Meningitis

Question 1

what would we see in blood (bacerial meningitis)

Answer 1

high WBC
low haemoglobin
low platelets due to trying to stop bleeding from septicaemia causing damage to blood vessels

high d-dimers and plasmin to prevent life-threatening clotting–> DIC

Question 2

what would we see in bacterial.M CSF

Answer 2

high neutrophils (yellowy exudate)
high protein
low glucose

Question 3

3 main bacterial causes

Answer 3

neisseria meningitidis (negative,diplocci)
streptococcus pneumonia (positive, diplocci)
haemophilius influenza B (negative,bacillus)

Question 4

tests for bacterial meningitis

Answer 4

tumblers

brudzinki’s neck

Question 5

2 types of hydrocephalus

Answer 5

communication - blocking the foramina in 4th ventricle

non-communicating - scar tissue blocking arachnid granulations

Question 6

main causes of viral meningitis

Answer 6

enteroviruses
mumps+ measles
herpes

Question 7

difference between bacterial and viral

Answer 7

bacterial = more dangerous

viral = tumblers test (blanching as no septicaemia)
moderate lymphocytes (high neutrophils in bacteria) in CSF

Question 8

what would you do if you suspected someone of meningitidis

Answer 8

give penicillin IV to prevent septicaemia (–>DIC–>Limb amputation)
and use antigen detection tests (PCR/latex agglutination assay)

OR

take CSF sample

• gram stain
• look at shape
• protein/WBC/glucose levels

blood sample

• presence of bacteria = septicaemia
• culture bacteria to confirm exact bacteria

Question 9

criteria for outbreak

Answer 9

2 confirmed cases from same serotype
within a defined group
all arising within 4 week period

Question 10

what prophylaxis is given in outbreak

Answer 10

2 x rifampicin for close

1 x ciproflaxcin if close contact <2yrs

NOT penicillin

Question 11

who do you give prophylaxis to if sporadic event

Answer 11

prolonged close contact irrespective of vaccination

transient close contacts/direct exposure to large particle droplets/secretions of resp tract