Meningitis

Question 1

What are the clinical features of meningitis?

Answer 1

Ongoing fever 
Stiff neck
Headache
Photophobia 
Non blanching rash

Question 2

What bacteria causes meningitis?

Answer 2

Neisseria meningitidis

Gram negative cocci

Question 3

How is meningitis spread?

Answer 3

Direct contact with respiratory secretions

Most people are harmlessly colonised

Question 4

What 3 features does neisseria meningitidis have which aid it and what are the effect on a host?

Answer 4

1. Pilus- enhances attachment
2. Polysaccharide capsule- (has antigen) helps adhesion, protects organism from host’s immune system (prevents phagocytosis)
   Different serogroup depending on the antigen that is there.
3. Endotoxin- released from within the cell, lipopolysaccharide that has the ability to provoke intense inflammatory responses

Question 5

What is the antibiotic given to those with meningitis?

Answer 5

Ceftriaxole (can penetrate CSF)

Question 6

If someone with meningitis gets sepsis what are the potential life-threatening complications?

Answer 6

• irreversible hypotension
• respiratory failure ;give oxygen, monitor blood gases and resp rate
• acute kidney injury (renal failure); monitor function, total up amount of fluid, catheterise patient, measure urine output
• raised intracranial pressure; infection in fluid surround brain, pressure needs to be measure as this has potential to restrict and damage brain, look at back of eye and CT brain (establish size)
• ischaemic necrosis of digits/hands/feet

Question 7

How do we confirm the diagnosis of meningitis?

Answer 7

Culture from patient before antibiotics are given

Use PCR to recover organism- identify pathogen

In order to confirm location of infection; perform lumbar puncture (if safe- don’t want to create vacuum and damage brain-suck brain down and trapped in spinal cord)

Question 8

How is CSF examined in someone who is suspected of having meningitis?

Answer 8

Lumbar puncture performed (if safe)

Look at appearance- turbidity and colour

Microscopy- WBCs and RBCs

Gram stain

PCR?

Question 9

How does N. meningitidis appear in a gram stain?

Answer 9

Gram negative diplococcus - two red/pink balls

Question 10

What is the most common group of N meningitidis found in the UK?

Answer 10

Serogroup B

Question 11

What are the two prevention methods for meningitis?

Answer 11

1. Vaccination

2. Antibiotic prophylaxis