Meningitis Flashcards
What are the symptoms of meningitis?
1) headache
2) neck stiffness
3) fever
4) altered mental state
What are the early signs of bacterial meningitis?
- intense malaise
- fever
- rigors
- severe headache
- photophobia
- cold hand and feet
- abnormal skin colour
- vomiting
- irritable
- prefers to lie still
What are the later signs of bacterial meningitis?
- *symptoms develop very quickly
- neck stiffness
- +ve kernig’s sign
- acute septicaemic petechial rash develops quickly
- slow cap refill
- low BP
- high temp
- fast pulse
What are the very late signs of bacterial meningitis?
- low conscious level
- coma
- seizures
What are the differentials for meningitis?
-subarachnoid haemorrhage
-migraine
-malaria
-encephalitis
-
What patient groups are most at risk of meningitis?
-immunocompromised e.g. HIV
What organism causes symptoms of a petechial rash?
Neisseria meningitidis
How is streptococcus pneumoniae most likely to cause meningitis?
- via skull fracture
- ear disease
Who does group B strep cause meningitis in?
neonates
What type of bacteria cause meningitis in neonates?
- group B strep
- Gram -ve bacilli e.g. Ecoli
What 2 bacteria account for 70% of acute bacterial meningitis cases outside of neonates?
- N meningtides
- strep pneumonia
What are the viral causes of meningitis?
- Enterovirus (coxsackie)
- Herpes (varicella zoster)
- CMV
- EBV
- HIV, poliomeyelitis, mumps
what invx should be done for meningitis?
1) bloods - FBC, U+Es, LFTs, glucose, coag screen
2) blood culture (septicaemic meningtides)
3) Throat swab
4) Stool sample (virus)
5) LUMBAR PUNCTURE (don’t do if raised ICP)
6) CT scan
What is the management of meningitis if outside of hospital?
IV / IM Benzylpenicillin
TRANSFER TO HSP
What is the treatment for septicaemic miningitis
Cafotaxime 2g IV
