Meningitis: Management Flashcards
What investigations does NICE suggest in someone who has suspected meningitis?
- Full blood count
- CRP
- Coagulation screen
- Blood culture
- Whole-blood PCR
- Blood glucose
- Blood gas
- +/- Lumbar puncture (As long as there is no raised ICP)
What should be given in a pre-hospital setting if meningococcal disease is suspected?
When should it not be given?
IM Benzylpenicillin
Don’t give it will delay transit to hospital
What antibiotics does the BNF recommend if meningococcal disease is suspected?
IV Benzylpenicillin or cefotaxime
What antibiotics does the BNF recommend if pneumococcal disease is suspected?
IV Cefotaxime
What should the initial therapy be for children < 3 months old?
IV Cefotaxime & Amoxicillin
What should the initial therapy be for patients 3 months to 50 years?
IV cefotaxime
What should the initial therapy be for patients >50 years?
IV Cefotaxime and Amoxicillin
What should be offered if someone has a penicillin or cephalosporin allergy/
Chloramphenicol
What 2 things should be offered to household and close contacts of patients affected with meningococcal meningitis?
1/ Oral ciprofloxacin or rifampicin
2/ Meningococcal vaccination/Booster doses if already had the vaccine in infancy.
Between Ciprofloxacin and Rifampicin, which does the HPA say is the drug of choice?
Ciprofloxacin
When is risk highest for a close contact to become infected?
First week.
Is prophylaxis is needed for pneumococcal meningitis?
Generally no…unless there is a cluster of cases. If so HPA have a protocol for Abx prophylaxis.