Meningitis_in_Children_Flashcards

Question 1

What are contraindications to lumbar puncture in suspected meningitis?

Answer 1

Focal neurological signs, papilloedema, significant bulging of the fontanelle, DIC, and signs of cerebral herniation (raised ICP).

Question 2

Should lumbar puncture be performed in meningococcal septicaemia?

Answer 2

No. It is contraindicated. Instead, obtain blood cultures and PCR for meningococcus.

Question 3

What is the antibiotic treatment for suspected meningitis in children under 3 months?

Answer 3

IV amoxicillin (or ampicillin) + IV cefotaxime.

Question 4

What is the antibiotic treatment for suspected meningitis in children over 3 months?

Answer 4

IV cefotaxime (or ceftriaxone).

Question 5

When should corticosteroids be avoided in meningitis treatment?

Answer 5

In children younger than 3 months.

Question 6

When should dexamethasone be considered in meningitis treatment?

Answer 6

If CSF shows purulence, WBC > 1000/µL, raised WBC with protein > 1 g/L, or bacteria on Gram stain.

Question 7

How is shock managed in meningitis?

Answer 7

With fluids, e.g. colloid resuscitation.

Question 8

What should be done in cases of respiratory impairment in meningitis?

Answer 8

Cerebral monitoring and mechanical ventilation.

Question 9

What is the public health approach for meningitis contacts?

Answer 9

Notify public health authorities and provide antibiotic prophylaxis with ciprofloxacin (preferred over rifampicin).