Meningitis Flashcards
Definition of Meningitis
Inflammation of the leptomeningeal (pia mater and arachnoid) coverings of the brain, most commonly caused by infection.
When to act now in meningitis
Headache, pyrexia, neck stiffness, altered mental status:
If any 2 co-exist and not yet in hospital, give benzylpenicillin 1.2g im/iv before admitting
Presenting symptoms of Meningitis
Severe headache, photophobia, neck or backache, irritability, drowsiness, vomiting, high-pitched crying or fits, clouding of consciousness, fever.
Careful history should include travel and exposure history: exposure to rodents (lymphocytic choriomeningitis virus), ticks (e.g. Lyme borrelia, Rocky Mountain spotted fever), mosquitos (West Nile virus, St. Louis encephalitis virus), sexual activity (HSV-2, HIV, syphilis), travel (C. Immitis, A. Cantonensis) and contact with other individuals with viral exanthems.
Signs of meningitis on physical examination
Signs of meningitis: photophobia, neck stiffness
Kernig’s sign: With hip flexed, pain/resistance on passive knee extension
Brudzinski sign: flexion of hips on neck flexion
Signs of infection: fever, tachycardia and hypotension, skin rash (petechiae with meningococcal septicaemia), altered mental state
Epidemiology of meningitis
Variation according to age, geography, social conditions.
UK public health laboratory service receives 2500 notifications per year.
More common in recent visitors to the Haj (meningococcal serogroup W135), epidemics occur in the meningitis belt of Africa (meningococcal serogroup A)
