Meningitis Flashcards
What is the definition of meningitis?
This is inflammation of the meninges
What cells are seen in the CSF of meningitis?
White cells
What is the pathology of meningitis?
Attachment to the mucosal epithelium, transgression of barrier, survival in the bloodstream, entry into CSF production of overt infection +/- encephalitis
What is the most common cause of meningitis in children and young people?
Neisseria Meningitides
What is the most comm causative organism in adults?
Streptococcus Pneumonaie
What other bacteria can cause meningitis?
H.Influenzae
Listeria monocytogenes
E.coli
Strep pyogenes
What viruses can cause meningitis?
Enterovirus
Mumps
HSV
What fungus can cause meningitis?
Cryptococcus
What are the key symptoms of meningitis?
Headache Neck stiffness Photophobia Nun-blanching purpuric rash Nausea and Vomiting Fever LOC Cranial Nerve palsies 6,7,8 Tachy/bradycardia Hypotension
What is the examination test to do in meningitis?
Kerning’s Sign = hip flexed and the patient can’t straighten their leg du to hamstring spasm
What are the 2 key investigations in meningitis?
Lumbar puncture
Blood cultures
If the CSF shows the following, what type of meningitis is present?
Clody, low glucose
High protein
Polymorphs
Bacterial
If the meningitis is viral in origin then what is the CSF results?
Usually clear
High glucose
Protein can be normal or raised
Mononuclear
If the CSF results show this then what type of meningitis is present? Slightly cloudy or fibrin web Mononuclear Low glucose High protein
Tuberculosis
What is the initial management of meningitis?
Benzylpenicillin 4hrly
If the meningitis is confirmed bacterial, then what antibiotic will you use?
Ceftriaxone
What additional medication will you use?
Dexamethasone - reduces long term complications
What are the associated conditions with meningitis?
Recent Skull Trauma
Alcoholism
DM
If a family member has also recently had meningitis then what is the MORE likely cause?
Meningococcal
What antibiotic covers Listeria monocytogenes?
Ampicillin
What medication will cover the viral causes of meningitis?
Aciclovir
What medication will cover the fungal causes of meningitis?
Amphotericin with Fluconazole
What are 4 common causes of NEONATAL MENINGITIS?
Group B streptococcus
E.coli
Listeria Monocytogenes
Enterovirus
What are the symptoms of neonatal meningitis?
Onset within 3 days of birth Prematurity Failure to thrive Problems ending Bacteraemia Respiratory distress Acquired at birth form mothers genital tract
Whta is the treatment of bacterial neonatal meningitis?
Parental AMPICILLIN and GENTAMICIN or CEFOTAXIME
What is the prevention options for meningitis?
AMOXICCILLIN or CO-AMOXICLAV for high risk mothers
What is the mortality for neonatal meningitis?
50%
What is PURPURA in the febrile child diagnosed as until proven otherwise?
Bacterial meningits
What is a cynical feature of meningitis in the child regarding the head?
Bulging fontanelle
