Meningitis Flashcards
What type of bacteria is neissiera meningitidis?
Gram negative diplococcus
What does meningococcal septicaemia cause?
Non blanching rash
What does the non blanching rahs in meningococcal septicaemia indicate the infection has caused?
Disseminated intravascular coagulopathy
SC haemorrhage
What is meningococcal meningitis
When bacteria is infecting meninges and CSF
Most common causes of meningitis
Neissiera meningitidis
Step pneumoniae
Neonates - group B strep
How is group B strep contracted?
During birth - normally in vaginal canal harmless
Presentation of meningitis
Fever
Neck stiff
Vomit
Headache
Photophobia
Altered consciousness
Seizures
Non blanching rash if septicaemia
How do neonates and babies present with meningitis?
Non specific signs and symptoms eg hypotonia
Poor feeding
Lethargy
Hypothermia
Bulging fontanelle
Who do NICE recommend LP for investgiation in?
Under 1 month with fever
1-3 months with fever and unwell
Under 1 year unexplained fever and other features of serious illlness
Special tests to perform for meningeal irritation
Kernigs test
Brudzinkis test
What is kernigs tets
involves lying the patient on their back, flexing one hip and knee to 90 degrees and then slowly straightening the knee whilst keeping the hip flexed at 90 degrees. This creates a slight stretch in the meninges. Where there is meningitis it will produce spinal pain or resistance to movement.
What is brudzinkis test
involves lying the patient flat on their back and gently using your hands to lift their head and neck off the bed and flex their chin to their chest. In a positive test this causes the patient to involuntarily flex their hips and knees.
Comunity treatment children with sus meningitis and non blacnhing rash
IM benzylpenicillin and hospital transfer
Dose is age dependent
What send for if meningococcal disease sus
LP
Meningococcal PCR
Antibiotics for children with meningitis under 3 onths vs over
Under 3 months - ceftriaxone + amoxicillin
Above 3 months - ceftriaxone
Vancomycin
