Meningitis Flashcards
(22 cards)
Define meningitis
the inflammation of the meninges. The meninges are the lining of the brain and spinal cord.
Common bacteria for bacterial meningitis in children
- Neisseria meningitidis (meningococcus)
- Streptococcus pneumoniae (pneumococcus)
Common bacteria for bacterial meningitis in neonates
group B strep (GBS)
Neisseria meningitidis gram staining
gram-negative diplococcus
Common causative virus for viral meningitis
- HSV
- VZV
- Enterovirus
Meningitis Ix
- LP
- Blood cultures
- BT for meningococcal PCR
- CSF for viral PCR
Suspected meningitis Mx
Intravenous or intramuscular ceftriaxone or benzylpenicillin
Special tests for meningitis
Kernig’s test
Brudzinski’s test
Positive Kernig’s sign
Knee Extension –> pain + cannot fully extend
Positive Brudzinski’s test
Neck flexion –> Knee flexion
Meningitis clinical presentations in children
- Fever
- Neck stiffness
- vomiting
- headache
- photobia
-
non-blanching rash
stiff neck, altered mental state (confusion, delirium and drowsiness, impaired consciousness), non-blanching rash, back rigidity, bulging fontanelle (in children younger than 2 years of age), photophobia, Kernig’s sign, Brudzinski’s sign, coma, paresis, focal neurological deficit, and seizures
Meningitis clinical presentations in neonates
- Hypotonia
- Poor feeding
- Lethargy
- Hypothermia
- Bulging fontanelle
- floppy
- Tachycardia
- Tachypnoea
Meningitis complications
- Hearing loss is a key complication
- Seizures and epilepsy
- Cognitive impairment and learning disability
- Memory loss
- Cerebral palsy with focal neurological deficits such as limb weakness or spasticity
- meningococcal septicaemia
contraindication for LP in meningitis
Raised ICP
what can LP lead to in raised ICP
brain herniation
what is required to rule out a raised ICP before a LP is performed
CT head
Meningitis close contact Mx/Tx
PO Ciprofloxacin
Bacterial Meningitis VS Meningococcal Disease
Bacterial Meningitis: Strep pneumoniae, Haemophilus influenzae
Meningococcal Disease: Specific to N. meningitidis infections
what RED flags Sx should make you suspect meningococcal
Rapid progressive Haemorrhagic, non-blanching rash with lesions larger than 2 mm (purpura)
Bacterial VS Viral meningitis CSF findings
Bacterial meningitis: Cloudy, elevated open pressure, >1000 WBC, elevated Protein >200, low glucose < 40
Viral Meningitis: Clear, normal open pressure, WBC (lymphocytes predominant), less protein, normal glucose
Meningitis MX for patitents with ceftriaxone or penicillin allergies
DO NOT give Abx
