes simplex virus and enterovirus, can cause this type of meningitis. Common symptoms of this type of meningitis include fever, headache, vomiting, fatigue, general weakness, apathy (loss of appetite). In most cases, viral meningitis improves on its own and does not require special treatment. If needed, your doctor may prescribe antivirals or supportive care to control existing symptoms. Signs and symptoms of meningitis in children Signs and symptoms of meningitis in children vary depending on the age of the child and its type, but the most common signs and symptoms of meningitis in children are as follows: Methods for diagnosing meningitis in children Diagnosis of meningitis in children should be made by a specialist doctor and depends on signs and symptoms, clinical evaluation and diagnostic tests. Meningitis diagnosis methods include the following: ### Clinical evaluation The doctor carefully reviews the child's clinical history, which includes current signs and symptoms, vaccination history, risk factors, and previous medical history. ### Physical examination The doctor performs a comprehensive physical examination of the child. This includes examination of the neck, spine, assessment of neurological function, and examination of skin signs and other physical symptoms. ### Cognitive tests Protein tests, lumpar bunge, glucose and PCR tests are among the diagnostic tests for children's meningitis, which are performed by a specialist doctor in the early stages for correct diagnosis. ### Brain and spinal cord imaging In some cases, imaging of the brain and spinal cord (such as an MRI scan) may be used to check for changes and inflammation in areas of the brain. Ways to treat meningitis in children The treatment of children's meningitis depends on the cause (bacteria or virus) and the severity of the disease. Among the treatments for meningitis in children, the following can be mentioned: ### Drug therapy For example, it is necessary to use antibiotics to control and treat meningitis bacterial infection. The type of antibiotic and the duration of its use depends on the type of bacteria present and its sensitivity to the drug. Children's meningitis is usually treated with drugs such as ceftriaxone or cefotaxime. ### Therapeutic support If needed, blood pressure monitoring, hydration (injection of fluids), fever reduction, pain control, and neurological care (care of nerve function) may be required. ### Normal and everyday care In most cases, viral meningitis improves on its own and does not require specific treatment. In these cases, it is recommended to provide adequate rest, more fluids, antibiotics and treatment of other relevant symptoms. ### Targeted treatment In some special cases, specific virus treatment may be required. For example, if herpes simplex infection is identified as the cause of meningitis, antivirals such as acyclovir may be prescribed. ### Paraclinical care Fluid infusion support: If large amounts of fluids are required, you may need to administer fluids and electrolytes to maintain proper hydration and electrolyte balance. Neurological care: regular examination and monitoring of neurological function, measurement of intracranial pressure and examination of other neurological symptoms are done to evaluate and follow up the child's neurological condition. Complications and risks of meningitis in children Meningitis in children can cause serious complications and risks. The most important complications and risks of meningitis in children are: \+ Neurological complications: Meningitis can cause damage to the central nervous system. These effects can include seizures, severe headaches, lack of attention, muscle weakness, memory and learning problems, changes in behavior and personality, hearing and vision loss, and even coma. \+ Vascular complications: Meningitis can cause inflammation of cerebral vessels, which leads to complications such as stroke, cerebrovascular insufficiency, and cerebral hemorrhage. Complications related to the respiratory system: Meningitis may affect the child's breathing and cause complications such as shortness of breath, dehydration, and inadequate oxygenation. \+ Cardiac complications: Meningitis can cause inflammation of the heart and cause complications such as cardiac arrhythmia (disruption in the heartbeat) and heart diseases in children. \+ Kidney complications: In some cases, meningitis may damage the kidneys and cause complications such as kidney failure. Fetal complications: If meningitis occurs during pregnancy, it may directly affect the fetus and cause fetal problems or the birth of a baby with meningitis. Which meningitis vaccines are available for children in Iran? In Iran, the meningitis vaccines that are available for children are: 1. Meningitis A and C vaccine (Meningococcus A and C) - This vaccine is used to prevent bacterial infections caused by meningitis serogroups A and C. - This vaccine is included in Iran's National Children's Vaccination Program and is injected to children twice. 2. Meningitis B vaccine (meningococcal B): - This vaccine is used to prevent infections caused by serogroup B meningitis. - Meningitis B vaccine is not yet included in Iran's national vaccination program, but it can be injected individually and with a doctor's prescription. 3. Multiple meningitis vaccine (Meningococcal A, C, Y and W135): - This vaccine is used to protect against the four main serogroups of meningitis. - The multiple meningitis vaccine is not included in Iran's national vaccination program for children, but it can be injected if necessary with a doctor's prescription. Therefore, meningitis A and C vaccines are available in Iran's national vaccination program, but meningitis B and multiple vaccines must be injected individually and with a doctor's prescription. last word The need for quick and appropriate treatment of meningitis in children is very important to reduce complications and serious risks. If you develop symptoms of meningitis such as high fever, severe headache, vomiting, discomfort from light, stiff neck and altonia (muscle weakness), be sure to see a pediatrician.