Paediatric Infectious Diseases 3 Flashcards
When is meningitis?
A disease caused by inflammation of the meninges
What is meningism?
The clinical signs and symptoms suggestive of meningeal irritation
What are the signs and symptoms of meningitis in young infants?
- Fever or hypothermia
- Poor feeding
- Vomiting
- Lethargy
- Irritability
- Respiratory distress
- Apnoea
- Bulging fontanelle
What are the signs and symptoms of meningitis in older children?
- Fever
- Headache
- Photophobia
- Neck stiffness (nuchal rigidity)
- Nausea & vomiting
- Reduced GCS
- Seizures
- Focal neurological deficits
What is nuchal rigidity?
Palpable resistance to neck flexion
What is Brudzinski’s sign?
Hips and knees flex on passive flexion of the neck
What is Kernig’s sign?
Pain on passive extension of the knee
What are the causes of childhood meningitis?
- Viral – Mainly Enterovirus (54-88%)
- Bacterial (4-18%)
- Fungal – Neonates/Immunocompromised
- Unknown/aseptic (40-76%)
What are the causes of bacterial meningitis in the neonate (<1 month)?
- Group B Streptococcus
- Escherichia coli
- Listeria monocytogenes
SAME AS SEPSIS
What are the causes of bacterial meningitis in older infants and children?
- Streptococcus pneumoniae
- Neisseria meningitidis
- Haemophilus influenzae type b (Hib)
SIMILAR TO SEPSIS
Descibe Haemophilus Influenzae
- Small, non-motile, gram-negative coccobacillus
- Nasopharyngealcarriage
What are the 2 types of H. Influenzae?
- Encapsulated H.influenzae
- Resist phagocytosis & complement mediated lysis
- 6 serotypes (a-f)
- Hibmain cause of invasive H. influenzae infection
- Bacteraemia, Meningitis, Epiglottitis, Pneumonia
- RF–asplenia, sickle cell disease, antibody deficiency
- Non-encapsulated = Non-typeable H.influenzae (NTHI)
- Otitis media & sinusitis
- Invasive infection rare
