CNS infections Flashcards
What organisms can cause bacterial meningitis in children
Neisseria meningitidis (meningococcus)
and
Streptococcus pneuomniae (pneumococcus)
What is meningococcul septicaemia?
meningococcus bacteria infection in the bloodstream
What type of bacteria is neisseria meningitidis
Gram negative diplococci
What organisms cause meningitis in neonates?
GBS
E-coli
Listeria
What most commonly causes encephalitis?
Herpes simplex virus
- mostly viral
Symptoms of meningitis?
Fever
stiff neck
vomiting
headache
photophobia
altered consciousness
seizures
What is the key symptom in meningococcal septicaemia?
Non-blanching rash (due to DIC)
How may neonates and babies present with meningitis?
Non-specific:
- hypotonia
- poor feeding
- lethargy
- hypothermia
- bulging fontanelle
And so should be treated for meningitis until ix prove otherwise
Symptoms of encephalitis?
Altered consciousness
altered cognition
unusual behaviour
acute onset of focal symptoms
acute onset seizures
fever
When is lumbar puncture done for meningitis?
Lumbar puncture if <1 month presenting with fever
1-3 months with fever and unwell
<1 year with fever and serious symptom
When is lumbar puncture NOT done for meningitis?
Do not do in meningococcal septicaemia due to potential DIC
Need to do coagulation screen first
How to assess for meningeal irritation?
Kernig’s test : pain on leg straightening
Brudzinski;s test : supine neck flexion causing knee.hip flexion
How to manage a baby <3 months with bacterial meningitis?
IV amoxicillin + cefotaxime
How to manage a baby >3 months with bacterial meningitis?
IV ceftriaxone
May also give dexamethasone in these children
How to manage meningitis is presenting to primary care?
Single dose IM/IV benzylpenicillin and phone ambulance
How to treat close contacts of meningitis?
Parents : ciprofloxacin to anyone with contact 7 days prior
How to manage Encephalitis?
IV aciclovir (trests HSV and VZV)
if cause of CMV : ganciclovir
Complication of meningitis in children?
Sensorineual hearing loss (so need to do audiological assessment 4-6 weeks after discharge)
