MENINGITIS Flashcards
Meningitis: CAUSES in Different AGE GROUPS
🧠⚡0-6: BEL ⚡
🧠⚡6m-6yr: SNEH ⚡
🧠⚡6yr-60yr: SNHE⚡
🧠⚡> 60yrs: SPL ⚡
⭐ NORMAL CSF VOLUME
⭐ NORMAL CSF PRESSURE
⭐ NORMAL CSF CELL COUNT
⭐ NORMAL CSF PROTEIN
⭐ NORMAL CSF GLUCOSE
⭐ NORMAL CSF VOLUME
🎯 150ml
⭐ NORMAL CSF PRESSURE
🎯 90-180 mm H2O
⭐ NORMAL CSF CELL COUNT
🎯 < 5 cell
⭐ NORMAL CSF PROTEIN
🎯 15-45
⭐ NORMAL CSF GLUCOSE
🎯 60-80% of Blood Glucose
Differentiate BETWEEN Acute Pyogenic, Acute Viral & Tuberculous MENINGITIS
Indications of LUMBAR PUNCTURE
🧠⚡M²ISS DM ⚡
🎯 DIAGNOSTIC
- INFECTIONS
✨ Meningitis
✨ Encephalitis - SUBARACHNOID HEMORRHAGE
- MALIGNANCY: Metastatic & 1°
- DEMYELINATING conditions:
✨ MS
✨ SSPE - GBS
- SPINAL CORD BLOCKAGE
- MYELOGRAPHY
🎯 THERAPEUTIC
1. Spinal Anaesthesia & Epidural Anaesthesia
- CSF Drainage in NORMAL PRESSURE HYDROCEPHALUS
- INTRATHECAL INJECTION of CHEMOTHERAPEUTIC DRUG
🚫 CONTRAINDICATION of LUMBAR PUNCTURE
- Raised ICP
- Coagulopathy
- Infection at Injection site
- Bone deformity at Injection site
Substance more in CSF than Blood
Causes of LOW GLUCOSE in CSF
- Pyogenic MENINGITIS
- TUBERCULOUS MENINGITIS
- Fungal MENINGITIS
- Carcinomatous MENINGITIS
Causes of ELEVATED CSF PROTEIN
- MENINGITIS
- ABSCESS BRAIN
- TUMOUR: Brain or SPINAL CORD Tumour
- GBS
- MS
- SYPHILIS
- HEMORRHAGE
- FROIN’S SYNDROME
Xanthochromasia
Yellowish appearance of CSF
Causes of XANTHOCHROMASIA
- Old SUBARACHNOID HEMORRHAGE
- Jaundice
- Froin SYNDROME
Froin SYNDROME
Albumino-cytological dissociation is seen in
🧠⚡FAG⚡
Increase in CSF PROTEIN without INCREASING CSF Cell count
F-FROIN’S LOCULATION SYNDROME A-ACOUSTIC NEUROFIBROMA G-GUILLIAN BARRE SYNDROME
✨ Non inflammatory degeneration of Brain Parenchyma
✨ Tumours
✨ Spinal Cord Compression
⚡⚡ MOST COMMON CAUSE of MENINGITIS
Streptococcus pneumoniae
Difference between:
✨ MENINGITIS
✨ Encephalitis
✨ Encephalopathy
✨ Acute Febrile Encephalopathy
✨ Meningitis
Meningeal signs present predominantly
Seizure Present/Absent
✨ Encephalitis
Sensorium affection (coma)
Seizures
⭐ Encephalitis: Inflammation of brain parenchyma
⭐ Encephalopathy: Noninflammatory diffuse cerebral dysfunction (altered sensorium due to any cause)
⭐ Acute febrile encephalopathy: A febrile illness with altered sensorium of ≤2 weeks duration in a previously well child. May have infectious or noninfectious causes
⭐ Meningitis: Inflammation of leptomeninges.
⚡⚡ MOST COMMON CAUSE of POST SHUNTING MENINGITIS
Staphylococcus epidermidis > > Staphylococcus aureus
⚡⚡ MOST COMMON CAUSE of MENINGITIS Post CRANIOTOMY, Head Trauma & CSF Rhinorrhea
Pseudomonas (Gram negative)
Classical Triad of MENINGITIS
SHORT HISTORY (1 DAY) with Lethargy & Drowsiness
- Fever HIGH GRADE
- Neck Stiffness
- Altered Sensorium
➕
Headache
Classical Tetrad of ENCEPHALITIS
Fever
➕
Altered Sensorium
➕
Focal Neurological Deficit
➕
Seizure
⚡⚡ MOST COMMON SYMPTOM OF MENINGITIS
Severe HEADACHE
Characteristics of Headache in ACUTE BACTERIAL MENINGITIS
Frontal TIGHTNESS, feels like Compression
🧑🏻⚕️ORDER of Clinical Features in Acute MENINGITIS
Tiredness
⬇️
Irritable
⬇️
LETHARGIC
⬇️
High Grade Fever with intermittent episodes of Vomiting
Which type of MENINGITIS present SUBACUTELY?
✨ TB MENINGITIS
✨ FUNGAL MENINGITIS
Classical Signs of MENINGITIS
- Neck Stiffness / Cervical RIGIDITY
- KERNIG’S sign
- BRUDZINSKI’s sign
KERNIG’S sign
BRUDZINSKI’s sign
Other Features of MENINGITIS
- Raised ICP
✨ Papilledema
✨ Projectile Vomiting
✨ 6th CN palsy
✨ Reduced level of Consciousness
✨ Cerebral Herniation - Decerebrate Posturing
- Cushing Reflex: ⬇️ HR, ⬆️ BP, RR ⬆️
Special features of MENINGOCOCCAL MENINGITIS
Rash: diffuse erythematous maculopapular
Focal Seizures of ➕ in MENINGITIS indicates
Encephalopathy
Meningism
Meaning
Classical constellation of symptoms and signs associated with irritation of the meninges.
INTERMITTENT NECK STIFFNESS IS CHARACTERISTIC FEATURE OF
Arnold Chiari Malformation
Causes of NECK STIFFNESS
- Meningism
✨ MENINGITIS
✨ SUB ARACHNOID HEMORRHAGE (SAH) - MENINGISM Mimics
✨ Cervical Spondylosis
✨ After Cervical Fusion
✨ Impending TONSILLAR HERNIATION (⬆️ ICP)
✨ Acute DYSTONIC Reaction
✨ Tetanus
✨ Strychnine Poisoning - INTERMITTENT: Arnold Chiari Malformation
Imaging before LUMBAR PUNCTURE is done i
NON-INFECTIVE CAUSES OF MENINGITIS
🧠⚡C²DS⚡
- Carcinomatous
- CTD
- Drugs
- Substances injected into SAH
Causes of CARCINOMATOUS MENINGITIS
- Leukemia
- Lymphoma
- Myeloma
- Melanoma
- Breast Cancer
- Lung cancer
CTDs causing MENINGITIS
- Behcet’s
- SLE
- Sarcoidosis
- Rheumatoid arthritis
- Sjogren’s
DRUGS causing MENINGITIS
Sulphasalazine
Cyclosporine
Azathioprine
Types of MENINGITIS based on HERNIATION
🎯 UNCOMPLICATED MENINGITIS
✨ Raised ICT ➕ NO IMPENDING HERNIATION
✨ Lumbar PUNCTURE DONE
🎯 COMPLICATED MENINGITIS
✨ RAISED ICT ➕ IMPENDING HERNIATION
✨ Lumbar PUNCTURE 🚫 CONTRAINDICATION
