Meningitis Flashcards
What is Meningitis?
Inflammation of the meninges of the brain. Can be caused by bacterial/viral/fungal
What type of bacteria is Neisseria meningitidis?
Gram negative diplococcus
What three bacteria can cause Meningitis in adults and children?
- Neisseria meningitidis
- Haemophilus influenza (less common due to intro of vaccine)
- Streptococcus Pneumoniae / pneumococcus
What bacteria can cause meningitis in pregnant women and the elderly?
Listeria monocytogenes. Found in cheese, why it is avoided in pregnancy.
What can be the cause of meningitis in neonates?
- Escheria coli
- Group B haemolytic streptococcus (eg strep agalactiae)
Found within vagina
What type of bacteria can cause meningitis in the immunocompromised?
- Cytomegalovirus
- Cryptococcus neoformans (fungi)
- TB - mycobacterium tuberculosis
- HIV
- Herpes simplex virus
Give two examples of direct spread meningitis?
- Ears
- Nasopharynx
- Cranial injury
- Congenital meningeal defect
How does Neisseria meningitidis present in acute bacterial meningitis?
- Petechial rash (pinpoint round red spots)
- Signs of sepsis
What are the risk factors for meningitis?
- Intrathecal (into spinal canal) drug administration
- Immunocompromised
- Elderly
- Pregnant
- Bacterial endocarditis
- Crowding (eg military base)
- Diabetes
- Malignancy
- IV drug abuse
What is the classic triad presentation in meningitis?
- Headache
- Neck stiffness
- Fever
How does acute bacterial meningitis present?
- Sudden onset
- Papilloedema
- Bilateral
- Can occur over hours to weeks
- Caused by raised ICA (check)
- Intense malaise, fever, rigors, severe headache, photophobia and vomiting - within hours or minutes
- Neck stiffness, positive kernig’s and brudzinski’s sign can appear within hours
- Seizures and focal CNS signs
Progressive drowsiness, materialising signs and cranial nerve lesions indicate complication eg venous sinus thrombosis, severe cerebral oedema or cerebral abscess
