meningitis + sepsis Flashcards
CIs to LP in kids
Bleeding - risk, DIC, nb rash, meningococcal septicaemia
Infection at LP site
General - reduced LOC, shock, resp insufficiency
↑ICP - focal seizure/neuro, papilloedema,
BIG-↑(up)
bacterial meningitis / meningococcal septicaemia - management in kids
(prehosp - IM/V benzylpenicillin)
sepsis six: blood cultures + PCR fluids + oxygen catheterise + lactate IV ceftriaxone if >3mo or meningococcal IV cefotaxime + amox if <3mo
Paracetamol if fever distressing Cerebral monitoring IV dex if >3mo + not meningococcus - decreases neuro + hearing risk + cerebral oedema Cipro prophylaxis to contacts Audiology within 4wk of discharge PHE
PCI-CAP
herpes simplex encephalitis - presentation
focal neuro + seizures
decreased LOC
bacterial meningitis - presentation
neck stiff
bulging fontanelle + decreased LOC
convulsive status epilepticus
sepsis - presentation
cold, mottled, pale, blue
^RR
lethargic/hard to rouse
oligouria
meningitis + sepsis - investigations
examination - obs, shock, kernig’s, raised ICP
bedside - gas + lactate + glucose + ECG
blood cultures ± PCR
clotting screen (DIC)
FBC, LFTs, U+Es (dehydration + renal function), CRP
source - urinalysis/MCS, CXR, nasal swab
sepsis - management in kids
sepsis six + monitor Hb
abx - IV ceftriaxone / cefotaxime (as per local GLs)
(ERYHTRO IF PEN ALLERGIC)
sepsis six
3 in: fluids, abx, O2
3 out: catheter, blood cultures, lactate
3 common pathogens for meningitis
s. pneumoniae
n. meningitis
h. influenzae
meningitis in kids - presentation
headache
general - lethargy, fever, vomiting, off feeds
specifics - ± neck stiffness, altered LOC, kernig’s
LP in meningitis in kids - what to do with it
blood glucose before - compare
protein + glucose
MC+S + gram stain
virology
PCR for virology, pneumococcus + meningococcus
repeat - may be normal early on
bacterial meningitis on LP
high neutrophil
low glucose
acute complications of meningitis in kids
sepsis
neuro - seizures, raised ICP, cerebral oedema
haem - anaemia, coagulopathy, DIC
metabolic - disturbance, SIADH
long-term complications of meningitis in kids
hearing + neurological problems
epilepsy
developmental, learning, psychosocial problems
1mo-6y - meningitis organisms in kids
n meningitidis (meningococcus) s pneumoniae (pneumococcus) h influenzae
