CLINICAL WORKSHOP: Meningitis case presentation Flashcards
What symptoms are seen?
sleepy expressionless irratable unresponsive refusing food vomit diarrhoea fever cold skin clammy skin
What do the symptoms mean?
cold/clammy= shock vomit/fever= infection sleepy/expressionless= altered consciousness
What is a maculopapular rash?
a flat, red area on the skin that is covered with small confluent bumps
What is petechia?
purple spots on skin from small bleeds from capillariese
What is petechia a sign of?
meningococcal diseas
What can you give as medication for meningococcal meningitis with septicaemia?
intramuscular dose of benzylpenicillin.
What are signs of septic shock?
cyanosed delayed capillary refill cold extremities tachycardia respiratory distress
What is non-blanching petechiae?
doesn’t go away with pressure
What is Brudzinki’s sign?
hip, knees, neck flexed
signs of meningitis
What medication can you give for meningitis?
dose of ceftriaxone is given
What kind of a drug is ceftriaxone?
this is a beta lactam antibiotic which binds to transpeptidases in cell wall synthesis and prevents it
What tests must be done?
Microbiology tests =blood culture, meningococcal PCR, throat swab
Biochemistry =electrolytes, blood gas
Haematology =full Blood Count, clotting screen
Antibiotic therapy
Fluid therapy
Supportive therapy
What action is taken?
Oxygen is administered through a face mask.
A cannula is inserted.
Investigations are performed.
Fluid resuscitation is commenced using normal saline (20ml/kg).
A dose of ceftriaxone is given.
He is intubated and ventilated.
He is transferred to the Paediatric ICU.
A lumbar puncture is considered but deferred until he is more stable.
When tumbler test is put on spots, what happens?
spots dont disappear- sign of meningiococcal disease
What is a sign of meningeal inflammation?
neck retraction and arching of back
