Meningitis & Encephalitis Flashcards
Meningitis
An infection of the protective membranes that surround the brain and spinal cord (meninges).
What are the signs of Meningitis?
- headache
- fever
- nausea/vomiting
- photophobia
- drowsiness
- seizures
- neck stiffness
- purpuric rash (particularly with invasive meningococcal disease)
Features of CF analysis in bacterial meningitis
Cloudy
Low glucose
High protein
10 - 5,000 polymorphs/mm³ WBCs
Features of CSF analysis viral meningitis
Clear/cloudy
60-80% of plasma glucose
Normal/raised protein
15 - 1,000 lymphocytes/mm³ WBCs
Features of CSF analysis in Tuberculous meningitis
Slight cloudy, fibrin web
Low glucose
High (> 1 g/l) protein
10 - 1,000 lymphocytes/mmm WBCs
Should a lumbar puncture be performed in meningitis?
Only if no signs of raised intracranial pressure
What is the management of meningococcal disease in pre-hospital settings?
Intramuscular benzylpenicillin may be given, as long as this doesn’t delay transit to hospital.
Intravenous dexamethasone should be given to all suspected meningitis patients unless the following is present; what are they?
- septic shock
- meningococcal septicaemia
- immunocompromised
- meningitis following surgery
Management of meningitis in a < 3 month old patient
Intravenous cefotaxime + amoxicillin (or ampicillin)
Management of meningitis in a 3 month to 50 year old patient
Intravenous cefotaxime (or ceftriaxone)
Management of meningitis in a over 50 year old patient
Intravenous cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin)
Management for Meningococcal meningitis
Intravenous benzylpenicillin or cefotaxime (or ceftriaxone)
Management for Pneumococcal meningitis
Intravenous cefotaxime (or ceftriaxone)
Management of Meningitis caused by Haemophilus influenzae
Intravenous cefotaxime (or ceftriaxone)
Management of Meningitis caused by Listeria
Intravenous amoxicillin (or ampicillin) + gentamicin
