Bacterial Meningitis

Question 1

• Is an acute inflammation of the CNS.
• is a serious and potentially life-threatening infection of the
protective membranes (meninges) that surround the brain and spinal
cord

Answer 1

Bacterial meningitis

Question 2

are 3 layers of membranes that cover and protect the
brain and the spinal cord.

Answer 2

Meninges

Question 3

is, as the name implies, an infection of the cerebral
meninges

Answer 3

Meningitis

Question 4

The most common bacteria that cause meningitis on newborns are: 3 kabilog

Answer 4

• Group B Streptococcus
• E. Coli
• Listeria Monocytogenes

Question 5

The most common bacteria that cause meningitis on child and adults are:

Answer 5

• Streptococcus pneumoniae
(pneumococcus)
• Neisseria meningitidis
(meningococcus)
• Haemophilus influenzae
type b (Hib) – less common
now due to vaccines

Question 6

A major cause of meningitis in newborns is

Answer 6

group B streptococci

Question 7

can spread to other newborns in the hospital
nursery if good handwashing technique is not used.

Answer 7

Group B streptococcal infection

Question 8

With the early onset form, _________ become apparent in the first
few hours of life.

Answer 8

symptoms of pneumonia

Question 10

can result in either an early-onset or a late onset illness.

Answer 10

Colonization

Question 11

The late-onset type leads to ________ instead of pneumonia. Late onset
neonatal meningitis, occurring between 7 and 28 days after birth.

Answer 11

meningitis

Question 12

Late onset
neonatal meningitis, occurring between 7 and 28 days after birth.

Answer 12

7 and 28 days after birth.

Question 13

occurs in an
epidemic form and is the only form readily transmitted to others.

Answer 13

Meningococcal (epidemic cerebrospinal) meningitis

Question 14

Meningococcal (epidemic cerebrospinal) meningitis is transmitted by

Answer 14

droplet infection from nasopharyngeal
secretions

Question 15

Although it may develop at any age, the risk of
meningococcal infection increases with the number of contacts;
therefore it occurs predominantly in ____ & ____

Answer 15

school-age children and
adolescents.

Question 16

Clinical manifestation of Bacterial Meningitis
Children and Adolescents

Answer 16

1. Usually abrupt onset
2. Fever
3. Chills
4. Headache
5. Vomiting
6. Alteration in sensorium
7. Seizures (often the initial sign)
8. Irritability
9. Agitation
10. May develop:
    • Photophobia
    • Delirium
    • Hallucinations
    • Aggressive behavior
    • Drowsiness
    • Stupor
    • Coma
11. Nuchal rigidity
    o May progress to opisthotonos
    o Positive Kernig and Brudzinski signs.
12. Hyperactive but variable reflex responses
13. Signs and symptoms peculiar to individual organisms

Question 17

What are the 2 signs if there’s a Presence of meningeal irritation:

Answer 17

Kernig and Brudzinski sign

Question 18

extension of leg causes spasm of the
hamstring, pain, and resistance when child is in supine
position with thigh and knee flexed to right angle

Answer 18

Kernig’s sign

Question 19

flexion of head causes flexion of
knees and both thighs at the hips.

Answer 19

Brudzinski’s sign

Question 20

Clinical manifestation of Bacterial Meningitis
Children and Adolescents

13. Signs and symptoms peculiar to individual
    organisms: 3 kabilog

Answer 20

• Petechial or purpuric rashes (meningococcal
infection), especially when associated with a
shock like state
• Joint involvement (meningococcal and H.
influenzae infection)
• Chronically draining ear (pneumococcal
meningitis)

Question 22

Clinical manifestation of Bacterial Meningitis
Infants and young children 9 kabilog
• Classic picture (above) rarely seen in children between 3 months and 2 years of age

Answer 22

1. Fever
2. Poor feeding
3. Vomiting
4. Marked irritability
5. Frequent seizures (often accompanied by a high-pitched cry)
6. Bulging fontanels
7. Nuchal rigidity may or may not be present
8. Brudzinski and Kernig signs are not helpful in diagnosis.
   o Difficult to elicit and evaluate in this age group
9. Subdural empyema (H. influenzae infection).

