17.3 Meningitis Flashcards
Meningitis CSF findings:
- bacteria
- viral
- fungal
- neutrophils, low CSF glucose. (do gram stain and culture)
- lymphocytes, normal CSF glucose
- lymphocytes, low CSF glucose
Viruses don’t eat glucose but bacteria and fungi do
Meningitis
-what layers are inflammed?
Pia and Arachnoid (leptomeninges)
non dura
N. meningitidis
- what population for meningitis
- how spread
- children, teens
- spread through nasopharynx, to blood
Meningitis
- most common virus
- population
cocksackievirus
-children
lumbar puncture
-what layers does needle pass through?
- skin
- ligaments
- epidural space
- dura
- arachnoid
(not pierce pia)
Nonvaccinated infant with suspected meningitis
-think what organism?
H. influenzae
Teenager with suspected meningitis
-think what infection
N. meningitidis
Meningitis bacteria:
neonates (3)
unvaccinated infants (1)
children, teens (1)
Adults and elderly (1)
neonates: GBS, E Coli, Listeria
unvaccinated infants : H. Influenza
children, teens : N. Meningitidis
Adults and elderly : Strep pneumo
Elderly adult with suspected meningitis
-think what infection
Strep pneumo
meningitis bacteria for neonates (3)
- mech of transmission
- how to prevent
GBS, E Coli, Listeria
- both GBS and E Coli are in vagina, transmitted during birth
- During 3rd trimester, pregnant women’s vagina is test for GBS and given Abx for prophylaxis if detected
Meningitis
- classic triad presentation (3)
- other symptoms may be present: (3)
- headache
- nuchal rigidity
- fever
- photophobia
- vomiting
- altered mental status
What symptom of meningitis is more characteristic of viral than bacterial or fungal?
Photophobia
Meningitis
-complications
Usu seen with bacterial meningitis b/c of pus and inflammation.
- Death from herniation secondary to edema
- Fibrosis-related sequelae (from healing) can cause hydrocephalus, hearing loss, seizures
What is normal CSF glucose level?
-what changes it
Normal expected is 2/3 that of blood glucose.
So 100 blood glucose, expect 66 CSF glucose.
Bacteria and fungi consume glucose
Lumbar puncture
- describe procedure, location
- location–what anatomical landmark
CSF sample by lumbar puncture
- spinal cord ends at L2
- puncture at L4/5 to get CSF (iliac crest)
