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Meningitis PDF by SMH

Meningitis is a clinical syndrome characterized by inflammation of the meninges, the protective membranes surrounding the brain and spinal cord, and can be caused by various infectious agents including bacteria, viruses, fungi, and parasites. Symptoms of meningitis include fever, headache, and altered mental state, with specific signs indicating possible sepsis. Diagnosis often involves lumbar puncture to analyze cerebrospinal fluid, and immediate treatment is critical for bacterial meningitis to prevent serious complications.

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Shair Muhammad hazara
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13 views2 pages

Meningitis PDF by SMH

Meningitis is a clinical syndrome characterized by inflammation of the meninges, the protective membranes surrounding the brain and spinal cord, and can be caused by various infectious agents including bacteria, viruses, fungi, and parasites. Symptoms of meningitis include fever, headache, and altered mental state, with specific signs indicating possible sepsis. Diagnosis often involves lumbar puncture to analyze cerebrospinal fluid, and immediate treatment is critical for bacterial meningitis to prevent serious complications.

Uploaded by

Shair Muhammad hazara
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Meningitis

Definition • Meningitis is primarily involving the meninges


• Meningitis is a clinical syndrome characterized ________ • Encephalitis is primarily involving the__________
of the meninges, the three layers of membranes that • The layers which enclose the brain and spinal
enclose the brain and spinal cord. Can be ______ or cord are as following:
______. • _________ - A tough outer membrane
• _________ – A lacy, web like middle
Aetiology membrane
• _________ – A delicate, fibrous inner
Types of meningitis layer that contains many of the blood
• Bacterial vessels that feed the brain and spinal
• Viral cord.
• Fungal
• Parasites
• Drugs

• Bacterial, fungal and parasitic infections can


cause chronic meningitis. The most common
cause of a chronic bacterial infection is
___________ ____________ (TB!) Acute bacterial meninigitis
Meningococcal meningitis
• Viral meningitis is more common and is • Most common type of bacterial meningitis in children and young
usually more benign than bacterial adults
meningitis • Caused by _________ _________
• Often found in nasopharynx of otherwise healthy individuals.
Pathophysiology • Thought that recent viral infections disrupt the epithelial surface and
• Most cases of meningitis are caused by an facilitate invasion by ________ __________.
infectious agent that has colonized or established a • Causes the typical non-blanching rash.
localised infection elsewhere in the host.
• The pathogen can then gain access to the CNS by
one of the following main pathways Pneumoncoccal meningitis
1. Most commonly, _________-> • Most common type of bacterial meningitis
haematogenous seeding of the CNS • Caused by __________________.
2. A retrograde _________pathway via • Present in 5-10% of healthy adults.
olfactory or peripheral nerves
3. Direct _________spread (eg. Sinusitis, Haemophilus Influenza meningitis
otitis media, trauma etc) • Meningitis is the most serous acute manifestations of systemic
infection with H influenza.
Signs & symptoms • In the past was a major cause of meningitis and the type __ strain
• Acute bacterial meningitis accounted for the majority of these cases.
presents with a classical triad of • However since the introduction of the _________ vaccine in the 1990
1. _________ the overall incidence of H influenza meningitis has decreased by 35%
2. _________ • _________accounts now for less than 9.4% of the H influenza cases
3. _________
• (+ altered mental
state) Sepsis
• Other symptoms of meningitis Meningococcal disease is the leading infectious cause of death in
include early childhood. It can present as bacterial meningitis
• Nausea and Vomiting (meningococcal meningitis) or as septicaemia . However it most
• Photophobia commonly presents as both.
• Sleepiness The SIRS criteria is useful in diagnosis sepsis, two or more of the
• Confusion following with a source of infection indicates sepsis.
• Irritability • Temperature _________
• Delirium • Heart Rate _________
• Coma • Respiratory Rate _________
• Notably these symptoms will be • WBC __________________
similar for any cause that will
cause inflammation of meninges.
For example, _________
_________.
Investigations

Lumbar puncture
Indications
1. _________(enceph/mening)
2. _________ Contraindications:
3. __________________ (sarcoid/MS) 1. S+S of ICP without negative imaging
4. __________________ (GBS/CIDP) 2. Focal neuro signs without negative imaging
5. ___________________________ 3. Local infection (skin, bone, pustular acne)
6. __________________ 4. Clotting disorders (INR>1.5 or platelets…)
7. ____________________________________
8. ___________________________
9. ____________________________________

CONSENT:
‘Lumbar puncture with CSF sampling’
 Aid further diagnosis and management
RISKS =
1. Pain
2. Headache
3. Bleeding
4. Infection
5. Failure of procedure
6. Anesthetic
7. Damage to surrounding structures (temp/perm)

Elevated protein – very high • Guillain-Barre • Fungal meningitis


(ie >2gl) • Spinal block • Malignant meningitis
• TB meningitis

Elevated protein – high • Bacterial meningitis • Neurosyphilis


(>1g/L) • Viral encephalitis • Subdural haematoma
• Cerebral abscess • Malignant meningitis

Low CSF glucose • Bacterial meningitis • Mumps meningitis


• TB meningitis • HSV encephalitis
• Malignant meningitis • SAH (sometimes)
• Fungal meningitis

Polymorphs Bacterial meningitis

Lymphocytes • Viral encephalitis/meningitis • HIV-assoc


• Partially-treated meningitis • Lymphoma, leukaemia
• Malignant meningitis • Lyme disease
• Bechet syndrome, SLE, CNS vasculitis

Oligoclonal bands • MS • Subacute sclerosing panencephalitis (rare, late comp of


• Neurosarcoidosis measles)
• CNS lymphoma • Neurosyphillis
• SLE

Complications
• Immediate Management
• Increased intracranial pressure
ABC!
• Coma
Treat causative organism
• Septic shock
Treat complications.
• Seizures
• Delayed
• Decreased hearing,
• Cranial nerve dysfunction
Acute bacterial meningitis
• Multiple seizures • Initial “blind” treatment must be started immediately (IM
• Focal paralysis benzylpenicillin)
• Subdural effusions • Guide with microbiological diagnosis
• Waterhouse-friderichsen syndrome • If septic use the sepsis 6
• (adrenal gland failure due
to bleeding into the
adrenal glands.)

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