Meningitits

Question 1

Sample used

Answer 1

CSF collected in sterile bottle; requires immediate attention

Rapid gram test can taken to ensure early treatment

Question 2

Gram negative causes of meningits and ager-groups

Answer 2

• Neisseria meningitidis(diplococci)
  
  • infants-young adults
• E. coli (bacilli)
  
  • Neonates
• HiB
  
  • infants (rare though due to vaccination)

Question 3

Gram positive causes of meningitis and age groups

Answer 3

• Strep pneumonia (diplococci)
  
  • Extremes of ages
• Listeria monocytogenes (bacilli)

Question 4

Age groups prone to viral meningits

Answer 4

ALL

Question 5

Characteristics in CSF, bacterial, and viral meningitis

Appearance

Cell types

Protein

Glucose

Answer 5

Question 6

Special adaptations when culturing CSF

Answer 6

• Centrifuged
  
  • Deposit inoculated with blood agar and heated blood agar
  • Incubated in CO2 rich
  • Next day

Question 7

Tests carried out on cultured samples

Answer 7

• PCR for N. meningitidis and Strep. pneumonia
  
  • Useful since instant drug asministration in emningitis may have rendered samples sterile
• Different methods for rare forms
  
  • TB meningitis(all ages) Ziehl-Neelsen film and stain
  • Cryptococcal - India wet ink
  • Trypanosomiasis - giemsa stain

Question 8

Treatment for meningitis:

1. N. meningitis
2. S. Pneumonia
3. H. influenza
4. E. coli

Answer 8

1. Benzylpenicillin
2. Benzylpenicillin or cefotaxime
3. Cefotaxime
4. Cetofaxime (+ gentamycin)

In suspected meningitis, benzylpenicillin should be injected before hospitalization

Viral iself-limiting

Question 9

Vaccines for meningitis

Answer 9

• HiB administered in early life
• Group A and C meningococus
  
  • Poor response in children and infants
• MMR given to all infants against mumps meningitis