15. Meningitis

Question 1

What is meningitis?

Answer 1

An acute infl. of the protective membranes covering the brain and spinal cord => meninges

Question 2

Causes

Answer 2

Infection w/viruses, bacteria, or other microorganisms, and less commonly by certain drugs
- Ear or sinus infection, a skull fracture, or surgeries

Question 3

Diagnosis

Answer 3

Blood:
- CBC, serum electrolytes & gluclose, BUN or creatinine, and liver function test

Other:

• Blood, nasopharynx, respiratory secretion, urine or skin lesion culture OR antigen/PCR detection assays
• Syphilis testing
• Serum procalcitonin testing
• Lumbar puncture and CSF analysis
• Neuroimaging (CT of the head or MRI of the brain)

Question 4

Treatment

Answer 4

V: Mostly benign & self-limited, certain cases w/specific antiviral therapy
- Acyclovir

B: B4 culture: Dexametason

• Neg. CSF gram stain: Dexametason + cefotaxime + ampicilin
• Pos. CSF gram stain: Penicillin G (meningococci & pneumococci) or ampicillin (H. influenza & listeria)

F:

• Cryptococcal (amphotericin B)
• Coccidioides immitis (amphotericin B)
• Histoplasma capsulatum (liposomal amphotericin B)
• Candida (amphotericin + 5-flucytosine)