Determine the severity of the illness: Determine the severity of the illness based on the child's age, symptoms, and laboratory findings. Consider using a validated clinical scoring system to assess the severity of the illness.
Obtain cultures: Obtain cultures of blood and CSF for microbiological diagnosis and to guide antibiotic therapy. Consider obtaining additional CSF samples if the initial results are inconclusive.
Initiate empirical antibiotic therapy: Start empiric antibiotic therapy immediately based on local resistance patterns and antibiotic stewardship principles. Choose an appropriate antibiotic based on the child's age, severity of symptoms, and previous antibiotic exposure.
Consider adjunctive therapies: Consider adjunctive therapies such as dexamethasone for children with suspected bacterial meningitis to reduce the risk of neurological sequelae.
Provide supportive care: Provide supportive care for the child's symptoms, including intravenous fluids, pain management, and antipyretics.
Monitor the child's response to therapy: Monitor the child's clinical response to therapy, including resolution of fever and improvement of neurological symptoms. Adjust therapy as needed based on their clinical response.
Consider referral to a specialist:Consider referral to a pediatric infectious disease specialist or a pediatric neurologist for complicated or severe cases, or those with underlying medical conditions that increase their risk of complications.
Follow-up: Schedule a follow-up appointment to monitor the child's response to therapy and ensure resolution of symptoms. Repeat cultures may be needed to confirm eradication of the infection.
Young, Stephen M., and Aaron Saguil. "Bacterial Meningitis in Children." American Family Physician 105.3 (2022): 311-312.
Young, Stephen M., and Aaron Saguil. "Bacterial Meningitis in Children."
American Family Physician
Meningitis in paediatric patients: