Meningoencephalitis Flashcards
What vaccine should you inquire about in a child with fever and headache
Pneumococcal
Meningococcal
Hemophillus
Influnza
What are the signs in the of active meningitis
- 6th nerve palsy
- cushing triad
- brudznski and kernig
- neck stiffness
Petchieal rash occur in which type of meningitis
Nisseria meningitidis
Meningococcemia
Why is the meningitis present with lethargy and intact level of consciousness
Because it doesn’t affect the parenchyma.
What are the symptoms seen in encephalitis not in meningitis?
- hallucinations
- photophobia
- change in personality & agression
What is the most common bacterial meningitis in children >3m - 14 yeaes
Strep pneumonia.
> Nisseria > hemophillus
How does strep pneumonia usually present under the microscope?
Gram positive diplococci
How does nisseria usually present under the microscope?
Gram negative diplococci
Why do we have to do brain CT before LP?
To avoid herniation if there’s incresae IOP
- hydrocephalus
- midline shift
- space occupying leison
Where to insert needle in lumbar puncture?
L3-L4 or L4-L5
What is the normal WBC in the CSF analysis
5-7. 20 in newborn.
What is the normal protein in CSF
In the 60s
What is the normal glucose in CSF in LP?
50% of serum
When to start antibiotics for the patient with meningitis?
Immediately because it’s life saving
What antibiotics should you give and for how long for meningitis in child aged >3m
strep pneumonia 14 days - nisseria 7 to 10 - h. Influnza 7 days
By 3rd generation cephalosporin + vancomycin.
What is the role of adjunctive dexamethasone therapy in meningitis
Showed benefits in early treatment
Reduce hearing loss
What are the late complications of meningitis
- decrease hearing loss (most common)
- paralysis or seizure
- intellectual difict
- ataxia
- hydrocephlaus
- ..
Are health care workers at high risk for meningitis?
Not, unless there’s direct mucosal contact
What is chemoprophylaxis if one is exposed to meningitis?
Rifampin or cefatrixone
Only in nisseria and hemophillus
What is the golden hour between the antibiotic and CT
2 hours
What is the most dangerous encephalitis organism?
Herpes simplex
What is the most common organism to cause encephalitis
Enterovirus (non-polio)
Physical signs of encephalaitis
- neurological: hemiparesis, involuntry movement, sizures etc..
- rash and fever.
What are the acute phase reactants that are positive in encephalitis?
Procalcitonin negative - CRP is positive
