Meningitis Flashcards
Symptoms
Headache Photophobia Vomiting Fever Clouding of consciousness Muscle spasm leading to neck rigidity (stiff on flexion)
Bacterial class
Neisseria meningitides
Streptococcus pneumonia
Bacteria in neonates
E.coli
Group B strep
Viral class
Enterovirus- echovirus, parechoviruses, coxsackie A and B, poliovirus
Mumps
Herpes simplex virus
Loss common causes
Haemophillus influenza B Listeria monocytogenes Mycobacterium tuberculosis Leptospirosis Borrelia burgdoferi Mycoplasma pneumonia HIV Herpes virus- VZV and EBV
Other types
Aseptic meningitis- tumour cells in the CSF- excessive leukocytes and proteins with no organism
Shunt associated meningitis- ventricle-atrial/peritoneal shunts
Cranial nerve issues
6, 7, 8
Acute vs subacute
Acute= less than 24 hours
Sub-acute is 1-7 days
Investigations
Blood cultures
Lumbar puncture
CSF microbiology- gram stain, cell count, bacteria and virus culture/PCR
CSF biochemistry- glucose and protein
FBC- neutrophils, leukocytes, platelets, clotting, fibrin degradation products
Urea and electrolytes
LFTs
CSF presentation bacterial meningitis
Turbid Greatly increased cells Neutrophils predominant Glucose reduced Protein greatly increased
CSF presentation viral meningitis
Clear to turbid Moderate increased cells Lymphocytes predominant Glucose normal Protein moderately increased
CSF presentation tuberculosis meningitis
Clear to turbid Moderate increased cells Lymphocytes predominant or mixed Glucose reduced Protein greatly increased
Antibiotics over the age of 3 months
IV Ceftriaxone
Antibiotics under the age of 3 months
IV cefotaxime
plus amoxicillin or ampillin
If travelled outside UK
Add vancomycin
