Neonatal meningitis contributes substantially to neurological disability worldwide. Its incidence remains low but is significantly higher in neonates with documented sepsis, preterm infants, and when meningitis is nosocomial. Neonates are at higher risk of meningitis because of immaturity in humoral and cellular immunity, and the absence of specific clinical signs makes diagnosis of meningitis more difficult in neonates than in older children. Neonatal meningitis remains, therefore, a public health challenge for pediatricians. Mortality and long-term complications in survivors are observed in 10-15% and 20-50%, respectively, depending on term at diagnosis, type of identified organisms, and delay before treatment. Neurological deficits range from moderate-to-severe disabilities to more subtle problems including visual deficits, middle-ear disease, and cognitive and behavioral impairments. Intracerebral complications should be documented using magnetic resonance imaging. Treatment should be initiated once the diagnosis is suspected using a parenteral combination of bactericidal antibiotics adapted to pathogen sensitivity.
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