Meningitis Flashcards
classic meningitis symptoms
fever headache neck stiffness photophobia nausea/vomiting
encapsulated pathogens?
neisseria meningitis
haemophilus influenza type B
strep pneumoniae
pathogens problem in preg and neonates for meningitis?
strep agalactae
listeria
viral meningitis viruses common
polio, echo, (enteroviruses) HepA, CoxA, CoxB
which is worse? bacterial or viral meningitis?
bacterial
when viral meningitis usually happen?
autumn, winter, lasts 3-4 days, ‘milder’
TB meningitis affects where?
base of brain
hind/mid-brain
clinical signs of meningitis
petechial rash: non-blanching (blood in tissue)–>pupura fulminans–> (DIC)
Kernig’s sign
how to dx meningitis?
LP
when do CT head for meningitis?
reduced conscious state/focal neuro signs
take blood cultures
start ABx and steroids
then CT
then LP if not increase ICP
empirical Rx for bacterial meningitis? when?
Ceftriaxone (good CSF penetration)
Penicillin (listeria)
+ dexamethasone within the hour
normal protein in CSF?
0.4g/dL
normal lymphocytes in CSF?
2 lymphocytes
no neutrophils
if suspect resistant/increase MICs: strep pneumoniae swapped genetics with enterococcus, then what Abxs to use?
vanco
ceftrixone
rifampicin
switch to Penicillin G if susceptible
how to treat N. Meningitis, Listeria?
Penicillin G