Question 23

Clinical manifestation of Bacterial Meningitis
Neonates: specific signs
11 kabilog

Answer 23

1. Extremely difficult to diagnose
2. Manifestations vague and nonspecific
3. Well at birth but within a few days begins to look and behave poorly
4. Refuse feedings
5. Poor sucking ability
6. Vomiting or diarrhea
7. Poor tone
8. Lack of movement
9. Weak cry
   10.Full, tense, and bulging fontanel may appear late in course of illness
   11.Neck usually supple

Question 24

Clinical manifestation of Bacterial Meningitis
Neonates: non-specific signs that may be present
8 kabilog

Answer 24

1. Hypothermia or fever (depending on the maturity of the infant)
2. Jaundice
3. Irritability
4. Drowsiness
5. Seizures
6. Respiratory irregularities or apnea
7. Cyanosis
8. Weight loss

Question 25

Diagnostic/Laboratory evaluation nga ginahimo if ang baby may bacterial meningitis 4 kabilog

Answer 25

Lumbar puncture Blood tests Ct scan or MRI Nose and throat or rectal swabs

Question 26

is the definitive diagnostic test, this is the only test that diagnoses meningitis

Answer 26

Lumbar puncture

Question 27

this can help diagnose infections that cause meningitis

Answer 27

Blood tests

Question 28

these are tests that show images of the brain. To examine brain abscess.

Answer 28

Ct scan or MRI

Question 29

is sometimes done to look for other conditions that may cause similar symptoms as meningitis.

Answer 29

Ct scan

Question 30

may show inflammatory changes in the meninges. These tests give more information. But meningitis can’t be diagnosed using these tests alone

Answer 30

MRI

Question 31

These tests help diagnose viral infections that cause meningitis.

Answer 31

Nose, throat or rectal swabs

Question 32

Therapeutic management of bacterial meningitis 10 kabilog

Answer 32

1. Isolation precautions 2. Initiation of antimicrobial therapy 3. Maintenance of optimum hydration 4. Maintenance of ventilation 5. Reduction of increased ICP 6. Management of bacterial shock 7. Control of seizures 8. Control of temperature extremes 9. Correction of anemia 10. Treatment of complication

Question 33

Prognosis: • Important factors in determining the prognosis:

Answer 33

1. Age of the child 2. Type of organism 3. The severity of the infection 4. The duration of the illness before the onset of the therapy 5. Sensitivity of the organism to antimicrobial drugs

Question 34

are most commonly seen when the disease occurs in the first 2 months of life and least often in children with meningococcal meningitis

Answer 34

Sequelae

Question 35

Preventions Vaccines are key: 4 kabilog

Answer 35

• Meningococcal vaccine • Pneumococcal vaccine Hib vaccine preventive antibiotics

Question 36

o It is given to children 11 to 12 years old, with a booster given at 16 years old o Vaccination is also recommended for all adolescents ages 13 through 18 years who did not receive a dose at age 11-12 years

Answer 36

Meningococcal vaccine

Question 37

oGiven as routine vaccination(recommended for everyone) oThis vaccine is recommended for all children beginning at 1 ½ months – 2 months (for 3 doses with 1 month interval per dose

Answer 37

Pneumococcal vaccine

Question 38

protects against Haemophilus influenzae type b, a bacterium that can cause serious infections, especially in young children. Before the vaccine, Hib was the leading cause of bacterial meningitis in children under 5.

Answer 38

Hib vaccine

Question 39

was the leading cause of bacterial meningitis in children under 5.

Answer 39

Hib

Question 40

Myriad of general symptoms can occur such as:

Answer 40

o Sudden cardiovascular shock o Seizures oNuchal rigidity o Apnea

Question 41

CSF results indicative of meningitis include:

Answer 41

o Increased white blood cells and protein levels o Increased ICP oGlucose level less than 60% of blood glucose

Question 42

If the meningitis is caused by haemophilus influenzae, the child may develop _____

Answer 42

Septic arthritis

Question 43

How many days Children usually have had ____:____ days of upper respiratory tract infection prior to the development of meningitis.

Answer 43

2-3 days

Question 44

If the child has had close association with someone with tuberculosis, a __________ test to rule out tuberculosis meningitis will be done.

Answer 44

tuberculin test

Question 45

are needed to identify the causative organism. Sa bacterial meningitis under ni sya sa lumbar puncture

Answer 45

Culture and stain

Question 46

DIIN NGA L TO L KAG HOUR GINA BUTANG ANG EMLA cream is a topical (skin) cream that contains the active substance lidocaine and prilocaine. It is used as local anesthetic to prevent pain during medical or surgical procedures.) applied to the skin overlying ______hour before lumbar puncture, reduces pain for children under going this procedure

Answer 46

L3 to L5 1 hour

Question 47

may be administered to reduce ICP and help prevent hearing loss

Answer 47

Dexamethasone or mannitol

Question 48

the steroids work by decreasing the swelling (inflammation) and reducing pressure that can build up in the brain. Steroids also reduce the risk for hearing loss and brain damage

Answer 48

Corticosteroids medicine

Question 49

Initial therapeutic management: under sa 8. Control of temperature extremes for best results in babies and toddlers up to 3 years of age. This method is naccurate and gives a quick reading of the baby’s internal temperature

Answer 49

Rectally

Question 50

Initial therapeutic management: under sa 10. Treatment of complication for children who develop disseminated intravascular coagulation syndrome

Answer 50

Heparin therapy