Meningitis Flashcards
What is meningitis?
Inflammation of the meninges
What is the main cause of bacterial meningitis in children?
Neisseria meningitidis (meningococcus)
What type of bacteria is Neisseria meningitidis (meningococcus)?
Gram-negative diplococcus bacteria
What is an alternative cause of bacterial meningitis in children?
Streptococcus pneumoniae (pneumococcus).
What is the most common cause of bacterial meningitis in neonates?
Group B streptococcus (GBS).
How does the child become infected by Group B streptococcus (GBS)?
During birth from GBS bacteria that live harmlessly in the mother’s vagina.
What is the classic triad of bacterial meningitis?
Fever
Neck stiffness
Photophobia
How does bacterial meningitis present?
- Vomiting
- Headache
- Altered consciousness
- Seizures.
What is meningococcal septicaemia?
Occurs when the bacteria is infecting the meninges and the cerebrospinal fluid around the brain and spinal cord.
What can meningococcal septicaemia present?
Non-blanching rash
How can a neonate with meningitis present?
- Hypotonia
- Poor feeding
- Lethargy
- Hypothermia
- Bulging fontanelle.
What physical feature can a neonate with meningitis present with?
Bulging fontanelle
What is the main investigation for bacterial meningitis?
Lumbar puncture
What 2 special tests can you do to look for meningeal irritation?
- Kernig’s test
* Brudzinski’s test
What is a positive Brudzinski’s test?
Patient will involuntarily flex their hips and knees.
What will a positive Kernig’s test cuase?
Spinal pain or resistance to movement.
What is the community management of suspected meningitis and non-blanching rash?
Urgent stat injection (IM or IV) of benzylpenicillin
Then transfer to hospital
What would you ideally do in a hospital with a child presenting with suspected meningitis?
Do a lumbar puncture and bloods prior to giving antibiotics
What would you send bloods for?
Meningococcal PCR to check for meningococcal disease
What antibiotics would you give to a child under 3 months in the hospital?
cefotaxime plus amoxicillin
What antibiotics would you give to a child over 3 months in the hospital?
Ceftriaxone
What is the main complication of bacterial meningitis?
Hearing loss
What should be given to prevent hearing loss?
Dexamethasone
What would you find in the CSF of someone with bacterial meningitis?
Cloudy
High protein
Low glucose
Mainly neutrophils
What is the most common cause of viral meningitis?
Enterococcus
How is viral meningitis diagnosed?
A sample of the CSF from the lumbar puncture should be sent for viral PCR testing.
What is usually the management of viral meningitis and why?
usually supportive management as it is less severe than bacterial meningitis
What can be used to treat viral meningitis caused by HSV or VZV?
IV acyclovir
How would the CSF of viral meningitis appear?
Clear
Normal or slightly raised protein
Normal glucose
High leucocytes
What is the post exposure prophylaxis for bacterial meningitis?
Single dose of ciprofloxacin
ideally within 24 hours of diagnosis
