Meningitis

Question 1

Symptoms and signs

Answer 1

Symptoms - Headache, photophobia, neck stiffness, fever.
Worse in mornings, raised ICP signs, rash and seizures.

Signs - Fever, non blanching rash, photophobia, papilloedema, Kurnigs sign.

Question 2

Investigation and management

Answer 2

A to E, fluid resusc if depleted.

Do not delay antibiotics, IV 1g ceftriaxone, +/- amoxicillin if elderly and immunocompromised.

ICU support of raised ICP suspected.

Investigations - Bloods: FBC, UandE, CRP, culture, LFT,

Lumbar puncture - gram stain and culture.

Turbid, low glucose, high WCC.

Contact public health.