Infectious Diseases 11 - Meningitis Flashcards
what does meningococcal septicaemia
non blanching rash
DIC + subcut bleeds
main causes of adult meningitis and kids
neisseria meningitidis + strep pneumoniae
GBS, E coli, Listeria
6 features of meningitis
fever neck stiffness vomiting headache photophobia seizures
in kids more generic (FTT, bulging fontanelle)
lumbar puncture for young babies
less than 1 month + fever always
1-3 months, fever + unwell with it
under 1 year features of serious illness
explain Kernig’s test
lie patient on back
flex knee 90 on bed
stretch out leg
produces spinal pain or resistance
explain Brudzinski’s test
lie patient flat on back
gently raise their head+neck
flex their chin to chest
involuntary hip/knee flexion in response
community management of suspected meningitis
no penicillin allergy!
under 1 year - 300mg IM benpen
1-9 years 600mg
10 yrs+ 1200mg benpen
management of meningitis once in hospital
blood culture
lumbar puncture
meningococcal PCR
serology of CSF
under 3 months = cefotaxime + amoxicillin
anyone older = ceftriaxone
consider vancomycin if high risk of resistance
why are steroids used in meningitis?
reduces risk of hearing loss and brain damage
dexa
contacts of meningitis patient
give PEP if sig contact within 7 days
1 dose cipro
viral meningitis
HSV, VZV
viral PCR of CSF
acyclovir
describe LP process for meningits
send blood glucose alongside
L3-4 area
bacterial LP results
low glucose
high protein
neutrophils
viral LP results
normal glucose
normal protein
lymphocytes
5 complications of meningitits
hearing loss
seizures / epilepsy
impairment/ disability
memory loss
focal neuro deficits
