Neonatal & Pediatric Meningitis Flashcards
Most common pathogen of pediatric (1-23 months) meningitis?
S. Pneumoniae & Neisseria meningitidis
Risk factors associated with poor outcomes in pediatric meningitis?
Young age
Seizures for longer than 72 hours
Delay in presentation
Need for inotropes/leukopenia
Late onset meningitis?
Bacterial meningitis acquired > 72 hours of life
Caused by a community acquired pathogen
Most common pathogen of pediatric (2-18 years) meningitis?
N. meningitides
How to treat neonatal meningitis?
Ampicillin + gentamicin
OR
Ampicillin + cefotaxime/ceftazidime (Resistant)
How to treat pediatric 1 – 23 months meningitis?
Vancomycin + cefotaxime/ceftriaxone
How to treat pediatric 2 – 18 years meningitis?
Vancomycin + Ceftriaxone
3rd Generation Cephalosporins
Cefotaxime, moxalactam, cefoperazone, ceftizoxime, ceftazidime, cefsulodin, and ceftriaxone
Pathophysiology of Meningitis?
Bacterial meningitis = increased WBCs in CSF & increased permeability of the BBB
Clinical presentation of Meningitis?
FEVER
POOR FEEDING
VOMITING
LETHARGY
APNEA
IRRITBILITY
NUCHAL RIGIDITY
SEIZURES
Bulging fontanelle
Most common presenting symptoms 1 – 5 months old?
Irritability
Most common presenting symptoms of Meningitis 6 - 11 months old?
Impaired consciousness
Most common presenting symptoms of Meningitis > 12 months old
Vomiting
Nuchal rigidity
Presentation of Children & Adolscents w/ Meningitis
NUCHAL RIGIDITY
HEADACHE
PHOTOPHOBIA
(+) KERNIG SIGN
(+) BRUDZINSKI SIGN
Empiric duration of therapy for neonatal meningitis?
14 days (group B streptococcus)
21 days (E. Coli)
