Meningitis

Question 1

Define meningitis.

Answer 1

Bacterial meningitis is a serious inflammation of the meninges caused by various bacteria.

Question 2

Explain the aetiology of meningitis.

Answer 2

Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib) are the predominant causative pathogens in both adults and children.

Question 3

Explain the risk factors of meningitis.

Answer 3

≤5 or ≥65 years of age
Crowding
Exposure to pathogens
Non-immunised infants
Immunodeficiency
Cancer
Asplenia/hyposplenic state
Cranial anatomical defects
Cochlear implants

Question 4

Summarise the epidemiology of meningitis.

Answer 4

The incidence of bacterial meningitis in Western countries and the US is 0.7 to 0.9 per 100,000 persons per year and has decreased by 3% to 4% in the past 10 to 20 years.

Question 5

Recognise the presenting symptoms of meningitis. Recognise the signs of meningitis on physical examination.

Answer 5

Stiff neck
Photophobia
Headache
Fever
Confusion
Vomiting
Non-blanching rash

Question 6

Identify appropriate investigations for meningitis and interpret the results.

Answer 6

LP
FBC
CRP
Blood culture

Question 7

Generate a management plan for meningitis.

Answer 7

Empirical antibiotic therapy

Plus:
Supportive therapy
Dexamethasone

Question 8

Identify the possible complications of meningitis and its management.

Answer 8

Shock
Elevated intracranial pressure
Hydrocephalus
Cognitive, academic, and behavioural problems
Seizures
Subdural effusion
Hearing loss
Brain abscess
Septic deep vein thrombosis

Question 9

Summarise the prognosis for patients with meningitis.

Answer 9

Generally, with prompt and adequate antimicrobial and supportive therapy, the outcome after acute bacterial meningitis is excellent. However, prognosis does depend on multiple factors such as age, presence of comorbidity, causative pathogen, and severity at presentation.