Meningitis

Question 1

What is meningitis?

Answer 1

Inflammation of the meninges

Question 2

What is affected by meningitis?

Answer 2

The brain and the spinal cord

Question 3

What are the main causes of bacterial meningitis in older children and adults?

Answer 3

Neisseria meningitidis

Streptococcus pneumonia

Question 4

What is the main cause of bacterial meningitis in babies?

Answer 4

Group B streptococcus

Question 5

How does meningitis present?

Answer 5

• Meningism- Fever, neck stiffness and Photophobia
• Nausea and vomiting
• Headache
• Altered consciousness and seizures

Question 6

What might you get with meningococcal septicaemia?

Answer 6

Non-blanching purpuric rash

Question 7

How do infants normally present?

Answer 7

Asymptomatically

Question 8

How is bacterial meningitis diagnosed?

Answer 8

Lumbar puncture

Question 9

When would you not do a lumbar puncture?

Answer 9

If there were signs of raised ICP

Question 10

How would the bacterial meningitis CSF appear?

Answer 10

• Cloudy
• Low glucose
• High protein
• Mainly polymorphs

Question 11

What is the management of community acquired bacterial meningitis?

Answer 11

Benzylpenicillin

Question 12

What is the management of hospital acquired bacterial meningitis?

Answer 12

Ceftriaxone/Cefotaxime and amoxicillin

Question 13

What would you give for prophylaxis of bacterial meningitis?

Answer 13

Ciprofloxacin or rifampicin

Question 14

When should you give prophylaxis for bacterial meningitis?

Answer 14

Within 24 hours

Question 15

What would you give to reduce the neurological problems?

Answer 15

Dexamethasone

Question 16

What are the causes of viral meningitis?

Answer 16

• Herpes-simplex virus
• Enterovirus
• Varicella-zoster virus

Question 17

How is viral meningitis diagnosed?

Answer 17

Lumbar puncture

Question 18

How would the viral meningitis CSF appear?

Answer 18

• Clear
• High glucose
• Normal protein
• Lymphocytes

Question 19

What is the management of viral meningitis?

Answer 19

IV acyclovir

Question 20

What is the main complication of meningitis?

Answer 20

Hearing loss

Question 21

How is hearing loss prevented in meningitis?

Answer 21

Dexamethasone

Question 22

What situation requires a person to be administered antibiotic prophylaxis?

Answer 22

People who have been exposed to a patient with confirmed bacterial meningitis within the 7 days before onset

Question 23

What is the management of meningitis for someone between 0-3months?

Answer 23

Intravenous cefotaxime + amoxicillin (or ampicillin)

Question 24

What is the medical management for someone between 3months- 50 years?

Answer 24

Intravenous cefotaxime (or ceftriaxone)

Question 25

What is the medical management of someone over 50?

Answer 25

Intravenous cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin)

Question 26

When should a lumbar puncture be delayed in someoen presenting with meningitis?

Answer 26

signs of severe sepsis or a rapidly evolving rash
severe respiratory/cardiac compromise
significant bleeding risk
signs of raised intracranial pressure

Question 27

What are signs of raised intracranial pressure?

Answer 27

focal neurological signs
papilloedema
continuous or uncontrolled seizures
GCS ≤ 12