Meningitis/Encephalitis Flashcards
What should be done before a lumbar puncture in suspected meningitis/encephalitis?
Do antibiotics
Administering antibiotics before a lumbar puncture is crucial in managing suspected cases of meningitis or encephalitis.
List four indications for doing CT before LP in suspected meningitis/encephalitis.
- Focal neurologic signs
- Seizure
- Papilledema, or the optic fundi cannot be visualized
- Confusion that interferes with neurologic exam / reduced Glasgow score
These indications help assess the risk of intracranial mass lesions.
Why is CT performed before LP in certain scenarios?
To assess the risk of intracranial mass lesion
If LP is performed with an existing mass lesion, it could lead to herniation and death.
What is the empiric treatment for meningitis?
Ceftriaxone + vancomycin
Steroids can be added if Streptococcus pneumoniae is confirmed.
What combination of antibiotics is recommended for Group B Strep in meningitis in neonates?
- Ampicillin + gentamicin
- Ampicillin + cefotaxime
The combination of vancomycin + ceftriaxone is incorrect for Group B Strep in neonates.
Which cephalosporin is generally preferred for neonates?
Cefotaxime
Ceftriaxone is usually avoided in neonates due to its adverse effects.
Why is ceftriaxone avoided in neonates?
It displaces bilirubin from albumin, increasing the risk of neonatal hyperbilirubinemia
Ceftriaxone can also cause calcium deposits in the lungs and kidneys.
What complication can meningitis cause in children?
Sensorineural hearing loss
This is a critical point to remember, especially in pediatric assessments.
What is the next best step for a child with a history of meningitis and academic difficulties?
Air-conduction audiometry
This test evaluates hearing loss, in contrast to tympanometry, which assesses tympanic membrane mobility.
