Meningitis in Children

Reviewed by Debra Lynn Palazzi, MD,  June 2026

Overview of Meningitis in Children

Meningitis is inflammation of the meninges, which are thin protective membranes that surround the brain and the spinal cord. It is usually caused by a bacterial or viral infection that invades the cerebral spinal fluid (CSF). Meningitis can also be caused by fungal and parasitic infections and other conditions such as head injuries, autoimmune diseases and cancer.

The infection usually starts when bacteria that live harmlessly in the respiratory tract enter the bloodstream and travel to the brain and spinal cord. In children who develop meningitis, the organism may first cause a cold, sinus infection or ear infection.

Certain types of meningitis are dangerous and can be life-threatening. Bacterial meningitis is usually more severe and may produce long-term complications or death. If a child has bacterial meningitis, parents need to treat it as a medical emergency. If the child is exhibiting the symptoms described below under Meningitis Symptoms in Children, a parent should immediately dial 911 or drive to the nearest to emergency center. 

Types of Meningitis in Children

Bacterial meningitis

The most common bacteria in newborns and young babies

• Group B Streptococcus
• Escherichia coli (or E. coli)
• Other gram-negative enteric bacilli (gut bacteria)

The most common bacteria in older babies and children

• Streptococcus pneumoniae
• Neisseria meningitidis (meningococcal meningitis)

Other bacterial infections that may cause meningitis

• Borrelia burgdorferi (Lyme disease)
• Mycobacteria tuberculosis (tuberculosis)
• Treponema pallidum (syphilis)
• Haemophilus influenzae type b (Hib) in unimmunized populations
• Listeria monocytogenes

Viral meningitis

Meningitis is most commonly caused by a virus and, with the exception of herpes simplex virus infection, is usually less severe than bacterial meningitis. 

Viruses that commonly cause viral meningitis

• Arboviruses (such as La Crosse and West Nile)
• Enteroviruses (such as coxsackieviruses and echoviruses)
• Herpes simplex virus (HSV)

Fungal meningitis

Fungi are uncommon causes of meningitis. Fungal meningitis usually occurs in patients with unique exposures or weak immune systems. Examples include:

• Candida, Aspergillus, Cryptococcus, Histoplasma, Blastomyces, Coccidioides and Cryptococcus 

Parasitic meningitis

Parasites are also uncommon causes of meningitis. Parasitic meningitis usually occurs in patients with unique exposures or weak immune systems. Examples include:

• Taenia solium (cysticercosis), Trichinella spiralis, Toxoplasma gondii, Angiostrongylus cantonensis

Meningitis Symptoms in Children 

Meningitis’ symptoms vary depending on the organism that is causing the infection. Children may experience symptoms differently and they may surface several days after the child has had a cold and runny nose, or diarrhea and vomiting. The symptoms of meningitis may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.

Symptoms in infants (may be difficult to pinpoint)

• Fever
• Poor feeding
• Sleeping more than usual
• Irritability or a noticeably different temperament
• Arching back
• Bulging fontanelle (soft spot on an infant's head)
• Cries when picked up or being held
• High-pitched cry
• Inconsolable crying
• A purple-red splotchy rash

Symptoms In children older than one year

• Fever
• Headache
• Irritability
• Confusion
• Decreased level of consciousness or sleepiness
• Nausea and vomiting
• Neck and/or back pain
• Neck stiffness
• Photophobia (sensitivity to light)
• Refusing to eat
• Seizures
• A purple-red splotchy rash

Diagnosis and Treatment of Children with Meningitis

In addition to a complete medical history and physical examination, diagnostic procedures for meningitis may include:

• Lumbar puncture (spinal tap). A special needle is placed into the spinal canal (the area around the spinal cord) in the lower back. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid can be removed and sent for testing to determine if an infection or other problems are present. 
• Blood testing. A blood culture is performed to try to grow the bacteria causing meningitis. Additional blood tests – including a complete blood count, inflammatory markers and a metabolic panel – are performed to assess the severity of illness and to detect potential complications.
• Computed tomography scan (CT scan). This diagnostic imaging procedure uses a combination of X-rays and computer technology to show detailed images of any part of the body, including the brain. In patients with meningitis, a CT scan may show that the lining of the brain is thickened and bright (enhances).

Specific treatment for meningitis will be determined by your child's doctor based on:

• Your child's age, overall health and medical history
• Extent of the disease
• The organism that is causing the infection
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment may include:

• Bacterial meningitis. Treatment for bacterial meningitis is a medical emergency and requires prompt administration of intravenous (IV) antibiotics. Early treatment is critical and improves the likelihood of a good outcome for your child. Antibiotics work by the killing bacteria that cause the infection.
• Viral meningitis. Treatment for viral meningitis is usually supportive (aimed at relieving symptoms). With the exception of the herpes simplex virus, no specific medications are available to treat the organisms that cause viral meningitis. Most children with viral meningitis not caused by herpes simplex virus recover on their own without treatment.
• Fungal meningitis. Anti-fungal medications are administered to the child with fungal meningitis.
• Parasitic meningitis. Treatment varies and depends on the cause and extent of disease. Your child may receive oral antiparasitic medication in combination with corticosteroids.

Patients with meningitis receive treatment in the hospital, usually in consultation with Texas Children's experts in Infectious Diseases. Patients may occasionally require Inpatient Rehabilitation. Patients treated at other institutions who require follow up at Texas Children’s can be referred to experts in Infectious Diseases for clinic appointments (call 832-824-4330). 

Supportive therapy for meningitis

While your child is recovering from meningitis, other therapies may be initiated to improve healing and comfort and provide relief from symptoms that include:

• Bed rest
• Increased fluid intake (this may involve encouraging fluids at home or receiving intravenous fluids in the hospital)
• Medications (to reduce fever and headache)
• Supplemental oxygen or mechanical ventilation (respirator) may be required if your child becomes very ill and has difficulty breathing.

Can meningitis be prevented?

Several vaccines are currently available to prevent some of the bacterial infections that can cause meningitis.

The American Academy of Pediatrics recommends children younger than 5 years should receive a 4-dose series of pneumococcal conjugate vaccine (PCV15 or PCV 20). pneumococcal conjugate vaccine can be given along with other childhood vaccines at the ages of 2 months, 4 months, 6 months and 12 to 15 months.

For Neisseria meningitidis (meningococcal meningitis), meningococcal vaccines are part of the routine immunization schedule for:

• Children 11 to 12 years of age (with a booster given at age 16) 
• Teens entering high school if they were not immunized at age 11 or 12 (with a booster at age 16 to 18, or up to 5 years later) 
• Infants and younger children at increased risk may also have this vaccine. Ask your child's health care provider about the number of doses and when they should be given.

Haemophilus influenzae type b (Hib) is no longer a common cause of meningitis in the United States because the Hib vaccine is given as a three or four part series during a child's routine immunizations starting at 2 months old.

Reducing the transmission of meningitis infection

If possible, parents should have their children 

• Avoid close contact with people who may be carrying the infection
• Avoid touching contaminated objects (such as doorknobs, hard surfaces or toys) and then touching their nose, mouth or eyes
• Avoid exposure to respiratory secretions from a sneeze, close conversation or by touching infected matter

If you have questions regarding prevention, please consult your child's doctor.