Unit 6: meningitis

Question 1

What are the side effects of benzylpenicillin?

Answer 1

Common: diarrhea, hypersensitivity, nausea, skin reactions, vomiting, thrombocytopenia.
Uncommon: antibiotic-associated collitis

Question 2

What are the recommended dosage of benzylpenicillin according to NICE guidelines for a patient diagnosed with meningitis?

Answer 2

Given IV
Adult: 2.4grams every 4 hours
Neonates: 50mg/kg every 12 hours Or 6-8 if older than 7days
Child: 50mg/kg every 4-6 hours

Question 3

What are some public health campaigns in response to meningitis?

Answer 3

Meningitis Now campiagns:
Adults Get it To - education in adults particularly over 55yrs who may have missed the introduction of MenC vaccine
Beat it Now campaign - successfully introduced MenC to vaccination programme
Meningitis research foundation - give information to new parents on how to spot meningitis in a child.

Question 4

What are the different meningitis vaccines?

Answer 4

1 in 6 vaccine
Meningitis B vaccine
MenACWY vaccine
Meningitis C/Hib vaccine
MMR vaccine
Streptococcus pneumonia vaccine

Question 5

What are the contraindication of a lumbar puncture?

Answer 5

Signs of a raised intracranial pressure
Papiladoma - eyes bulging
Loss of consciousness
Low GCS
Seizures
Respiratory problems

Question 6

What are the complications of a lumbar puncture?

Answer 6

If raised intracranial pressure CSF may continue to leak out of the puncture hole down a pressure gradient
This will decrease protection for the meninges, become more ridged, increase the intensity of headache - termed a spinal headache
May also have temporary backpain and swelling

Question 7

What are the doses of benzylpenicillin used for a suspected meningitis case in the community?

Answer 7

From age 10yrs give 1.2 grams
Between 1-9yrs give 600mg
Younger than 1yr give 300mg

Question 8

What type of vaccine are the different types of meningitis vaccine?

Answer 8

1 in 6 vaccine - inactivated pathogen
Meningitis B vaccine - recombinant (reverse vaccinology)
MenACWY vaccine - conjugate
Meningitis C/Hib vaccine - conjugate
MMR vaccine - attenuated live virus vaccine
Streptococcus pneumonia vaccine - conjugate

Question 9

When should you have each of the different meningitis vaccines?

Answer 9

1 in 6 vaccine - first dose at 8 weeks
Meningitis B vaccine - first dose at 8 weeks
MenACWY vaccine - age 14yrs
Meningitis C/Hib vaccine - 1 yrs
MMR vaccine - first dose at 1yr.
Streptococcus pneumonia vaccine - first dose at 12 weeks

Question 10

How might the composition of CSF change for a bacterial meningitis infection?

Answer 10

Increase wbcs - particularly neutrophils
Decreased glucose
Increased protein
Turgid appearance

Question 11

How might the CSF composition change in a viral meningitis infection?

Answer 11

Clear appearance
increased wbcs - less than bacterial and predmoniantly lymphocytes
Elevates protein but less than bacterial
Glucose level remains normal.