ER infections 2 Flashcards
Presenting symptoms of Bacterial meningitis include
Classic triad - fever, neck stiff, altered Mental status
- 2/4 symptoms - present in 95% of patients
complications of BM
1- altered mental status 2- Elevated ICP, and cerebral edema 3- seizures 4- focal neurologic deficits 5- sensorineural hearing loss 6- cerebrovascular abnormalities
Spinal needle for an LP is inserted between
3rd and 4th vertebrae
Pink tinge to CSF fluid could indicate
Subarachnoid hemorrhage
CSF analysis of Tube 1,2,3,4
1: Cell count and diff
2: Glucose protein
3: Gram stain, extra fluid for viral etc.
4: repeat cell count,
if blood in 1 and 4 –> likely a hemorrhage
If viral meningitis what do you expect in cell count
Lymphocytosis
If bacterial meningitis what do you expect in cell count
High neutrophils or normal count
- protein usually elevated
When do you treat for bacterial meningitis
RIGHT AWAY
Treatment for Bacterial meningitis
1- Dex (IV - before or with Abx)
- every 6 hours for 2 days to 4 days
- to blunt inflammatory response
causative organisms of bacterial meningitis
1 - strep pneumo
2- listeria
3- gram neg bacilli
Abx to give for BM adults >50
- Ampilicillin, Vanco, Cetriaxone or Cefotaxime
alternate is menopenem and vanco
Abx for BM if 1 month to 50 years
- Vanco, Ceftraixone or Cefotaxime, +/- ampicillin
same as before -
Neonates with BM
high chance of it being group B strep
How do you treat neonates with bM
Ampicillin - IV, and cefotaxime or gentamycin
Which abx treats listeria
AMPICILLIN
