Meningitis

Question 1

Define meningitis.

Answer 1

Inflammation of the meninges surrounding the brain and spinal cord.

Question 2

Name 3 causative microorganisms of meningitis.

Answer 2

E. coli. Group B streptococcus (infants). Haemophilus influenzae (older infants, kids). Neisseria meningitidis (young adults). Streptococcus pneumoniae (elderly).

Question 3

Describe the pathogenesis of meningitis.

Answer 3

Pathogens enter the blood stream, directly from other infection e.g. ottitis media (infection of ear).

Question 4

Give 2 symptoms of meningitis.

Answer 4

Fever. Headache. Nausea. Vomiting. Lethargy.

Question 5

If we investigated the CSF fluid for a patient with meningitis, state 3 things we would find.

Answer 5

Elevated opening pressure. Elevated protein. Reduced glucose. CSF lactate. Pleocytosis (prescence of abnormally large number of lymphocytes in CSF). Bacterial culture of CSF.

Question 6

Give 2 signs of meningitis.

Answer 6

Small haemorrhagic lesion of foot.

Spots are a common feature of meningococcal infections.

Brudziński’s sign: passive neck flexion → pain, involuntary flexion of hips, knees.

Kernig’s sign: resistance to knee extension when hip flexed to 90º.

Jolt accentuation of headache: headache worsens if individual asked to “jolt” head from side to side in horizontal plane

Question 7

What is a purpura?

Answer 7

It’s a small hemorrhage into the skin, mucous membrane or serosal surface. Because purpura is caused by extravasation of blood from the vasculature into the skin it does not blanch with pressure.

Question 8

Meningococcal disease describes what 2 major illnesses?

Answer 8

Meningitis. Septicaemia (blood poisoning).

Question 9

How does purpura present?

Answer 9

Rash (or a small red dot - called petechiae).