Pediatric Bacterial Meningitis Flashcards
BM - Organisms Affecting Neonates
GBS
E. coli
L. monocytogenes
Klebsiella
BM - Organism Affecting Children 1-23 Months of Age
S. pneumoniae
N. meningitidis
H. influenzae
E. coli
BM - Organism Affecting Children over 2 yo
N. meningitidis
S. pneumoniae
BM - Risk Factors for Neonates
preterm birth
low birthweight
chorioamnionitis
maternal endometritis
maternal GBS
traumatic delivery
urinary tract abnormalities
BM - Risk Factors in Children
asplenia
primary immunodeficiency
HIV
sickle cell anemia
cochlear implant
CSF leak
recurrent URIs
daycare attendance
prior exposure
penetrating head trauma
lack of immunizations
BM - Presentation in Infants
poor feeding
vomiting
fever
seizures
irritability
lethargy
bulging fontanelle
BM - Presentation in Children
fever
headache
lethargy
vomiting
myalgia
photophobia
stiff neck
seizures
confusion
BM - Diagnosis
history
physical exam
CSF analysis
blood cultures
BM - CSF analysis
> 1000 WBC/mcL
45 mg/dL protein
< 40 mg/dL glucose
positive bacterial culture
BM - Empiric Treatment for Neonates
ampicillin + aminoglycoside
OR
ampicillin + cefotaxime
BM - Empiric Treatment for Children 1-23 Months of Age
vancomycin + cefotaxime or ceftriaxone
BM - Empiric Treatment for Children over 2 yo
vancomycin + cefotaxime or ceftriaxone
BM - Dexamethasone Use
purpose to decrease hearing loss in patients with H. influenzae colonization
not recommended in neonates
adjunctive therapy 10-20 min before first dose of antibiotics
BM - Dexamethasone Dose
0.15 mg/kg/dose IV every 6 hrs for 2-4 days
BM - Dexamethasone Indications
H. influenzae - recommended
S. pneumoniae - consider if high risk of mortality
Gram-negative organisms - not recommended
