Sepsis & Meningitis Flashcards
Define Sepsis?
Bacteraemi + SIRS:
- Tachypnoea
- Tachycardia
- Fever/Hypothermia
- Leucocytosis/Leucocytopenia
What organisms cause sepsis?
Neonates:
- Group B Strep, E. Coli & Listeria Monocytogenes
Children:
- Pneumococcus, Meningococcus, Group A strep & Staph Aureus
At what age is sepsis most common?
In neonates, gets progressively less from there
How might sepsis look in a kid?
Fever/hypothermia
Chills & rigors
Cold hands/feet + Slow cap refill
Muscle weakness & muscle/joint ache
Rash
Low UO, vomiting & diarrhoea
Sepsis 6 in kids is a bit different, what criteria do we use to spot it?
- Hypotension
- Fever/Hypothermia
- Tachycardia
- Tachypnoea
- Alt Mental Status
- Slow cap refill / poor perfusion / mottled peripheries
Sepsis 6 is a bit different in kids, what are the 6 actions?
- Take Blood cultures
- Give IV resus
- Give IV Abx
- Give Inotropes
- Give O2
Get Senior Help
Meningitis in kids often comes secondary to sepsis, what organisms cause it?
Neonates: (Same as sepsis)
- Group B Strep
- E. Coli
- Listeria Monocytogenes
Children
- Pneumococcus
- Meningococcus
- H. Influenzae
How would meningitis present in a kid?
Older kids will show classic signs such as depressed consciousness, seizures,. focal neuro signs, headaches & photophobia
Neonates will be lethargic, irritable have a bulging fontanelle & “Nappy Pain”
What blood tests would you do in a septic/meningeal child?
FBC CRP Coagulation study Blood gas Glc U&Es + Creatinine
What non-blood tests would you do for septicaemia/meningitis?
LP with antigen testing & PCR
Culture blood, CSF, Urine & skin
Urinalysis
Head CT
What would you expect to see after testing a septic/meningeal child?
FBC - Leucocytosis & thrombocytopenia CRP - Elevated Coag Study - Low due to DIC Blood Gas - Metabolic Acidosis Glc - Hypoglycaemia
CSF - Pleocytosis, high protein & low Glc
How do you treat a child with meningitis?
ABCD & G (glc)
Broad spec Abx - Specifically Ceftriaxone or Cefotaxime (add amoxicillin for neonates)
How can we prevent Meningitis?
With vaccines for:
- Pneumococcus
- Meningococcus
- H. Influenzae
List 3 major complications of pneumococcal meningitis?
Brain damage hearing loss & hydrocephalus
Where can pneumococcal infections occur in the body and what is likely to precede them?
Viral inf tends to predispose to invasive pneumococcal disease.
Can be found:
- Pneumonia
- Meningitis
- Septicaemia
- Otitis Media
- Sinusitis
- Arthritis
- OM
- Peritonitis