Meningitis + encephalitis Flashcards
Categories of CNS infections
- encephalitis: infections of parenchyma
- meningitis: infections of meninges
What is the triad of meningism?
Headache
Neck stiffness
Photophobia
Presentation of meningitis
- triad of meningism with fever
- joint pain
- meningococcal non blanching rash
- reduced GCS
- flu like symptoms
Presentation for babies in meningitis
- listen to parents
- inconsolable crying/high pitched
- reduced feeds
- floppy
- bulging fontanelle
What commonly causes meningitis rash?
Meningococcal meningitis/septicaemia
Describe meningeal rash
Non balancing
Often on trunk, legs, mucous membranes, conjunctivae
What is meningitis commonly due to in neonates?
E. coli
Group B streptococcus
Listeria monocytogenes
What is meningitis commonly due to in children?
Haemophilias influenzae type B
Neisseria meningitidis
What is meningitis commonly due to in eldery?
Streptococcus pneumoniae
Listeria monocytogenes
Risk factors of meningitis
- CSF defects e.g. spina bifida
- spinal procedures e.g. surgery, lumbar puncture
- diabetes
- alcoholism
- endocarditis
- splenectomy
- crowded housing
Pathophysiology of meningitis
- nasal commensals enter circulation > bacteraemia
- damages vessel walls in brain + meninges
- allowing pathogens to enter subarachnoid space
- pathogen multiply rapidly > purulent CSF + meningeal inflammation
- cerebral oedema + raised ICP
Complications of meningitis
- septic shock
- disseminated intravascular coagulation
- coma
- seizures
- hearing loss
- hydrocephalus
- focal paralysis
What is Kernig sign?
- supine patient with thigh flexed at 90°
- extension of knee met with resistance
What is Brudzinki’s neck sign?
When neck is flexed there is involuntary flexion of knees and hips
What are two tests signs of meningitis?
Kernig sign
Brudzinski
