Akut Bakteriell Meningit

Question 1

CSV Analys för Akut Bakteriell Meningit

Answer 1

Opening Pressure
White Blood Cell Count
WBC dominance
CSV protein
CSV glucose
CSV/seru glucose ratio

Referens: Acute bacterial meningitis in adults. McGill F. et al. Lancet(388): 3036-3047.

Question 2

Inledande Behandling (Vuxna)

Answer 2

-Cefotaxim 3g x 4 (+ampicillin 3gx4 till patienter >50 år samt immunosupprimerade individer för att täcka L. monocytogenes)

ELLER

-Meropenem 2g x 3

Referens: Läkemedelsboken (Akuta svåra infektioner - Initial behandling)

Question 3

Duration of treatment

Answer 3

There are no randomized trials. General current guidance is:

• 5-7 days for meningococcal disease
• 10-14 days for pneumococcal disease
• At least 21 days for Listeria meningitis

Referens: Acute bacterial meningitis in adults. McGill F. et al. Lancet(388): 3036-3047. PMID: 27265346