Neonatal Meningitis: Causes, Treatment, and Prevention

Is your newborn showing signs of neonatal meningitis? Get the facts and find out how you can prevent this serious infection.

By Jean Rothman

Medically reviewed by Pat F. Bass III, MD, MPH

In the United States, there are roughly 300 to 400 cases of neonatal meningitis for every 100,000 live births. A rare type of meningitis, this often life-threatening condition affects newborns and is caused by various bacteria, including group B strep, E. coli, and listeria. 

The most common cause of neonatal meningitis in the United States is group B beta-hemolytic streptococcus, or group B strep. According to the U.S. Centers for Disease Control and Prevention, 10 to 30 percent of pregnant women carry group B strep, which can potentially lead to meningitis at or near the time of birth. 

Neonatal meningitis can also be caused by Escherichia coli (E. coli), and in rare cases, listeria monocytogenes (listeria). Pregnant women are among those at high risk for developing listeriosis, a food-borne illness that results from contaminated foods like soft cheeses, hot dogs, and luncheon meats. Listeria can be passed on through the birth canal during pregnancy. 

Symptoms of Neonatal Meningitis

 

Because neonatal meningitis can be fatal, any infant showing symptoms should be taken to the emergency room immediately. Signs of neonatal meningitis may include:

• Feeding poorly or refusing to feed
• Irritability
• Trouble breathing
• Bulging fonatelle, the soft spot at the top of the head
• Diarrhea
• Feeling too warm or too cold

Neonatal Meningitis Diagnosis and Treatment

When doctors suspect neonatal meningitis, the newborn will have a lumbar puncture, or spinal tap, a procedure in which a needle is inserted in the back to withdraw spinal fluid for laboratory examination. Infants with neonatal meningitis are generally treated with:

• Fluids
• Antimicrobial agents (medications that work against bacteria causing meningitis)

Depending on the severity of the illness, the infant may require other therapies, such as:

• Anticonvulsant medicine, if the baby is having seizures
• Monitoring with an intracranial (inside the head) pressure monitoring device placed
• Evaluation for cerebral abscess, a mass in the brain resulting from a bacterial or fungal infection
• Evaluation for hydrocephalus, commonly referred to as water on the brain

How to Prevent Neonatal Meningitis

 

If a pregnant woman is given antibiotics during labor, her baby’s risk of having group B strep disease is greatly reduced. Doctors typically test a woman for group B strep in the third trimester. Group B strep cannot be prevented by the mother taking antibiotics before going into labor. 

Women who should receive antibiotics during labor include those who:

• Have previously had a baby with a group-B strep infection
• Have a urinary tract infection caused by group B strep
• Have group-B strep bacteria, but are not infected

Neonatal Meningitis: Avoiding Listeriosis

There are numerous ways to reduce your risk of listeriosis. Here are some tips:

• Thoroughly cook any raw food from animal sources
• Wash vegetables thoroughly before eating
• Do not drink unpasteurized milk or eat products made with unpasteurized milk

Neonatal meningitis is a serious condition. Take steps to educate yourself about the condition before you have a baby so that you can be familiar with the warning signs and minimize your child's risk of infection.