Meningitis Flashcards
empirical therapy for suspected meningitis in child aged 0 -3 months ?
IV cefotaxime + amoxicillin
empirical therapy for suspected meningitis in 3 months - 50 yrs ?
IV cefotaxime
empirical therapy for suspected meningitis in adults aged > 50yrs ?
IV cefotaxime + amoxicillin
treatment for confirmed meningitis caused by neissieria meningitides (meningococcus) ?
IV benzylpenicillin or cefotaxime
treatment for confirmed meningitis caused by streptococcus pneumonia (pneumococcus) ?
IV cefotaxime
treatment for confirmed meningitis caused by haemophilia influenzae ?
IV cefotaxime
causative organisms for meningitis in neonates - 3 months?
group B streptococcus
e.coli
listeria monocytogenes
causative organisms for meningitis in children aged 3 months - 6 yrs ?
neissiseria meningitis
streptococcus pnuemoniae
haemophilus influenzae
causative organisms for meningitis in children 6 years and older ?
neisseria meningitis
streptococcus pneumonia
causative organisms for meningitis in adults ?
neissieria meningitis
streptococcus pneumoniae
listeria monocytogenes (in adults > 60yrs)
LP features of bacterial meningitis ?
cloudy appearance
protein (> 1g/l)
glucose < 1/2 plasma
WCC: neutrophils
LP features of viral meningitis ?
cloudy/clear appearance
protein normal or raised
glucose 60-80% plasma
WCC: lymphocytes (15-100)
LP features of fungal meningitis ?
cloudy appearance
protein high
glucose low
WCC: lymphocytes (20-200)
meningitis is a complication of what infection ?
mumps (paramyxovirus)
treatment for confirmed meningitis caused by listeria ?
IV amoxicillin + gentamicin
describe the managing of contacts when there is a confirmed case of meningitis ?
all household members and close contacts should be offered prophylaxis
all close contacts within 7 days before symptom onset should be offered prophylaxis
prophylaxis = oral ciprofloxacin or rifampicin
vaccinations should be offered to all close contacts and boosters for those who received vaccine in infancy
prophylaxis isn’t required if meningitis caused by streptococcus pneumonia
why are patients with meningitis given steroids ?
IV dexamethasone given to prevent neurological sequelae
i.e. sepsis, hydrocephalus, raised ICP, epilepsy, abscess etc
what neurological sequel can occur following meningitis ? how is this prevented ?
IV dexamethasone given to all patients to prevent this
sensorineural hearing loss (most common)
sepsis, intracranial abscess
epilepsy, migraine
hydrocephalus, herniation
treatment of choice for meningitis if patient is penicillin or cephalosporin allergic ?
chloramphenicol
