Meningitis

Question 1

Bacterial meningitis pathogens

Answer 1

Strep pneumoniae 
H flu 
Neisseria meningitidis 
Listeria monocytogenes 
E. Coli

Question 2

Bacterial meningitis treatment

Answer 2

1. Ceftriaxone (Neisseria, strep, h flu )
2. Vancomycin (strep)
3. IF >50 yrs old, ampicillin (listeria)

Question 3

Meningitis corticosteroid role/dose

Answer 3

• Adjunctive corticosteroids may improve outcomes by reducing reactive meningeal inflammation and neurologic sequelae related to antibiotic-induced bacterial lysis
• outcome benefit associated with systemic corticosteroids seems most pronounced with patients with Streptococcus pneumoniae meningitis

DOSING:
Dexamethasone 0.15 mg/kg every 6 hours for up to 96 hour

Question 4

Bacterial meningitis lab results

Answer 4

1. CSF glucose < 34 mg/dL
2. CSF: BG < 0.23
3. CSF protein > 220 mg/dL
4. CSF leukocyte count > 2000 cells/mm3
5. CSF neutrophil count > 1180 cells/mm3

Question 5

Bacterial meningitis s/sx

Answer 5

Fever
HA
stiff neck
Other: N/V, photophobia, altered mental status