Meningitis Flashcards
1
Q
Features of meningitis
A
Headache Neck stiffness Kernig's sign Brudzinski's sign Photophobia Nausea/vomiting Non blanching purpuric rash
2
Q
Kernig’s sign
A
Flex hip with knees at 90 degrees
Straightening legs causes neck pain
3
Q
Brudzinski’s sign
A
Bending neck - pt flexes hips and knees
4
Q
Abx therapy of meningitis
A
Community - Benzylpenicillin 1.2g IV/IM
< 50 - ceftriaxone 2g IV/IM BD
> 50 - ceftriaxone + ampicillin 2g IV per 4 hrs
If suspect viral - aciclovir
5
Q
Acute management of meningitis
A
1) A to E
2) Differs if mainly septic or mainly meningitic S) DON'T LP Ceftriaxone 2g IV ITU if shocked M) LP if no shock or contraindications Dexamethasone Ceftriaxone 2g IV post LP
3) Continued management (another flashcard)
6
Q
Continuing management of meningitis
A
Ceftriaxone 2g BD IV:
- Meningococcus 7 days
- Pneumococcus 14 days
Maintenance fluids:
- Urine output 30ml/h
- SBP > 80 mmHg
Rifampicin prophylaxis for household contacts
7
Q
Bacterial causative organisms of meningitis
A
Meningococcus Pneumococcus Listeria Haemophilus TB Cryptococcus
8
Q
Viral causative agents of meningitis
A
Enteroviruses
HSV2
9
Q
Contraindications to an LP
A
Thrombocytopenia Delayed abx Raised ICP Unstable pt Coagulation disorder Infection at LP site Focal neurology
10
Q
CSF findings in bacterial meningitis Appearence Cells Count Glucose Protein
A
Turbid White cells 100-1000 Decreased > 1.5
11
Q
CSF findings in viral meningitis Appearence Cells Count Glucose Protein
A
Clear Lymphocytic/mononuclear 50-1000 Normal < 1
12
Q
CSF findings in TB meningitis Appearence Cells Count Glucose Protein
A
Fibrin web Lymphocytic/mononuclear 10-1000 Decreased 1-5
