Meningitis Flashcards
What are the most common causative bacterial organisms?
Neisseria Meningitidis (gram -ve diplococcus)
Streptococcus pneumoniae (gram +ve diplococcus)
Listeria Monocytogenes
Haemophilus Influenzae
Streptococcus Group B - esp. in neonates from birth canal
What are the most common viral causes of meningitis?
Entervirus*
Coxsackie virus
Who must be notified when there is a case of meningitis?
Notify the proper officer who will notify Public Health England -> allows for contact tracing and provides data for epidemiological studies
What are early clinical features of meningitis? (mins-hrs)
headache Leg pains cold hands and feet abnormal skin colour fevers neck stiffness
What are the late clinical features of meningitis?
MENINGISM: Reduced GCS Neck stiffness Photophobia Kernig's sign (pain and resistance on passive knee extension with hip fully flexed) Brudzinski's sign papilloedema SEIZURES (~20%) +/-focal CNS signs PETECHIAL RASH ( non-blanching) (only in bacterial)
What investigations are done for meningitis?
- blood cultures (do before LP)
- Abx
- bloods - U&E, FBC, CRP, serum glucose, lactate
- LP
- head CT scan
- throat swabs
- pneumococcal and meningococcal serum PCR
- lumbar puncture
When would you CT before LP?
- age > 60
- immunocompromised
- CNS history
- new onset/recent seizures
- decreas(ed/ing) conscious level
- focal neurological signs
- papilloedema
what is the management of bacterial meningitis?
•CEFOTAXIME (2g/6hr IV)
add Amoxicillin if risk of listeria (e.g. if >55, immunocompromised, history of alcohol excess)
Add steroids (dexamethasone) in pneumococcal meningitis to reduce rates of hearing loss/short term neurology/mortality
Consider vancomycin in return travellers
What are the strains of meningococcal meningitis
A, B, C, W, X, Y
What are the most common strains of neisseria meningitidis?
MenB
MenC
Where are meningococcal bacteria carried?
carried in human nasal passage
How does viral meningitis present differently to bacterial?
no rash , generally less severe,
How long does viral meningitis last for?
usually around 4-10 days
What is the treatment for viral meningitis?
Usually supportive measures
Can give acyclovir if severe
When is prophylaxis given for meningitis?
For those who have been in contact with patient with meningitis
