1: Infections - Meningitis Flashcards
What is the main cause of meningitis in children
Viral
What proportion of meningitis in children is viral
2/3 cases
What is the most-common cause of bacterial meningitis in children 0-3 months
Group B Streptococcus
What are 3 organisms that cause meningitis in children 0-3 months
- Group B Streptococcus
- S. Pneumonia
- N. Meningitides
What is most common cause of meningitis in children 3-6 years
N. Meningitides
What are 3 organisms that cause meningitis in children 3-6 years
- N. Meningitides
- S. Pneumonia
- H.Influenza
What is the main cause of bacterial meningitis in 6-60 year-olds
N. Meningitides
What are two causes of bacterial meningitis in 6-60 year-olds
N. Meningitides
S. Pneumonia
When is Listeria Monocytogenes are more common cause of meningitis
- 0-3 months
- > 60 years
- Immunocompromised
What can cause meningitis in immunocompromised patients
Cryptococcus Neoformans
What are 5 risk factors for Meningitis
- Sinusitis
- Otitis media
- Immunocompromised
- Maternal Group B Infection
- Crowded Living Conditions
Explain order of septic signs to meningitis signs
Septic signs typically precede meningitis signs
What are the septic signs of meningococcal septicaemia
- Fever
- Abnormal skin colour
- Rash
- Shock: tachycardia, low RR, low BP
When does a non-blanching petechial rash occur
If caused by N. meningitides
What are 5 meningeal signs of meningitis
- Photophobia
- Neck stiffness
- Kernig’s
- Brundinzki’s sign
- Opisthotonus
When is neck stiffness absent
Under 18-months
What is Kernig’s sign
Resistance to knee extension, when hips are flexed
What is Brudzinski’s sign
When neck is bent, hips will flex
What is opisthotonus
Spasm muscles - causing backward arching of head, neck and spine
What is problem with meningitis in children
Often quite non-specific symptoms
When should meningitis be suspected in infants
Any unwell infant with fever
What are 5 early symptoms of meningitis in infants
Lethargy Vomiting Irritable Poor appetite Dyspneoa
What are 3 late-symptoms of meningitis in infants
Bulging fontanelle
Seizures
High-pitch cry
What are symptoms of meningitis in young children
Fever
Poor Feeding
Lethargy
How do older children with meningitis present
Triad:
- Headache
- Neck Stiffness
- Photophobia
If in the community and suspect meningitis, what should be given
IM (of IV) Benzylpenicillin
If in hospital, what 4 investigations are ordered for neonates (under 1 -month) with meningitis
- FBC
- CRP
- Blood Culture
- LP - send for culture
What is given to manage neonates under 1-month
Cefotaxime and Amoxicillin
Why is amoxicillin given
To cover for listeria - which is more common in younger patients