[71] Bacterial Meningitis Flashcards
What is meningitis?
Inflammation of the meninges covering the brain
What usually precedes a bacterial infection of the meninges?
Bacteraemia
What is responsible for the damage caused by meningeal infection?
Host response to the organism
What changes influence the damage caused by the immune system?
- Release of inflammatory mediators
- Activated leukocytes
- Endothelial damage
What can occur as a result of immune response in meningitis?
- Cerebral oedema
- Raised ICP
- Decreased cerebral blood flow
What effect can inflammatory response have below the meninges?
Vasculopathy leading to cerebral cortical infarction
How may meningitis cause hydrocephalus?
Fibrin deposits may block CSF reabsorption
What does the causative organism vary according to?
Age of the child
What are the most common causative organisms in neonates - 3 months?
- Group B strep
- E. coli
- Listeria monocytogenes
What are the most common causative organisms in 1 month - 6 years?
- Neisseria meningitides
- Strep pneumoniae
- Haemophilus influenzae
What are the most common causative organisms in >6 year olds?
- Neisseria meningitides
- Strep pneumoniae
What has affected the commonness of causative organisms over time?
Introduction of vaccines
How may meningitis present in general?
- Non-specifically
- With specific symptoms
What is the result of meningitis sometimes presenting with non-specific symptoms?
It can be hard to distinguish from other conditions
What are some non-specific symptoms of meningitis?
- Fever
- N&V
- Lethargy
- Irritability
- Refusing food
- Headache
- Muscle aches/joint pains
What are some more specific symptoms of meningitis?
- Non-blanching rash
- Stiff neck
- Altered mental state
- Shock
- Photophobia
- Bulging fontanelle
- Focal neurological deficits
- Seizures
How may focal neurological deficits present?
- Cranial nerve involvement
- Abnormal pupils
What physical examination tests may be useful when looking for meningitis?
Kernig’s and Brudzinski tests