Meningitis

Question 1

What is meningitis?

Answer 1

Meningitis is an infection-mediated inflammation of the meninges. It can be caused by infectious agents such as: bacteria, viruses, and fungi, or can be caused by noninfectious agents such as toxins, granulomatous disease, and autoimmune disease.

Question 2

Why its incidence is high in young infants?

Answer 2

A major risk factor for bacterial meningitis is the lack of preexisting immunity to specific pathogens and serotypes, reflected by the higher incidence of meningitis in young infants. Other risk factors are close contact to persons with colonization of the pathologic organism and a Defects of the complement system (C5-C8).

Question 3

RF

Answer 3

The risk of pneumococcal meningitis is increased in children with congenital or acquired CSF leak across a mucocutaneous barrier, such as a lumbar dural sinus, cranial or midline facial defects (cribriform plate), fistulas of the middle ear (stapedial foot plate) or inner ear (oval window, internal auditory canal, cochlear aqueduct), or CSF leakage as a result of basilar or other skull fracture.
The mode of transmission of these pathogens is through contact with respiratory tract secretions or droplets.
4

Question 4

Abx

Answer 4

لازم نسوي LP في أقل من ساعتين بعد الABx علشان ما تتغير النتيجة وتصير sterile gram

NEONATE
◂ Ampicillin + cefotaxim or
gentamicin ◂ For 14-21 days
◂ >30 DAYS OLD
◂ Ceftriaxone or cefotaxim +
Vancomycin ◂ For 7-14 days
 Dexamethasone | if suspected HIB to decrease incidence of hearing loss

Question 5

Petechial rash

Answer 5

Is classcal symptom of neseria

Most likely meningeotoxemia

Question 6

LUMBAR PUNCTURE

Answer 6

Indications For the diagnosis or for measurement of opening pressure.
Complications
1. Contamination of the CSF sample with blood from the epidural venous plexus 2. Local back pain 3. Headache (uncommon in children younger than 10 years of age) 4. Apnea/hypoventilation caused by positioning for the procedure in young infants 5. Spinal epidural/subdural hematoma or spinal cord bleeding 6. Infection 7. Subarachnoid epidermoid tumor formation 8. Ocular muscle palsy (transient) 9. Epidural CSF leak 10. Brainstem herniation

Question 7

PREVENTION

Answer 7

◂ Chemoprophylaxis is recommended for all close contacts of patients
with meningococcal meningitis, regardless of age or immunization
status. Using Rifampin orally, Ceftriaxone IM or Ciprofloxacin orally.
◂ Rifampin prophylaxis should be given to all household contacts of
patients with invasive disease caused by H. influenzae type b, if any close
family member younger than 48 months has not been fully immunized
or if an immunocompromised.
◂ Antibiotic prophylaxis should not be administered to contacts of children
diagnosed with pneumococcal meningitis.

Question 8

complication

Answer 8

Cerebrovascular complication like stroke or
hemorrhage. ◂ Hydrocephalous ◂ Brain abscess ◂ Subdural effusion

Chronic complications
◂ Developmental delay ◂ Late-onset seizures ◂ Cerebral palsy ◂ Hearing loss ◂ Cognitive impairment