Meningitis Flashcards
What is meningism?
A symptom complex characterised by headache, photophobia and vomiting with muscle spasm leading to neck rigidity
Causes of meningism
Meningitis
SAH
Infection accompanied by bacteraemia
What is meningitis?
Inflammation of the meninges
What are the five steps of the pathenogenesis of meningitis?
Attachment to mucosal epithelial cells Transgression of the mucosal barrier Survival in the blood stream Entry into CSF Production of overt infection in the meninges with or without brain infection
Classification of meningitis
Bacterial
Viral
Fungal
Bacterial causes of meningitis
Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae
Viral causes of meningitis
Enteroviruses
Mumps
Herpes simplex virus
Aseptic meningitis causes
Non-infective meningitis
Tumour cells in the CSF
Leptospirosis
Lyme disease
Shunt meningitis
Associated with ventriculo-atrial/peritoneal shunts
Coagulase negative staphylococci (eg, Staph. epidermidis) mostly
Low grade or fulminant
Often requires removal of the shunt & antibiotic therapy
Fulminant
Of severe and sudden onset
Associated illness
Influenza Tonsillitis Pneumonia Sinusitis UTI Any severe bacteraemic illness
Risk factors for associated illness
Recent skull trauma
Alcoholism
DM
Meningococcal meningitis treatment
Parenteral
Benzylpenicillin to start, move onto ceftriaxone if appropriate as it has a narrower spectrum
At the time of discharge, rifampicin or ciprofloxacin to eradicate carriage of N. meningitidis from the nasopharynx
Pneumococcal meningitis treatment
High dose ceftriaxone
Enteroviral meningitis treatment
Symptomatic and recovery usually occurs within 72 hours
Chronic infection treated with IV immunoglobulin
