Bacterial Meningitis Flashcards
MCC of Bac Meningitis in Newborn
SEL-
Strep agalactiae- GBS
E.Coli
Listeria
MCC of Bac Meningitis in 1mo- 2yo
HENS Strep Pneumo N. Meningitidis E. Coli HiB in non vaccinated children
MCC of Bac Meningitis in teens and young adults
Strep Penuno
Nisseria Meningitidis
MCC of Bac Meningitis in the elderly
Strep Penuno
N. Meningitidis
Listeria
MCC of Bac Meningitis related to instrumentation
Staph Epidermidis
MCC of bac meningitis in immuncompromised/ those with HIV
Syphyillis
Bioterror agent of Meningitis
Anthrax
N. Meningitidis- microscopic characteristics
Gram - diplococci
intracellular
capsule- 13 serogroups- used for typing, and capsular polysacharides determine virulence
pilli
Major types of N.Meningitidis
A, B, C, Y, W135
What types of N. Meningitidis are there vaccines for?
A
There is not one for B
What is the pathology of Meningitis caused by N. Meningitidis
1) Previous ENT infection ie pneumonia
2) N. Menigitidis is transfered to the body via respiratory droplets or by hands
3) Pilli helps it bind to the nasopharyngeal epithelium
4) Nasopharyngeal colonization
5) Crosses BBB and releases an endotoxin (like all gram negatives)
6) immune response causing release of cytokines and complement
7) Cerebral edema –> ICP increase –> CBF decrease –> stupor –> death
What is systemic spread called
This is called Meningococcemia
What is Waterhouse Friderichson Syndrome
Infection of the adrenal glands by N. Meningitidis. Hemmorhages caused by the N. Meningitidis infection leading to adrenal gland failure.
Doesn’t mean that there is meningitis
Is there exudate on the brain during meningitis
Yes and boy is it purulent
Sx/ Symptoms of bacterial meningitis
Prolonged fever w/o response to antipyretics
petechial rash
Nuchal rigidity
vomiting, lethargy, change in mental status, irritability
What are the two signs to look for in meningitis
Kernig and Brudzinski
What symptom would you find in infants with bacterial meningitis
bulging fontanelles
Early complications of meningitis
hypovolemia
cerebral edema
seizures
cranial nerve palsies
Late complications of meningitis
hearing loss
epilepsy
MR and Learning disabilities
hydrocephalous
Non neuro complications
Shock
Multi Organ dysfunction
Pupura
Treatment for Bacterial Meningitis
Steroids to decrease the inflammation and prevent damage
Then antibiotics to deal with the specific etiologic agent
Prophylaxis for those that they have been in contact with
CSF findings in bac meningitis pressure lymphs neutrophils glucose protein
Pressure- inc Lymphs- normal Neutrophils- inc (b/c bacterial) glucose- dec Protein- inc
CSF findings in Viral meningitis Pressure lymphs Neutrophils Glucose Protein
Pressure- normal/ inc lymphs- inc b/c viral PMNs- normal glucose- normal protein- normal/ inc
CSF findings Fungal meningitis Pressure lymphs Neutrophils Glucose Protein
Pressure- inc lymphs- inc PMN's- normal Glucose- dec Protein- inc
