CBL Cases

Question 1

What are the 3 main bacterial causes of meningitis?

Which is the most common?

Which is the most severe?

Answer 1

Strep. pneumoniae (80%)
-Mortality rate: 30%

Neisseria meningitidis (10-15%)

Listeria monocytogenes

Question 2

List 4 risk factors for bacterial meningitis.

Answer 2

Alcohol abuse
Age
Splenectomy
Head trauma

Question 3

Which investigations would you do for someone with suspected bacterial meningitis? (4)

NOTE: you must have these in the right order.

Answer 3

Bloods, including:

• FBC
• U&Es
• CRP

Blood cultures

CT scan

Lumbar puncture and CSF samples

Question 4

What are the contraindications for lumbar puncture? (1)

Answer 4

Raised intracranial pressure (NOTE: therefore patients should always have a CT scan first!)

Question 5

How would you treat bacterial meningitis? (3)

Answer 5

Correct blood sugar

Steroids, e.g.
-Dexamethasone (give BEFORE antibiotics - this is to combat strep pneumoniae)

Antibiotics, e.g.

• Ceftriaxone
• Amoxicillin (for listeria)