Meningitis Flashcards
define meningism
symptom complex of: headache photophobia vomiting muscle spasm
what can meningism be caused by?
> meningitis
subarachnoid haemorrhage
infection by bacteraemia
viral infection
define meningitis
infection of the meninges
what are the main causes of bacterial meningitis?
> Neisseria meningitidis
> streptococcus pneumonia
what are the main causes of bacterial meningitis in neonates?
> e. coli
> group b streptococci
what enteroviruses cause meningitis?
> echovirus
parechoviruses
coxsackie a and b viruses
polio
what other viruses can causes meningitis?
> mumps
> herpes simplex
what non-infection causes of meningitis are there?
> tumour
drug reactions
sacrcoidosis
in shunt associated meningitis would you expect the course to be low or high grade?
low grade
what signs and symptoms may meningitis present with?
> vomiting > headache > photophobia > neck stiffness > fever > altered consciousness
in what patients may meningitis presentation be subtle?
> elderly
neonates
infants
immunocompromised
for how long are signs and symptoms present in acute meningitis?
less than 24 hours and rapidly progressive
in subacute meningitis how long would you expect signs and symptoms to be present for?
1-7 days
what are the risk factors for meningitis?
> skull trauma
alcoholism
diabetes mellitus
contact with an infected person
what is kernigs sign?
this is when the patients hip is flexed and they cannot straighten their leg due to hamstring spasm
if there is papilledema/focal signs what should you do before taking a lumbar puncture?
a head ct
name that meningitis: CSF findings: > turbid appearance > cell number greatly increased > neutrophils are predominant cell > glucose is reduced > protein is greatly increased
bacterial meningitis
Name that meningitis CSF findings: > clear/turbid appearance > lymphocytes are the predominant cell > normal glucose > moderately increased protein
viral meningitis
Name that meningitis CSF findings > clear-turbid appearance > mixed cell type/lymphocyte > reduced glucose > greatly increased protein
tuberculosis meningitis
what would a xanthochromic specimen suggest?
a subarachnoid haemorrhage
what antibiotics would you give to treat acute bacterial meningitis?
> BENZYLPENICILLIN (4 hour regular doses)
> ceftriaxone
what management reduces death rate in acute bacterial meningitis?
> AB prophylaxis of close contacts > rapid detection of the pathogen > early clinical recognition > rapid initiation of antibiotic therapy > early recognition and management of septicaemia and sequelae
what predisposing factors exist for neonatal meningitis?
> low birth weight
prolonged rupture of the membranes
maternal diabetes mellitus
