Meningitis Academic Notes

MENINGITIS Meningitis is inflammation of the protective membranes cord. covering -the brain and spinal • The inflammation may be caused by infection wirth viruses, bacteria a/ other microorganisms and less commonly by certain drugs. can be life-threcatching becaus Meningitis ammation's prosimily Spinal cord; theat love the condida brain and spinal medical emergency. Causes •Meningitis is usually caused by infection from viruses or microorganisms. • Most cases are due to infection with with bacteria, E parasites being the next most comanda pas •It may also result from various non infectiou causes. lypes Bacterial Causes • Individuals with a cerebral shunt/related. device are increased the risk of infection. through those devices. In these cases, infections with staphylococa are more likely In a small propostion of people, an infection in the head and neck area, such as otitis. media or mastoiditis, can lead to meningitis.. •Recipients of cochlear implants for hearing, Loss are at an increased risk of preumococoal meningitis. • Tuberculous meningitis, meningitis due to infection with Mycobacterium tuberculosis, is more common in those from countries cohere This common, bat is also encountered in those with immune problems, such as AIDS. Viral and Parasitic Viruses That can cause meningitis include • Enteroviruses • Herpes simplex virus type & Celess commonly type) • Varicella 20gter virus Cknown for causing chickenpox HIV 1 Parasitic A parasitia cause is often assumed when there is predominance of eosinophils in the CSF Non infectious •Meningitis may occurs as a result of several nonlatetious causes: Spread or 어 cances, to the neoplastic meningitis) meninges Cmalignant •Certain drugs Cmbunly NSAIDs, antibiotic & IV immunoglobuling H L may bell caused by several inflammatory condition such as Garcoidosis (which is then Called neurosarcoidosis) Inflammatory growth Connective tisque disorders such as SLE. • Certain forms of vasculitis Cinlammatory Condition of the blood vessel wall) such ag Behcet's disease - Delcking of immare power •Epidermoid cysta & dermord cysts may cause meningitis. into the by releasing irritant matte arachnoid space. •Rarely, migraine may cause meningitis. Pathophysiology Bacteria enters, blood stream/traume Enters-the macosal qurlace/cavity Breakdown of normal barriers. Crosses the blood brain barries (BBE) ↓ Pacliterates in the CSF Inflammation of the meninges.. Increase in ICP Signs and Symptom A severe headache. -Nuchal Povedad pasidety inability to flex the ned @stiffness) to neck tone The classid triad of diagnostic consists of nuchal rigidity, Sudden high leven & attered mental - Photophobla - Phonophobia Cintolerance to loud noises) - Signs- itive Imp Kernig's sign Patient Lyling to 190 is assessed cuith the Supine, with the hip & knee 90. In a patient with positive kernig's sign, pain Limits passive extension of the Oknee, Positive Brudzinsk's sign. of the neck the knee Es hip. causes occurs when flexion involuntary flexion of -Visual manifestation - Blurred vision, diplopia, e -Ear manifestation- Hearing deficit.. • Blood culture • Lumbas puncture 4 Chest Xray CSF analysis CT Scan Gram Glain CGF analysis of meniningitis. Type of meningitis Gilucose Protein Cells Acute bacterial Low High PMNs often. >300/00m3 Acute viral Normal Normal mononuclear <300/mm3 high I uberculous High mononuclear & PMNS<300/mm³ Fungal high <300/mm Malignant Low high. Usually momoncle treatment Initial reatment • Meningitis is potentially life threatening & has a high mortality rate if untreated Low with Treatment wide spectrum antibiotics should not be delayed while confirmatory testsave being conducted. meningococcal disease is suspected in primary cafe, quidelines recommend that benzylpenicillin be administered before traster to hospital. H a poctient is resistant to penicillin derivative administer erythromycin. • In-bavenous-Huids should be administered if hypotension/shock present..