Meningitis

Question 1

Px

Answer 1

Non blanching purpuric/petechial rash usually means meningococcal septacaemia. Only get rash in septacaemia.

Question 2

Mx

Answer 2

A to E
Abx and maybe IV dex if over 3 mnth and if susp strep- ceftriaxone 2g IV immed, then twice daily for adult.
IV fluids
Oxygen
Isolate for 24hr
Inform infectious disease for transfer to isolation cubicle
Inform ITU

Question 3

ix

Answer 3

Bloods- FBC, UE, gluc, LFT, CRP, clotting, ABG, HIV serology
Blood culture
Swab cult eg throat, skin lesion, aspirate
LP
ETDA sample to micro for meningococcal and pneumococcal PCR

Question 4

Neisseria meningitidis

Answer 4

Droplet transmission, requires LT contact
Peak in under 5yo, and again at 15-19
Prodrome- malaise, pyrexia, vom
Symps- headache, stiff neck, photophobia, drowsy, confus, petechial rash in 80%
LT complics- hear loss, sev vis impair, comm probs, seiz, brain damage, limb loss.
Mx- abx, fluids, ?intubation as risk PO.

Question 5

LP

Answer 5

20-20000 WBC/mm^3 nut predom
Prot over 100mg/dl
Low gluc under 2mmol/L