Meningitis

Question 1

What are the most common causes of bacterial meningitis with increasing age?

Answer 1

Group B strep/HiB
Strep pneumoniae
Neisseria meningitidis
Strep pneumoniae

Question 2

Who is at risk of meningitis from Listeria monocytogenes?

Answer 2

Pregnant
Over 50s
Immunocompromised
From unpasteurised milk

Question 3

What are the neurological sequelae of meningitis?

Answer 3

Deafness
Cognitive impairment 
Paralysis 
Visual loss 
Epilepsy

Question 4

What is the treatment of bacterial meningitis?

Answer 4

Ceftriaxone (+Vance if pen resistance)
Ampicillin for listeria
Benzylpenicillin for meningococcal

Question 5

Which serotypes of N. Meningitidis cause outbreaks?

Answer 5

A, B and C

A is every 2-10 years in the meningitis belt

Question 6

How do you prevent meningitis?

Answer 6

Reduce overcrowding
Vaccination
Household contacts of meningococcal -stat PO cipro

Question 7

What are the features of the PCV vaccine?

Answer 7

PCV10 and PCV13
Immunogenicity in early infancy
Reduces disease and colonisation
Three doses

Question 8

What are the features of the HibCV vaccine?

Answer 8

IM alone or with DTP/HepB

3 doses

Question 9

What are the features of the meningococcal vaccines?

Answer 9

Polysaccharide vaccines are used in outbreak control but protection reduces over time
Conjugate vaccines give longer immunity. One dose of monovalent serogroup A given across meningitis belt. Quadrivalent used in resouce rich countries