Meningitis Flashcards
Whats is meningism
Triad of
Headache
Photophobia
Painful neck –> cant flex it
What are the causes of bacterial meningitis
It is usually secondary to bactaeremic illness
Neisseria meningitidis (meningococcal septicemia) and Strep. pneumoniae most common in west
Listeria
Mycobacterium tuberculosis
Staph. aureus
What are the causes of viral meningitis
Enteroviruses (echo, Coxsackie, polio) mumps influenza Herpes simplex varicella zoster Epstein–Barr HIV
What other causes of meningitis are there
Fungi
protzoa and parasites
non-infective (sterile) causes
Malignancy
SLE
sarcoidosis
What is the commonest cause of meningitis
viral meningitis
How does viral meningitis present
Usually affects children and young adults
acute headache, irritability and meningism
what is the most severe Sx of viral meningitis
The headache
How to investigate Viral meningitis
LP for CSF - increased lymphocytes
glucose normal
protein normal or maybe elevated
Management of viral meningitis
Symptomatic control
usually will be relieved with time (Usually complete recovery within days)
How does bacterial meningitis present
headache, neck stiffness, drowsiness, and fever
with meningococcal meningitis usually will have at least 2 of the following:
● Fever
● Altered consciousness
● Purpuric rash - nonblanching
● Neck stiffness
What can pneumococcal meningitis be associated with
Pneumonia
Which occurs especially with older patients, acloholics, and Px with splenectomy.
How to investigate bacterial meningitis
CT:
when there is signs of drowsiness, seizures
Before LP (risk of coning if LP done when there is raised ICP)
Bloods cultures, PCR of blood, CSF
LP
what is coning
herniation of brain down the foramen magnum
What is CSF
cerebrospinal fluid
Management of bacterial meningitis
Bacterial meningitis give parenteral ABx immediately and admitted to hospital.
Give broad intially then specific after CSF investigation.
Adjunctive corticosteroid therapy is useful in children and adults.
