Meningitis Flashcards
What is meningitis?
Inflammation of the meninges
What is affected by meningitis?
The brain and the spinal cord
What are the main causes of bacterial meningitis in older children and adults?
Neisseria meningitidis
Streptococcus pneumonia
What is the main cause of bacterial meningitis in babies?
Group B streptococcus
How does meningitis present?
- Meningism- Fever, neck stiffness and Photophobia
- Nausea and vomiting
- Headache
- Altered consciousness and seizures
What might you get with meningococcal septicaemia?
Non-blanching purpuric rash
How do infants normally present?
Asymptomatically
How is bacterial meningitis diagnosed?
Lumbar puncture
When would you not do a lumbar puncture?
If there were signs of raised ICP
How would the bacterial meningitis CSF appear?
- Cloudy
- Low glucose
- High protein
- Mainly polymorphs
What is the management of community acquired bacterial meningitis?
Benzylpenicillin
What is the management of hospital acquired bacterial meningitis?
Ceftriaxone/Cefotaxime and amoxicillin
What would you give for prophylaxis of bacterial meningitis?
Ciprofloxacin or rifampicin
When should you give prophylaxis for bacterial meningitis?
Within 24 hours
What would you give to reduce the neurological problems?
Dexamethasone
What are the causes of viral meningitis?
- Herpes-simplex virus
- Enterovirus
- Varicella-zoster virus
How is viral meningitis diagnosed?
Lumbar puncture
How would the viral meningitis CSF appear?
- Clear
- High glucose
- Normal protein
- Lymphocytes
What is the management of viral meningitis?
IV acyclovir
What is the main complication of meningitis?
Hearing loss
How is hearing loss prevented in meningitis?
Dexamethasone
What situation requires a person to be administered antibiotic prophylaxis?
People who have been exposed to a patient with confirmed bacterial meningitis within the 7 days before onset
What is the management of meningitis for someone between 0-3months?
Intravenous cefotaxime + amoxicillin (or ampicillin)
What is the medical management for someone between 3months- 50 years?
Intravenous cefotaxime (or ceftriaxone)
What is the medical management of someone over 50?
Intravenous cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin)
When should a lumbar puncture be delayed in someoen presenting with meningitis?
signs of severe sepsis or a rapidly evolving rash
severe respiratory/cardiac compromise
significant bleeding risk
signs of raised intracranial pressure
What are signs of raised intracranial pressure?
focal neurological signs
papilloedema
continuous or uncontrolled seizures
GCS ≤ 12
