meningitis/encephalitis Flashcards
meningitis organisms Newborns Infants Toddler to 6 years old Teenagers and young adults Adults
Newborns – Group B Strep
Infants – E. coli
Toddler to 6 years old – Haemophilus influenzae
Teenagers and young adults – Neisseria meningitidis
Adults – Streptococcus pneumoniae (70% of all cases are caused by Strep pneumo)
70% of all meningitis in adults are caused by what
strep pneumo
1 of all meningitis in teens are caused by what
neiserria
common organism in meningitis
- newborns
- infants
GBS
ecoli
Fever Headache Vomiting Stiff neck Confusion
bacterial meningitis
what special finding in a Neisseria infection
Petechial rash
bacterial meningitis sx
Fever Headache Vomiting Stiff neck Confusion
Lumbar puncture results for bacterial meningitis
- fluid appearance?
- pressure?
- WBC
- protein
- glucose
Cloudy fluid. Normal is clear and colorless
Elevated pressure
Elevated WBCs from about a normal of 5 up to 10,000 during infection
Protein is elevated. Normal is 15-60. During infection the range is 100-500
Glucose is decreased. Normal is about 60% of serum glucose. During infection it may be below 40
**Cultures and Gram stain
meningitis symptoms plus altered mental status, papilledema, focal neuro deficits
- what to do next?
CT to rule of a space occupying lesion
diagnostic test for meningitis
Cultures and Gram stain
Vaccination for meningitis prevention
H. Flu
Neisseria meningitidis
Strep pneumonia
Testing pregnant woman at ___ weeks for group B strep.
Testing pregnant woman at 35-37 weeks for group B strep. Treat GBS positive moms with penicillin during labor.
meningitis tx for neonates and infants up to 3 months
Neonates: ampicillin and cefotaxime; or ampicillin/gentamicin/cefotaxime
infants up to 3 months receive same combo but higher doses of cefotaxime or ceftriaxone
meningitis tx for immunocompetent children older than 3 months of age
and adults younger than 55 yrs of age
cefotaxime or ceftriaxone plus vancomycin
meningitis tx
if it is hospital acquired, post-traumatic, post neurosurgery meningitis, or pt is immunocompromised
ampicillin plus ceftazidime plus vancomycin
when is dexmathasone recommended
in adults with meningitis secondary to s pneumo and in kids older than 1 month of age with meningitis secondary to Hib
common viruses in meningitis
enteroviruses(coxsackie virus, echovirus), herpes simplex
presents with an acute confusional state, especially in kids and young adults
viral meningitis
rash, pharyngitis, adenopathy, pleuritis, carditis, jaundice, organomegaly, diarrhea
particular causal agent in viral meningitis
encephalitis features (3)
markedly altered consciousness, seizures, personality changes
viral meningitis CSF
- pressure
- WBC
- protein, glucose, serum blood counts
pressure nml
WBC less than 1000
all nml
herpes tx for viral meningitis
acyclovir
mycobacterium TB
fungi(cryptococcus, cocidioides, histoplasma)
spirochetes(treponema pallidum, borrelia burgdorferi)
granulomatous meningitis
granulomatous meningitis incidence in who
immunocompromised
granulomatous meningitis non infectious causes
sarcoidosis and other granulomatous conditions
granulomatous meningitis presentation
less acute; sx for wks to months
subtle mental status changes
granulomatous meningitis CSF
high protein, low glucose, lymphocytosis
granulomatous meningitis CT or MRI
marked enhancement of meninges, especially hydrocephalus
