meningitis Flashcards
what re the clinical manifestation of meningitis ?
headache - bursting in nature
stiff neck
kerning sign -supine position
inability to extend the knee with the hip flexed
brudzinski sign - in supine option
patients hips and knee flex automatically when the examiner flex patients neck
what are the classical symptoms for acute pyogenic bacterial meningitis
fever
nuchal rigidity
altered consciousness specific for bacterial meningitis - due to cerebral edema increased intrcranila pressure also seizures
bacteriaal meningitis therapy depends on what ?
blood culture
lumbar puncture - contradicted if increased intrcranila pressure
CSF examination ESSENTIAL - high amount of neutrophils , protein and glucose
what are the clinical manifestation in meningococcal infection ?
rash
how does meningitis occur ? and what are the four routes in which microbes enter the CNS
hematogenous
from otitis ,media , sinusitis
mastoiditis
direct - from fractures and long malformations
PNS - rabies and herepes zoster virus
what are the responsible organism for meningitis and what are the dependant on ?
dependant on the age
adults - streptococcus pneumonia ,
neisseria meningitides - abrupt onset of symptoms confusion and coma
neonates - ecoli , strep
infants - neisseria meningococcus , h influenza
children - n meningococcus , s pneumonia
what is the treatment of meningococcal infection ?
benzylpenicillin - intravenous
3rd gen cefalopsorins
what is the therapy of tuberculosis ?
pyrazinamide and isonside , rifampicin - given all together for 2 months
then continue with isonisde and rifampicin
what is the meninges made out of ?
dura mater
arachnoid mater
pia mater
if bacterial meningitis is suspected what is immediately started ?
emperic therapy immediately started
how can we differentiate between viral meningitis and bacterial meningitis ?
serum procalcitonin
c reactive protein
in tuberculosis meningitis where is the inflammation present ?
at the base of the skull , forming tuberculoma - granulomatous inflammtion
