meningitis Flashcards
how does meningitis CSF (viral/ bacterial) compare with normal CSF in in terms of appearance, glucose, protein, WBC?
Meningitis has
higher wbc, protein
lower glucose (bacterial lower)
appearance:
viral clear like normal csf
bacterial is turbid
which age groups pneumonia is caused by listeria
extremes <1mo and >50yo
which age groups pneumonia is caused by nesseria and strep.pneumo?
after 1mo all have
which age groups pneumonia is caused by strep. agalactiae (grp B)?
0-2yo
what bacteria does a 3 yo with meningitis have? What abx would you give?
strep. pneumo and neisseria
what bacteria does a 65yo with meningitis have? What abx would you give?
listeria, strep pneumo, neisseria, gram neg aerobes (e coli, kleb). ceftriaxone + ampicillin
what bacteria does a 1yo with meningitis have? What abx would you give?
strep agalactiae, strep pneumo, neisseria, E coli. ceftriaxone + vanco
what drug do you give other than abx for adult meningitis patients?
dexamethasone 10mg q6h, up to 4 days
What do you give toddlers in the same day care as a 5 year old, weighing 16kg meningitis patient positive for neisseria meningitidis?
chemoprophylaxis. PO rifampicin Q12H, 4 doses 10mg/kg x 16 =160mg
What do you give the parent of a meningitis patient positive for neisseria?
PO rifampicin 600 mg q12h 4 doses OR
ciprofloxacin 500mg, one dose
Patient with meningitis is culture positive for neisseria, what abx do you give if they are allergic to amoxicillin
ceftriaxone 5-7days
Patient with meningitis is culture positive for strep pneumo, what abx do you give
pen G or ampicillin 10-14days
Patient with meningitis is culture positive for strep pneumo, what abx do you give if they are allergic to
vancomycin +rifampicin for 10-14 days
If a 70yo meningitis patient currently on empiric ceftriaxone + ampicillin, is culture negative for listeria, strep, pneumo, strep, agalactiae, neisseria, what do you do?
continue empiric for at least 14 days
Why are all drugs used in meningitis max dose and IV
To achieve adequate CNS concentration
If culture is negative for hemophilus influenxae or strep-pnueumo for a pt currently on empiric treatment what action do you take?
stop dexamethasone
Who is adjunctive corticosteroids recommended for in patients with meningitis?
all >6 weeks old
when do you administer dexamethasone
30mins bef abx or during
