Meningitis Flashcards
Presentation of meningitis
Fever, stiff neck, headache, vomiting, photophobia, altered consciousness, seizures, non-blanching rash in septicaemia, hypotonia, poor feeding, lethargy, hypothermia, bulging fontanelle
Most common cause of meningitis in neonates
Group B strep
Most common cause of meningitis in children and adults
Neisseria and streptococcus pneumoniae
Typical antibiotics to give in infants
Under 3 months = cefotaxime + amoxicillin
Over 3 months = ceftriaxone
Management of meningitis
Stat injection of IV benzypenicillin - IM or IV.
Diagnosis of meningitis
Blood culture and LP for CSF performed prior to starting antibiotics
When is vancomycin added
If there is a risk of resistance such as foreign travel or prolonged Abx exposure
Use of steroids in meningitis
Steroids used in becterial meningitis to reduce frequency of hearing loss and neurological damage.
Which steroids given in meningitis
Dexamethasone given 4 times daily for 4 days to children over 3 months if LP suggestive of bacteria
Bacterial appearance of LP
Cloudy, high protein, low glucose, high neutrophils, culture shows bacteria
Viral appearance of LP
Clear, mildly raised/normal protein, normal glucose, high lymphocytes, negative blood culture
Complications of meningitis
Hearing loss, seizures and epilepsy, cognitive impairment, learning disability, memory loss, cerebral palsy
Treatment of viral meningitis
Suuportive and aciclovir can be used if confirmed HSV or VZV infection
