10- Meningitis Flashcards
What are common causative organisms for meningitis in neonates?
E.coli, Group B streptococcus, Listeria monocytogenes
What are the most common causative organisms for meningitis in children?
Haemophilia influenzae type B, neisseria meningitidis
What are the most common causative organisms for meningitis in the elderly?
Streptococcus pneumoniae, listeria monocytogenes
What are risk factors for meningitis infection?
CSF defects, spinal procedures, endocarditis, diabetes, alcoholism, splenectomy, crowded housing
What are the clinical features making up the meningism triad?
Headache, neck stiffness, photophobia
What clinical features can be seen in meningitis?
Meningism with fever, flu-like symptoms, seizure, rash, joint pains, drowsiness
What other signs may also be seen in babies?
Inconsolable crying poor feeding, rigidity/floppiness, bulging fontanelle (late sign)
What is the pathophysiology of meningitis?
Bacteria enter circulation, damaging vessel in brain and entering subarachnoid space. They then multiply and produce purulent CSF and meningeal inflammation
What investigations could be carried out if you suspect meningitis?
Bloods and culture, lumbar puncture, maybe chest X-ray or urine culture looking for infective cause
How will the lumbar puncture findings present in bacterial meningitis?
Cloudy CSF, high protein (primarily neutrophils), high white cell, low glucose
How will the findings of a lumbar puncture appear in viral meningitis?
Clear or cloudy, proteins normal or raised, high white cells (primarily lymphocytes), normal glucose
What supportive and medical treatments are considered in bacterial meningitis?
Supportive: analgesia, antipyretic, fluids
Medical: IV ceftriaxone, dexamethasone
Why might you give dexamethasone in meningitis?
To prevent hearing loss by reducing swelling of vestibulocochlear nerve or cochlea
Which drugs would you give for viral meningitis caused by a herpes virus and cytomegalovirus?
Herpes: Aciclovir
CMV: ganciclovir