Bacterial meningitis

Question 1

Most common pathogens < 1 month

Answer 1

Group B Strep
E. coli
Listeria monocytogenes
Klebsiella

Question 2

Most common pathogens 1-23 months

Answer 2

S. pneumoniae
Neisseria meningitidis
H influenzae
E. coli

Question 3

Most common pathogens 2-50 years

Answer 3

N. meningitidis
S. pneumoniae

Question 4

Meningitis presentation: infants

Answer 4

poor feeding
vomiting
fever
seizures
irritability
lethargy
bulging fontanelle

Question 5

Meningitis presentation: children

Answer 5

fever
headache
lethargy
vomiting
myalgia
photophobia
stiff neck
seizure
confusion

Question 6

CSF lumbar puncture findings indicative of meningitis

Answer 6

WBC > 1000
Protein > 45
Glucose < 40

Question 7

Empiric treatment < 1 month

Answer 7

Ampicillin + AG
Ampicillin + cefotaxime
(+ acyclovir if HSV suspected)

Question 8

Empiric treatment 1-23 months

Answer 8

Vancomycin + cefotaxime or ceftriaxone

Question 9

Empiric treatment 2-50 years

Answer 9

Vancomycin + cefotaxime or ceftriaxone

Question 10

Dexamethasone in pediatric meningitis

Answer 10

controversial
decrease hearing loss in patients with H influenzae
always given before or with first dose of abx