Wk 7 Meningitis Flashcards
(23 cards)
mortality of meningitis
up to 25% depending on org
percentage of strep pneumonia for meningitis
47% (1995)
percentage of haemophilus influenza for meningitis
45% (1986)
other pathogens for meningitis
listeria, aerobic gram - bacilli, strep agalactiae (52% in neonates), and staph aureus (trauma, CSH shunts)
classic triad for meningitis
only 2/3 of patients have all 3
fever, neck stiffness and change in mental status (confusion, lethargy, coma)
long term complications of meningitis
hearing loss (10%), seizure disorder, learning difficulties and neurological problems (spasticity, paresis and ataxia)
patients benefiting from CT in meningitis
immunocomp, hx of CNS dx, papilledema, new onset seizure, altered consciousness or focal neurological deficit
meningitis dx
CSF examination by lumbar puncture
gram stain, culture and sensitivities, cell count with diff, CSF protein and CSF glucose
opening P in CSF findings for bacterial meningitis
> 180 (normal <20)
WBC count in CSF findings for bacterial meningitis
1000-5000 (normal 0-10)
% of Neutrophils in CSF findings for bacterial meningitis
> 80%
Protein in CSF findings for bacterial meningitis
100-500 (normal is 10-45)
Glucose in CSF findings for bacterial meningitis
<40 (normal is 50-100)
gram stain in CSF findings for bacterial meningitis
+ in 60-90%
culture in CSF findings for bacterial meningitis
+ in 70-85%
tx of meningitis for >50, EtOH or other debilitating dx
Ampicillin
inc risk of L. monocytogenes
duration of N meningitides therapy
7 days
duration of H flu therapy
7 days
duration of S pneumo therapy
10-14 days
duration of S agalactiae therapy
14-21 days
duration of aerobic gram - bacilli therapy
21 days
duration of L monocytogenes therapy
> 21 days
dexamethasone findings
reduction in unfavorable outcomes and mortality
even better findings in pt’s with S pneumo meningitis
