Meningitis

Question 1

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Features of meningitis

Answer 1

• Fever
• Headache
• Neck stiffness
• Photophobia
• Sometimes N+V
• Non-blanching rash

Question 2

Difference between encephalitis and meningitis

Answer 2

• Meningitis is inflammation of leptomeninges
• Encephalitis is inflammation of brain parenchyma itself
• Encephalitis presents with seizures, altered conc/decreased GCS, focal neurological deficits

Question 3

Immediate management of suspected meningococcal sepsis

Answer 3

• Sepsis 6
• Can give IV benzopenicillin if in primary care before hospitalisation
• Dexamethasone can help improve outcomes

Question 4

Investigations to confirm meninngitis

Answer 4

• Lumbar puncture - as long as no signs of raised ICP - can check with CT first if necessary
• Blood cultures/samples
• Throat swabs

Question 5

What is a notifiable disease?

Answer 5

Disease which you must notify public health about
Ensures they can contact trace, monitor disease spread and provide early warning if outbreak occurs, triggers investigations too

Question 6

What disease is suprisingly (maybe) not notifiable

Answer 6

HIV

Question 7

3 types of meningitis

Answer 7

Bacterial
Tuberculosis
Viral

Question 8

CSF in bacterial meningitis

Answer 8

• Cloudy
• Polymorphs maor cell - eg neutrophils
• Protein more than 1.5g/L
• Glucose less than half of plasma
• Bacteria in culture and smear

Question 9

CSF in tuberculosis meningitis

Answer 9

• Fibrin web
• Lymphocytes/monocytes major cell
• Glucose less than 1/2 plasma
• 1-5g/L protein
• No bacteria found in smear (but in culture)

Question 10

CSF in viral meningitis

Answer 10

• Clear
• Lymphocytes and monocytes main cell type
• Glucose more than 1/2 plasma
• Protein less than 1g/L
• No bacteria in smear or culture

Question 11

Complications of meningitis

Answer 11

• Hearing loss
• Epilepsy
• Problems with memory
• Vision loss
• Loss limbs
• Co-ordination movement and balance problems
• Learning difficulties