Meningitis Flashcards
What are bacterial causes of meningitis?
Neisseria meningitidis - meningococcal
Streptococcus pneumoniae - Pneumococcus
What are bacterial causes of meningitis only in neonates?
E.coli
Group B streptococci
What viruses can cause meningitis?
Enteroviruses
Mumps
Herpes simplex virus
What fungi can cause meningitis?
Cryptococcus neoformans
What are symptoms of meningism?
Headache
Photophobia
Neck stiffness
(Vomiting)
What are symptoms of bacterial meningitis?
Meningism symptoms
Lethargy
Clouding of consciousness
Fever
What cranial nerves may have palsy in meningitis?
VI
VII
VIII
What are associated risk factors for meningitis?
Recent skull trauma
Alcoholism
Diabetes mellitus
Exposure to recently infected people
What are general features in examination of meningitis?
Is the patient pyrexial
Assess levels of consciousness
Conjunctival petechiae
Rashes
What are CVS features of examination of meningitis?
Tachycardia/bradycardia
Blood pressure - hypotension suggests septic shock
What signs can be demonstrated in meningitis?
Kernig’s sign
Flex the neck to attempt to touch chin to chest - difficult with neck stiffness
What is Kernig’s sign?
Patient’s leg can’t be straightened with flexed hip due to hamstring spasm
How is meningitis diagnosed?
Lumbar puncture
What tests should be done on CSF in meningitis?
Gram stain/culture Differential cell count Antigen detection test Glucose level Protein level
What are normal CSF findings?
Clear appearance Small numbers of cells Predominant cell type is lymphocytes Normal glucose - 60% of blood level Normal protein
What are bacterial meningitis CSF features?
Turbid appearance Greatly increased cell count Predominant cell type is neutrophils Reduced glucose Greatly increased protein
What are viral meningitis CSF features?
Clear to turbid appearance Moderate increase in cells Predominantly cell type is lymphocytes Normal glucose level Moderate increase in protein
Where do bacteria causing bacterial meningitis typically originate?
Nasopharynx colonisation
What antibiotics are used for bacterial meningitis?
Benzypenicillin
Ceftriaxone
What type of rash is seen in meningococcal meningitis?
Petechial
What is fulminant meningococcal septicaemia?
Suddenness of symptoms with rapid deterioration in consciousness, fever, systemic shock, renal failure, and DIC
What are bad prognostic markers for meningococcal disease?
Delay of antibiotics Extremes of age Purpuric lesions Hyperpyrexia >40 DIC Metabolic acidosis
