Meningitis Flashcards
Meningism refers to a symptom complex covering
Headache, Photophobia and Vomiting with Muscle Spasm
What type of headache/bleed can cause Meningism
Subarachnoid Haeemorhage
What type of neck stiffness is class for meningism
Passive Neck Flexion Stiffness
What constitutes the leptomeninges
pia and arachnoid
Infections from middle ear may extend into
Temporal Lobe
Pathogenesis of Meninigits 5 Steps
- Attachment into Mucosal Epithelial Cells
- Transgression of Mucosal Barrier
- Survival in Blood Stream
- Entry into CSF
- Production of infection in Meninges with or without brain infection (encephalitis)
Which bacteria may cause bacterial meningitis in neonates
e coli
group b streptococci
which bacteria may cause bacterial meningitis in children and adults
neisseria meningitides or streptococcus pneumonia
10-30% of patients with ventriculo-atrial/peritoneal shunts develop
ventriculitis and meningitis
For patients with ventriculo-atrial/peritoneal shunts who develop ventriculitis and meningitis which bacteria is it
coagulase neg staphylococci eg staph epidermidis
How is aseptic meningitis confirmed
cytology of CSF
Risk factors for Meningitis
Alcohol
Recent skull trauma
diabetes
Hypotension of Systolic <90 suggests
septic shock
Cranial Nerve palsies are typical of what type of meningitis
Tuberculosis or Cryptoccal Meningitis
Papilloedema is unusual in Meningitis. what would you consider instead?
intracranial space occupying lesion
Traditional physical signs in Meningitis
Kernig Sign
Flex Neck
What is Kernig Sign
Hip Flexed
Patient cannot straighten leg due to hamstring spasm in meningism
For patients with focal neurological signs or papilloedema what to do instead of lumbar puncture
ct head scan
when is lumbar puncture contraindicated
space occupying lesion
What is found in CSF in true meningitis
elevated white cells
Which cell type present in CSF for bacterial meningitis
Neutrophils
which cell type for viral meningitis or tuberculous meningitis
lymphocytes
what does glucose do in bacterial and tuberculous meningitis
reduced
what does protein do in bacterial and tuberculous meningitis
great increase
Bacterial meningitis 3 organisms
Streptocccus Pneumoniae
Neisseria meningitides
Haemophilus Influenza
Which antibiotic is good for bacterial meningitis
Benzylpenicillin
Nesierria Meningitis (meningococcal meningitis) is primarily a disease of
Children and young adults
What happens in Fulminant Meningococcal Septicaemia
Sudden deterioating patient
Septicaemia Shock
Disseminated Intravascular Coagulation
What happens in Fulminant Meningococcal Septicaemia to CSF
Sterile
Little or No increase in White Cells
What is Fulminant Meningococcal related to
Waterhouse Frederichsen Syndrome with bilateral adrenal haemorrhages with hypoadrenalism
Suspect Meningitis then give
Parenteral Penicillin prior to transfer to hospital
Acute unwell meningitis parent give
High dose Ceftriaxone prior to LP but after taking bloods
what should adult patients who had meningitis be given on discharge
rifampicin or ciprofloxacin
most common bacterial meningitis in adults
pneumoccal meinigits
predisposing factors to pneumococcal meningitis
alcohol pneumonia sinusitis endocarditis head trauma splenectomy
pneumoccal meningitis on microbiology
gram + diploccci
a haemolytic on blood
treatment of penumoccal meningitis
ceftriazone
most common cause of viral meningitis
enteroviruses especially echovirus and coxsackie
mumps
in the immunocompromised persistent meningitis viral may cause
chronic enteroviral meningitis or meningoencephalitis
diagnosis for viral meningitis
PCR of CSF
Throat Swabs
Treatment for Viral Meningitis caused by Herpes
Aciclovir
Most important cause of meningitis in fungal meningitis
cryptococcal meningitis found in bird droppings
cryptoccal meningitis is what type of organism
polysaccharide
fungal meningitis treatment
parenteral amphotericin
Following fungal meningitis what are patients who have hIV given
Long term fluconazole
Neonatal meningitis bacterias
B Streptocci, E Coli and L Monocytogenes
Predisposing factors to neonatal meningitis
Low birth weight
prolonged membrane rupture
maternal diabetes
Group B Streptocci IN Neonatal Meinigits give
Benzyopenicllin and Amoxyciliin or Cefotaxime
Listeria monocytogenes in neonatal meningitis - in pregnant women give them
ampicillin with gentamicin
early onset of neonatal meningitis is classified as
within 3 days of birth
late onset of neonatal meningitis is classified as
more than one week after exams
treatment of neonatal meningitis
parenteral ampicillin and gentamicin
For high risk mothers at risk of passing on neonatal meningitis through group b strep to baby they are given
amoxicillin or co amoxiclav whilst pregnant
significant risk factors for group b neonatal meningitis
pre term delivery <37 weeks
Prolonged interval between membrane rupture and delivery >18 hrs
Previous child had it
Intrapartum Fever
