Meningitis Flashcards
meningitis in simple terms
Inflammation of the meningeal lining of the brain and spine.
the meninges
Protect the brain from injury and infection.
Organs that comprise the CNS- brain and spinal cord are covered by three connective tissue layers called the meninges:
- Pia mater (closest to the brain and spinal cord)
- Arachnoid
- Dura mater
cerebrospinal fluid
- Flows within the subarachnoid space beneath the arachnoid membrane
- Maintains constant pressure inside skull- intracranial pressure
how is CSF produced
by the choroid plexus
- plasma is filtered from the blood by epithelial cells to produce CSF
characteristics of CSF
- Clear
- Plasma-like fluid
- Contains glucose and some protein
- Few or no cells (cells likely to be lymphocytes)
patient risk factors
- Extremes of age
- Diabetes mellitus
- Chronic kidney failure
- Immunosuppression
• Cancer
• HIV
• Immunosuppressants
bacteria that most often cause meningitis
- Neisseria meningitidis
- Streptococcus pneumoniae
- Haemophilus influenzae
virus that most often cause meningitis
Cocsackie viruses A and Be
Herpes: HSV 1 and 2
fungus that most often cause meningitis
cryptococcus
Viral meningitis is the most
common and least serious type.
patient symptoms
- Non-blanching purpuric rash (using glass or tubler test)
- Stiff neck (nuchal ridigity)
- Confusion
- Photophobia
- Drowsiness
- Increased pulse rate
- Aching muscle and joints
- Being sick
- Headache
mechanism of infection
When pathogen gets into your bloodstream from your sinuses, ears or throat. Pathogen travel through. Bloodstream to brain.
Haemophilus influenza and Meningococcal meningitis can spread via respiratory droplets
prevention
vaccinations
Men A
Men B
Men ACWY
prophylaxis
for people who have been in close contact
to get a CSF culture
lumbar puncture
how to take a lumbar puncture
- Spinal cord ends at L1, below this level the nerve roots of the cauda equina float in CSF
- Needles passed between the spinous process of two adjacent lower lumbar vertebrae to enter the spinal canal by puncturing the dura
- Small amount of CSF remove and sent to lab
normal CSF
- clear
- WBC <5 CELLS/UL
- protein <0.4
- GLUCOSE 2.6-4.6 mol/l
bacteria CSF
- often cloudy
- increased WBC >5-500
- neutrophils dominant
- increased protein
- low glucose
tuberculous meningitis
- clear/ cloudy
- increased WBC 5-1000
- lymphocytes
- moderate protein increase
- glucose normal/ slightly decreased
viral meningitis
- clear
- increased WBC 5-1000
- lymphocytes
- moderate protein increase
- glucose normal
fungal meningitis
- clear/cloudy
- increased WBC 5-500
- lymphocytes
- protein increased
- glucose low
antibiotics
ceftriaxone (cephalosporin) IV 2g every 12 hours
if pt severely ill
do not wait for lumbar puncture give ceftriaxone
outcome of infection
- Brain swelling
- Permanent disability
- Coma
- Death
- Sepsis
- Complete resolution
