Nervous system infections

Question 1

What are examples of nervous system infection?

Answer 1

Meningitis
Meningococcal septacaemia

Question 2

What is meningitis?

Answer 2

Inflammation of two inner meninges (Pia and arachnoid mater) of brain and spinal cord

Causes are infective( bacterial/ fungal/viral) or non-infective ( cancers, autoimmune disorders, drugs)

Most common in babies and children

Question 2

What are two different type of bacterial meningitis?

Answer 2

Meningococcal disease is infection with Neisseria meningitidis

Pneumococcal disease is infection streptococcus pneumoniae.

Question 3

How would you manage suspected bacterial meningitis with non-blanching rash?

Answer 3

IMMEDIATE; Parenteral benzylpenicillin

DOSAGE:

<1= 300mg
1-9 yrs= 600mg
Adults and children 10 years= 1200mg

history of rash with penicillins is not contraindicated

but do not use IF ANAPHYLAXIS reaction to penicillin

Question 4

How would you manage suspected bacterial meningitis without a non-blanching rash

Answer 4

Urgent 999 call to transfer to hospital
Do not give parenteral ABx unless urgent transfer to hospital is not possible then you’d give;

benzylpenicillin, cefotaxime, or chloramphenicol.

Question 4

Meningitis
What treatment would be given once the patient is in hospital?

Answer 4

Fluids to prevent dehydration
ABX- cefotaxime
ceftriaxone
chloramphenicol
Oxygen if needed
steroid to reduce swelling around brain