Microbiology Flashcards
types of meningitis
- acute pyogenic (bacterial)
- acute aseptic
- viral
- acute focal suppurative infection (abscess, empyema)
define meningitis
inflammation of the meninges that line the brain
normal CSF
white cells <5
red cells 0
protein 150-450mg/ml
glucose 0.6
what do neutrophils in the CSF indicate?
bacterial meningitis
what do lymphocytes in the CSF indicate?
aseptic or viral meningitis
how can bacterial meningitis be spread?
nasopharyngeal colonisation
direct extension (fracture)
remote foci
bacterial cause of meningitis
listeria group B strep E. coli H. influenza neisseria meningitis strep pneumonia TB cryptococcal
presentation of meningitis
fever stiff neck photophobia headache altered consciousness rash (non-blanching, petechial rash with tumbler test)
RF for meningitis
immunocompromised
head trauma/ surgery
cribriform plate fracture
diagnosis of meningitis
CT
lumbar puncture (not in raised ICP so rule out with CT)
antigen tests, PCR, blood culture, coag screen
swab throat and petechial rash lesions for microscopy and culture
management of bacterial meningitis
ceftriaxone IV 2g bd (or chloramphenicol) + dexamethasone
if listeria= IV amoxicillin added
recent travel to country with penicillin resistance then add vancomycin
prevention of secondary cases of meningitis
report to public health
GPs informed
alert for 6 months
prophylaxis regimes for bacterial meningits
rifampicin or ciprofloxacin
aseptic meningitis CSF
low WBC
minimally elevated protein
normal glucose
what time of year is viral meningitis common?
late summer/autumn (freshers)
