Meningitis

Question 1

What are the most common bacterial organisms?

Answer 1

Meningococcus
Pneumococcus
H. Influenza
Listeria monocytogenes

Question 2

What viruses can cause it?

Answer 2

HSV

VZV

Question 3

What is affected by the infection?

Answer 3

Meninges

Question 4

What are the early symptoms of meningitis?

Answer 4

Headache
Leg pain
Cold hands and feet

Question 5

Early signs of meningitis?

Answer 5

Non blanching petechial rash

Question 6

Late features of meningitis?

Answer 6

Meningism

Reduced GCS
Seizures (30%)
Focal CNS signs

Question 7

What is meningism?

Answer 7

Neck stiffness
Photophobia
Kernig’s +

Question 8

What are late signs of meningitis?

Answer 8

Galloping sepsis

Question 9

What is galloping sepsis?

Answer 9

Slow cap refill
Low BP and high HR
Pyrexia

Question 10

Initial investigation BEFORE meningitic investigations?

Answer 10

Blood and throat swab cultures if deemed time

CT Head in reduced consciousness

Bloods

Question 11

Meningitic investigations?

Answer 11

LP if CT okay

• Measure opening pressure
• WILL BE RAISED IN MENINGITIS

Question 12

Pharma treatment in signs of no sepsis?

Answer 12

Ceftriaxome if <55yrs

+ Amoxicillin if >55yrs
+ Vancomycin if indicated

Dexamethasone

Aciclovir for viral

Question 13

What should be given to those closely contacted with the person?

Answer 13

Prophylaxis

Question 14

Findings on LP in bacterial meningitis?

Answer 14

• Increased opening pressure
• High cell count (mainly neutrophils)
• Low glucose
• High protein

Question 15

Findings on LP in viral meningitis?

Answer 15

• Normal/increased opening pressure
• High cell count (mainly lymphocytes
• Normal glucose
• Slightly increased protein