Pediatric Meningitis Flashcards Preview

Therapeutics III > Pediatric Meningitis > Flashcards

Flashcards in Pediatric Meningitis Deck (27)
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1
Q

what are the 3 membranes of the meninges

A
  1. dura mater
  2. arachnoid space
  3. pia mater
2
Q

what keeps foreign matter out of CSF

A

tight junctions (BBB)

3
Q

when do antibiotics get the best penetration through BBB when trying to treat meningitis

A

when inflammation is present and tight junctions are open wider

4
Q

what is meningitis

A

infection/ inflammation of CSF in subarachnoid space of the brain (most common CNS infection)

5
Q

what is the difference in septic vs. aseptic meningitis

A
septic = bacterial
aseptic = viral (usually HSV)
6
Q

what is the main factor in determining mortality in meningitis

A

time until identified/ treated

7
Q

what are 3 common neurologic disabilities seen in pediatric meningitis

A

seizures, hearing loss, and hydrocephalus

8
Q

why is meningitis most common in pediatrics

A

the blood brain barrier is not fully developed in pediatrics

9
Q

what are some risk factors of meningitis

A

age
gender
immunosuppression
head trauma

10
Q

the pathophysiology of meningitis can lead to what

A
  1. edema
  2. increased intercranial pressure
  3. DIC (dissmeninated intravascular coagulation
  4. SIADH
  5. ischemia
11
Q

what are the 6 classic signs and symptoms of meningitis

A
  1. severe headache
  2. fever/ vomiting
  3. drowsiness/ impaired consciousness
  4. stiff neck (unusual in young children)
  5. dislike of bright lights (unusual in young children)
  6. rash
12
Q

what are the 2 tests done in the ER for meningitis

A
  1. Brudzinski’s sign (legs bend involuntarily when neck bends)
  2. Kernig’s sign (when knees at 90, legs spasm)
13
Q

what is the first step to meningitis management

A
  1. blood cultures
  2. lumbar puncture
  3. start empiric antimicrobial therapy +/- dexamethasone
14
Q

what range of protein in CSF indicates bacterial meningitis?
viral meningitis?

A

bacterial = 80-500

viral =30-150

15
Q

what range of glucose in CSF indicates bacterial meningitis?

A

bacterial = less than 30; or 1/2 serum glucose

bacteria need nutrition

16
Q

what range of WBC in CSF indicates bacterial meningitis?

viral meningitis?

A
bacterial = 400 - 100,000
viral = 5-500
17
Q

what is the most likely pathogen in newborns to 1 month old with meningitis

A
  1. group B strep
  2. E. choli
  3. Listeria (why expecting mothers should avoided unpasteurized cheeses and dairy products)
18
Q

what is the most likely pathogen in people greater than one month old with meningitis

A
  1. N. meningitis

2. strep pneumoniae

19
Q

what is the empiric treatment for bacterial meningitis in newborns, less than 1 month old

A

ampicillin and aminoglycoside
OR
ampicillin and cefotaxime

20
Q

what is the empiric treatment in people greater than 3 months old with meningitis

A

vancomycin AND cefotaxime or ceftriazone

21
Q

what is the most common cause of bacterial meningitis in people older than 1 month

A

neiserria meningitis (meningococcus)

22
Q

what is the most common symptom of meningococcus meningitis

A

rash

23
Q

what are the first choice options for treating N meningitis if PCN MIC is between 0.1-1

A

3rd gen cephalosporin (cefotaxime or ceftriaxone)

24
Q

what are the first choice options for treating N meningitis if PCN MIC is less than 0.1

A

Penicillin G

25
Q

what are some alternative treatments for treating N meningitis

A

fluoroquinolone
meropenem
chloramphenicol

26
Q

what is the duration of therapy when treating N meningitis

A

5-7 days

27
Q

which meningitis causing bug are coma and seizures most common

A

streptococcus pneumoniae (pneumococcal)