Meningitis

Question 1

Q1: What is meningitis?

Answer 1

Meningitis is an infection of the protective membranes that surround the brain and spinal cord, called the meninges.

Question 2

What are the causes of meningitis? (6)

Answer 2

Infectious causes:
• Bacterial
• Viral
• Fungal

Non-infectious causes:
• Cancer
• Autoimmune conditions
• Certain drugs

Question 3

How does bacterial meningitis compare to viral meningitis?

Answer 3

• Bacterial meningitis is rarer but more serious than viral meningitis.

Question 4

In which age group is bacterial meningitis most common?

Answer 4

Bacterial meningitis is most common in babies and children.

Question 5

What is meningococcal disease, and what can it lead to? (4)

Answer 5

Meningococcal disease is an infection with Neisseria meningitidis and can lead to:

• Meningococcal meningitis (15% of cases)
• Meningococcal septicaemia (25% of cases)
• A combination of both (60% of cases).

Question 6

Which strain is responsible for most invasive meningococcal disease cases in people under 25?

Answer 6

MenB (Meningococcal group B) is responsible for the majority of invasive meningococcal disease cases in people under 25.

Question 7

What is pneumococcal disease?

Answer 7

Pneumococcal disease is an infection caused by Streptococcus pneumoniae.

Question 8

How is meningitis transmitted?

Answer 8

•Transmitted by aerosol, droplets, or direct contact with secretions from the upper respiratory tract, Transmission usually requires either frequent or prolonged close contact

Question 9

What is the incubation period for meningitis ?

Answer 9

Incubation = 3-5 days

Question 10

How do vaccinations help in preventing meningitis?

Answer 10

Vaccinations provide protection against certain causes of meningitis by immunizing against specific bacteria and viruses.

Question 11

What is the MenB vaccine, and when is it offered?

Answer 11

The MenB vaccine protects against Meningococcal group B and is offered:

• At 8 weeks of age
• A second dose at 16 weeks
• A booster at 1 year

Question 12

When is the 6-1 vaccine offered ?

Answer 12

The 6-in-1 vaccine is offered to babies at:

• 8 weeks
• 12 weeks
• 16 weeks

Question 13

When is the pneumococcal vaccine offered?

Answer 13

• Babies: 2 doses at 12 weeks and 1 year
• Adults aged 65 or over: Single dose

Question 14

When is the Hib/MenC vaccine offered?

Answer 14

The Hib/MenC vaccine is offered to babies at 1 year of age.

Question 15

Who receives the MenACWY vaccine, and when is it offered? (3)

Answer 15

The MenACWY vaccine is offered to:

• Teenagers
• Sixth formers
• “Fresher” students going to university for the first time

Question 16

What’s re the common non-specific symptoms of meningitis ? (9)

Answer 16

•Fever
•Vomiting/nausea
•Lethargy
•Irritability/unsettled behaviour
•Ill appearance
•Refusing food/drink
•Headache
•Muscle ache/joint pain
•Respiratory symptoms/signs or breathing difficulty

Question 17

What are common non-specific symptoms of bacterial meningitis in children and young people?

Answer 17

Fever, vomiting, irritability, and upper respiratory tract symptoms.

Question 18

Why is bacterial meningitis difficult to distinguish from viral infections in children?

Answer 18

Because the symptoms are often non-specific and similar to those of viral infections.

Question 19

What increases the likelihood of bacterial meningitis or meningococcal septicaemia?

Answer 19

The presence of more specific symptoms such as stiff neck, usual skin colour (pale), shock/hypertension, leg pain, unconsciousness, seizures etc

Question 20

What classical signs of bacterial meningitis may be absent in infants?

Answer 20

Neck stiffness, bulging fontanelle, and high-pitched cry.

Question 21

What factors should be taken into account when assessing bacterial meningitis in children?

Answer 21

1. Level of parental or carer concern
   
   2. Speed of progression of the illness
   3. Overall severity of the illness

Question 22

What is the ‘glass test’ ?

Answer 22

The rash usually starts as small, red pinpricks before spreading quickly and turning into red or purple blotches. It does not fade if you press the side of a clear glass firmly against the skin.

Question 23

What complications can bacterial meningitis cause? (7)

Answer 23

•Can cause sepsis (blood poisoning) = life-threatening
•Permanent damage to brain or nerves
•Hearing or vision loss
•Problems with memory/concentration
•Epilepsy
•Movement problems
•Loss of limbs

Question 24

What should you do if meningitis is suspected?

Answer 24

• Call 999 for an ambulance or go to the nearest A&E immediately, Do not wait for all symptoms or a rash to appear.

Question 25

How is meningitis confirmed and differentiated in secondary care?

Answer 25

• Confirm meningitis with tests, Determine whether it is viral or bacterial.

Question 26

What is the immediate treatment for meningitis while waiting for test results?

Answer 26

• Begin prophylactic empirical antibiotics (e.g., IV/IM benzylpenicillin).

Question 27

How is viral meningitis managed?

Answer 27

• Self-limiting: Usually resolves within 7-10 days, Manage at home with supportive care.

Question 28

How is bacterial meningitis managed? (3)

Answer 28

Requires hospitalization for at least 1 week:

Treatment includes:

• IV antibiotics
• IV fluids
• Oxygen (O2) support.