Meningitis Flashcards
What is meningitis?
Meningitis usually implies serious infection of the meninges
What is the most common type of meningitis?
Viral
Viral meningitis tends to get better on its own within 7 to 10 days and can often be treated at home.
What viruses can cause meningitis?
Enteroviruses
Mumps
Herpes simplex
HIV
Epstein-Barr
What bacteria can cause meningitis?
N. meningitidis
S. pneumoniae
S. aureus
Listeria monocytogenes
What are key facts about bacterial meningitis?
In acute bacterial meningitis, the pia-arachnoid is congested with polymorphs.
- A layer of pus forms.
- This may organise to form adhesions, causing cranial nerve palsies and hydrocephalus.
What are the classic symptoms of meningitis?
A triad of classic symptoms:
- Headache
- Neck stiffness
- Fever
In acute bacterial infection there is usually intense malaise, fever, rigors, severe headache, photophobia and vomiting, developing within hours or minutes
The patient is irritable and often prefers to lie still.
What is petechial rash often caused by?
Meningococcal infection
Diagnostic criterium! No lumbar punction, immediate antibiotics
What is a positive Kernig’s sign?
When the patient is lying with the quadriceps flexed on the abdomen, the leg cannot be extended
What is Kernig’s sign a sign of?
Meningitis
How does bacterial meningitis often present?
Triad of symptoms. Onset is typically sudden, with rigors and high fever. Acute septicaemic shock may develop in any bacterial meningitis
Petechial rash is diagnostic
What antibiotic do you normally use in bacterial meningitis?
Cefotaxime
What antibiotic do you use in bacterial meningitis caused by meningococcus?
Benzylpenicillin
Cefotaxime is alternative
What is the worst type of meningitis?
Bacterial! Lethal!
Viral is self-limiting
How would you treat bacterial meningitis?
Hospital admission, IV antibiotics
Lumbar puncture is performed if there is no clinical suspicion of a mass lesion
