meningitis Flashcards
what usually precedes a viral meningitis?
is neck stiffness reliable in children?
- pharyngitis or GI upset
- no, should treat with a very low threshold
what symptom might indicate a bacterial meningitis?
what is common in infants?
- drowsiness
- a reduction in the level of consciousness is a SERIOUS sign
- meningeal cry
- convulsions may be the presenting feature
what might you do in examination of meningitis?
- kernigs and brudzinskis
- look for rashes
- bulging fontanelle in neonates
why is it important to do blood glucose as well as CSF glucose?
what should be done with the lumbar puncture?
- to compare how much difference and see if bacterial
- analysis of white cells
- cloudiness
- glucose
- must be cultured to identify what organism
what is the treatment of bacterial meningitis?
viral meningitis?
what else should be done?
- IV cefotaxime
- steroids
- supportive
- give rifampicin to all those who have been in close contact
how quickly will a baby develop symptoms of meningitis?
- 6 hours becomes drowsy and purpuric rash
what complications may you get in a child with bacterial meningitis?
- hydrocephalus
- subdural effusion
- deafness
what kind of viral meningitis would you normally treat wth antivirals?
- herpes simplex meningoencephalitis
what type of meningitis might cause sensorineural hearing impairment?
- viral mumps meningitis
what is the most likely cause of neonatal meningitis? (3)
- Group B strep
- E.coli
- Listeria
what is the organism responsible for meningococcal septicaemia?
where does it usually colonise?
who might get vaccinated against it?
- N. meningitides
- nasal flora
- quad vaccine for adolescents going to uni
what investigations would you do?
how can you confirm it is caused by n.meningitids?
- ABCDE
- BUFALO/ sepsis 6
- Bloods: FBC, CRP, U&Es, renal function, LFTs
- PCR of pharyngeal swab
- lumbar puncture
what blood results would you see/ test for if you suspected DIC?
- prothrombin time (PT) and activated partial thromboplastin time (aPTT) elevated
- low platelets and fibrinogen
how should you treat this in the community?
- start on benzylpenicillin or cefotaxime
how do you reduce cerebral oedema in those with raised ICP?
what do you give for DIC?
- dialysis, haemofiltration
- anticoagulants
- corticosteroids
