Meningitis Flashcards
What are the causes of meningitis?
Bacterial Viral Sarcoid Drugs Malignancy
What are the most common causes of bacterial meningitis?
Neisseria meningitides
Strep. pneumonia
Neonates= GBS, listeria monocytogenes
What are the common viral causes of meningitis?
HSV
VZV
Enterovirus
What is the presentation of meningitis?
Classic= fever, neck stiffness, altered consciousness
Headache, photophobia
N&V
Non blanching rash-meningococcal septicaemia
What is the presentation of meningitis in neonates?
Bulging fontanelle
Non specific- fever, poor feeding, hypothermia, hypotonia
When is non blanching rash seen?
Meningococcal septicaemia
What investigations are done for meningitis?
Meningeal irritation LP Blood cultures Meningococcal PCR if suspected CT/MRI if LP contraindicated
What is seen on LP in bacterial meningitis?
Increased opening pressure
High neutrophils
Reduced glucose
High protein
What is seen on LP with viral meningitis?
Normal to increased opening pressure
High lymphocytes
Normal glucose
Slightly raised protein
What is Kernig’s sign?
Hip and knee flexed to 90 degrees, straightening leg –> spinal pain and resistance to movement
What is Brudzinski’s sign?
Flexion of neck will cause flexion of hips and knees
What are some contraindications to LP?
GCS <9
Haemodynamically unstable
Active seizures
What is the management of bacterial meningitis suspected in the community?
Stat IM benzylpenicillin and transfer to hospital
What is the management of bacterial meningitis in a <3month old?
IV amoxicillin/ampicillin and cefotaxime
What is the management of bacterial meningitis?
IV cefotaxime/ceftriaxone
Dexamethasone
(+ vancomycin if recent foreign travel )
