Acute bacterial meningitis

Question 1

Acute bacterial meningitis

Answer 1

Acute bacterial meningitis

Common symptoms:

• Rapid onset
• Headache
• High fever
• Nuchal rigidity
• Photophobia
• Confusion
• Vomitting

Question 2

Acute bacterial meningitis in Neonates

Answer 2

Acute bacterial meningitis

Neonates:

• Bulging fontanelle
• Paradoxical irritability

Question 3

Acute bacterial meningitis: obtaining CSF and what is found

Answer 3

Acute bacterial meningitis: obtaining CSF and what is found

• Obtain Cerebrospinal fluid
• Lumbar puncture/spinal tap
• Turbid CSF
• Gram stain: PMNs (Polymorphonuclear leukocytes) + pathogen
• Bacterial Antigen Detection test
  
  • Detects antigen in CSF
• Culture: Diagnostic
  
  • Blood cultures also positive
• Biochem analysis
  
  • Low glucose
  • High protein
  • High nos. PMNs (neutrophils)

Question 4

What’s this?

Answer 4

Acute bacterial Meningitis

(Neonatal meningitis)

1. Group B Streptococcus

(Strep. Agalactiae)

GPC chains (gram positive cocci chain)

Question 5

What this?

Answer 5

Acute bacterial Meningitis

(Neonatal meningitis)

Escherichia coli

GNB (gram negative bacilli) rod

Question 6

what’s this?

Answer 6

Acute bacterial Meningitis

(Neonatal meningitis)

Listeria monocytogenes

GPB (Gram positive bacilli (rod))

Question 7

what’s this?

Answer 7

Acute bacterial Meningitis

Strep.pneumoniae
GPC pairs (Gram positive cocci pairs (diplococci))

Question 8

Acute bacterial Meningitis

Answer 8

Acute bacterial Meningitis

Neisseria meningitidis
GNC pairs (Gram negative cocci pairs (diplococci))

Question 9

what’s this

Answer 9

Acute bacterial Meningitis

H.influenzae type b

Pleomorphic GNB (rods and filaments))

Question 10

Empiric therapy regimens for acute bacterial meningitis to treat patients Younger than 1 month (neonates):

Answer 10

Younger than 1 month (neonates):
Ampicillin + cefotaxime
OR
Ampcillin + Aminoglycoside

to treat (in patients less than 1 month):

• Group B Streptococcus
• Escherichia coli
• Listeria monocytogenes
• Klebsiella

Question 11

Empiric therapy regimens for acute bacterial meningitis to treat One month to 23 months

Answer 11

One month to 23 months:

Vancomycin + 3rd generation Cephalosporin
(Ceftriaxone or Cefotaxime)

to treat (in patients 1-23 months):

Strept. Pneumoniae
N.Meningitidis → with petechial rash
→ 3rd gen Cephalosporin/penicillin
GBS
H.Influenzae type b

Question 12

Empiric therapy regimens for acute bacterial meningitis to treat patients 2 to 50 years:

Answer 12

Empiric therapy regimens for acute bacterial meningitis to treat patients 2 to 50 years:

2 to 50 years:

Vancomycin + 3rd gen Cephalosporin

to treat (in patients 2 to 50 years):

N. Meningitidis

Strept. pneumoniae

Question 13

Empiric therapy regimens for acute bacterial meningitis to treat patients Older than 50 years

Answer 13

Empiric therapy regimens for acute bacterial meningitis to treat patients

Older than 50 years:

Vancomycin + 3rd gen cephalosporin

to treat ( in 50+ patients):

• Strep pnemoniae
• N. Meningitidis
• Listeria monocytogenes
• Aerobic GNB
  *