Meningitis

Question 1

What are the most common causes of meningitis in neonates?

Answer 1

Group B streptococci, Listeria monocytogenes, E. coli

Question 2

What is the most common cause of meningitis in children and teenagers?

Answer 2

Neisseria meningitidis; occurs through nasal pharynx –> blood –> meninges

Question 3

What is the most common cause of meningitis in adults and elderly?

Answer 3

Streptococci pneumoniae

Question 4

What is the most common cause of meningitis in unvaccinated infants?

Answer 4

Haemophilus influenzae

Question 5

What is the most common viral cause of meningitis?

Answer 5

Coxsackie virus in children- fecal-oral transmission

Question 6

Fungi commonly cause meningitis in which type of individuals?

Answer 6

Immunocompromised patients

Question 7

Which layer does a lumbar puncture not pierce through?

Answer 7

Pia! LP samples CSF in subarachnoid space

Question 8

What complications are seen with bacterial meningitis?

Answer 8

Complications due to:

(1) No room –> herniation –> death
(2) Healing process –> fibrosis –> hydrocephalus, hearing loss, seizures

Question 9

What is the clinical presentation of meningitis?

Answer 9

Classic triad: headache, nuchal rigidity, fever + photophobia, altered mental status, vomiting

Question 10

What should be performed before a LP for meningitis?

Answer 10

CT Scan! To make sure no shifts, masses or abnormalities

Question 11

What treatments are recommended for bacterial meningitis if bacteria is unknown?

Answer 11

Vancomycin + 3rd generation cephalosporin - broad coverage; important to start treatment right away!

Question 12

Vaccines exist for which of the bacteria that cause meningitis?

Answer 12

Haemophilus B, Neisseria meningitidis (for high risk individuals), Strep pneumo (7 and 23 valent) but NOT for E. coli