meningitis

Question 1

what type of bacteria niseria meningitidis?

Answer 1

• gram negative diplococci

Question 2

what are the maiin causes of meningitis in children and adults?

Answer 2

• neisseria meningitidis and streptococcus pneumoniae

Question 3

what is the most common cause of meningitis in neonates?

Answer 3

GBS

Question 4

what has happened when children appear with a non blanching rash?

Answer 4

• meningicoccal septicaemia
• bacteraemia- in the blood stream
• DIC

Question 5

Which children need a lumbar puncture?

Answer 5

• <1month presenting with fever
• 1-3 months fever and unwell
• <1 year with unexplained fever and other features suggesting they are seriously unwell

Question 6

what is kernigs test?

Answer 6

lying patient flat and bending knee- to stretch meninges

Question 7

what is brudzinskis test?

Answer 7

lying patient flat and bending head- stretched meninges

Question 8

what should be given in the community to child with non blanching rash and suspected meningitis?

Answer 8

• benxylpenicilin before transfer to hospital

Question 9

which antibiiotics are used to treat <3 month for meningitis?

Answer 9

cefotaxime and amoxicillin- to cover the listeria if contracted in pregnancy

Question 10

which antibiotics should be given to >3 months for meningitis?

Answer 10

ceftriaxone

Question 11

when should vancomycin be added to the antibiotic regimine for meningitis?

Answer 11

• if there is a risk of penecilin resistant pneumococcal infection - e.g. recent foregin travel or prolonged abx exposure

Question 12

who is considered an infectious contact in meningitis?

Answer 12

anyone in contact 7 days prior to the onset of illness- if nnosxs have developed after 77 days they are unlikely to get ill

Question 13

what is post exposure prophylaxis for meningitis?

Answer 13

single dose of ciprofloxacin within 24 hours

Question 14

what are the most common causes of viral meningitis?

Answer 14

• HSV
• Enterovirus
• VSV

the sample from the lumbar puncture should be sent for viral PCR testing

Question 15

where is the lumbar puncture inserted?

Answer 15

l3-4

Question 16

what are complications of meningitis?

Answer 16

Hearing loss is a key complication
Seizures and epilepsy
Cognitive impairment and learning disability
Memory loss
Cerebral palsy, with focal neurological deficits such as limb weakness or spasticity

Question 17

what will a bacterial infection show in lumbar puncture?

Answer 17

• coudy
• high protein
• low glucose
• high neutrophils
• bacteria in the culture

Question 18

what will a viral infection show on lumbar puncture?

Answer 18

• clear
• protein mildly raised
• glucose is normal
• lymphocytes are high
• culture is negative