Meningitis SR

Question 1

Symptoms of meningitis

Answer 1

Headache
Photophobia
Neck stiffness
Drowsiness

Question 2

Symptoms of systemic inflammatory response

Answer 2

Fever
Drowsiness
Septic shock
Rash

Question 3

Investigation

Answer 3

CSF
Blood cultures
Throat swab
Blood to detect bacterial DNA by PCR

Question 4

Meningococcal menigitis

Answer 4

presence of rash!

Neisseria mengitidis

Question 5

Complement is triggered by

Answer 5

1. antibodies bound to bacteral components

2. bacterial sugars bound to an immune protein called mannose binding lectin

Question 6

Immune evasion/ survival factors

Answer 6

1. can have 14 different polysaccharide capsules which prevents formation of complement attack complex
2. GNA1870 binds factor H which downregulates complement
3. Type 4 pili bind c4 binding protein which cleaves the c3 convertase
4. releases blebs of LPS which acts as a decoy
5. porA also binds C4BP
6. avoids immune system by expressing host structures: diff LPS that has identical structure to human blood group antigen

Question 7

Management

Answer 7

1. IV antibiotics (penicillin)
2. resuscitate
3. blood cultures when IV line sited
4. transfer to hospital
5. investigations
6. pain relief, fluids, IV antibiotics
7. droplet precautions
8. prophylaxis to contacts

If viral,

1. reassurance
2. analgesia
3. recover at home usually

Question 8

Drugs

Answer 8

1. cefazolin, cephalexin (oral)
2. cefuroxime, cefaclor (oral)
3. ceftriaxone, ceftazidime
4. cefepime, cefpirome
5. ceftaroline

Question 9

Management of septic shock

Answer 9

1. maintain organ function - IV fluids, oxygen etc

2. resolve infection - antibiotics, surgery, etc