Meningitis Flashcards
What is meningitis
Infective and non-infective inflammation of the meninges
What are the bacterial causes of meningitis
S. Pneumoniae
N. Mengitidis
H. Influenzae (children)
Listeria
S. Agalectiae
What are the viral causes of meningitis
Enteroviruses -Coxsackie A/B -Polio HSV2
What are the non-infective causes of meningitis
Malignancy NSAIDs Sarcoidosis SLE Behcet's
What are the presentations of meningitis
Meningism -Headache -Stiff neck -Photophobia Kerrigs Sx Brudzinski reflex
What are the investigations for bacterial meningitis
Bloods ABG Blood culture CT head Lumbar puncture and CSF analysis
Why would you do a lumbar puncture (L3/4) for Meningitis
Check the CSF macroscopically and then send for microscopy
What might the CSF look like in bacterial meningitis
Cloudy Neutrophilia Culture positive Raised Protein Low glucose (<50%)
What might the CSF look like in viral meningitis
Clear/Turbid Lymphocytosis Culture negative Normal protein Raised glucose
What might the CSF look like in TB meningitis
Cloudy with fibrin Lymphocytosis High protein Low glucose
What are the complications of Meningitis
Septic shock DIC Coma Seizure Death
What is Meningism
Headache
Stiff neck
Photophobia
How would bacterial meningitis be treated
Ceftriaxone/Cefotaxime w/ steroids
How would bacterial meningitis by Listeria be treated
Amoxicillin
In GP, If a patient presents with non blanching rash, what is the protocol
Suspect meningococcal septicemia
IM Benzylpencillin
Urgent Hospital referral
What are the main complications of Meningitis
Meningococcal septicemia (DIC) Waterhouse Friderichsen syndrome (Adrenal insufficiency by hemorrhage)
What is the most common bacteria causing meningitis in neonates
Group B Alpha (S Agalactae)
Listeria
E Coli
S Pneumonia
What is the most common bacteria causing meningitis in infants
S Pneumo
N Meningitidis
N Meningitis
What is the most common bacteria causing meningitis in adults
S Pneumo
N Meningitidis
N Meningitis
What is the most common bacteria causing meningitis in elderly
S Pneumo
N Meningitis
Listeria (Cheese)
Where is listeria typically found
Soft cheese
What is the most common meningitis causing organism found in pregnant women
Gram positive Listeria
What is Meningism
Haedache
Photophobia
Stiff neck
What are the 2 main meningitis clinical signs
Kernig
Brudzinski
At what level is lumbar puncture done in meningitis
L3/L4
Cloudy with a fibrin web on lumbar puncture suggests what meningitis
Fungal/TB
In what type of meningitis is protein level found normal/ Glucose is raised on LP
Viral
Why is there low glucose found in lumbar puncture for bacterial and TB meningitis
Aerobic organisms use up glucose and turn the fluid cloudy
What are the two gram positive diplococcus most commonly found on Meningitis
S Pneumoniae
S Agalectiae
What type of bacteria is N Meninigitidsis
Gram negative Diplococcus
What vaccine protects agasint N Meniningitidis
Men B/C
ACWY
What vaccine protects against S Pneumoniae
PCV Vaccine
Where does S Agalacteiae colonise
Maternal flora
Give 4 risk factors for meningitis
Immunocompromised
Crowding
Extreme ages
Not vaccinated
