1.42 Meningitis Case 2

Question 1

Explain pneumococcal meningitis….

Answer 1

Gram positive
Heamolytic - spleen issues 
Abrupt onset
Csf leaks 
Lungs, ear and sinus focus 
Puss in CNS -  neurological deficits 
pneumonia

Question 2

Explain haemophilia meningitis…

Answer 2

Haemophilus influenzae type b  (HIB)
Gram -ve coccobacillus
Children under 4 
Poor living conditions 
Sporadic - nurseries

Question 3

Explain viral meningitis…

Answer 3

CSF sterile on culture - no organisms seen

Enteroviruses - Polio, ECHO, coxsackie, HIV, HSV, and mumps

Question 4

Explain fungal meningitis…

Answer 4

Slow onset
Focal neurological signs - hydrocephalus, intracranial pressure
Treatment - antifungals
High likelihood of relapse

Question 5

Explain tuberculosis meningitis…

Answer 5

• Mycobacterium tuberculosis - stain with Ziehl-Nielson
• Meningitis always secondary to TB elsewhere in the body - lungs, GI
• Chronic meningitis - time course in weeks
universally fatal without treatment
abnormal behaviour, confusion, insidious, cranial nerve palsies, convulsions, pappiloedema,

Question 6

Complications of meningitis…

Answer 6

Hydrocephalus, Hearing loss, cranial nerve palsies, cognitive impairment, epilepsy, psyhoclogical, visual loss, increased ventricle size