Meningitis

Question 1

meningitis in simple terms

Answer 1

Inflammation of the meningeal lining of the brain and spine.

Question 2

the meninges

Answer 2

Protect the brain from injury and infection.

Question 3

Organs that comprise the CNS- brain and spinal cord are covered by three connective tissue layers called the meninges:

Answer 3

1. Pia mater (closest to the brain and spinal cord)
2. Arachnoid
3. Dura mater

Question 4

cerebrospinal fluid

Answer 4

• Flows within the subarachnoid space beneath the arachnoid membrane
• Maintains constant pressure inside skull- intracranial pressure

Question 5

how is CSF produced

Answer 5

by the choroid plexus

- plasma is filtered from the blood by epithelial cells to produce CSF

Question 6

characteristics of CSF

Answer 6

• Clear
• Plasma-like fluid
• Contains glucose and some protein
• Few or no cells (cells likely to be lymphocytes)

Question 7

patient risk factors

Answer 7

• Extremes of age
• Diabetes mellitus
• Chronic kidney failure
• Immunosuppression
  • Cancer
  • HIV
  • Immunosuppressants

Question 8

bacteria that most often cause meningitis

Answer 8

• Neisseria meningitidis
• Streptococcus pneumoniae
• Haemophilus influenzae

Question 9

virus that most often cause meningitis

Answer 9

Cocsackie viruses A and Be

Herpes: HSV 1 and 2

Question 10

fungus that most often cause meningitis

Answer 10

cryptococcus

Question 11

Viral meningitis is the most

Answer 11

common and least serious type.

Question 12

patient symptoms

Answer 12

• Non-blanching purpuric rash (using glass or tubler test)
• Stiff neck (nuchal ridigity)
• Confusion
• Photophobia
• Drowsiness
• Increased pulse rate
• Aching muscle and joints
• Being sick
• Headache

Question 13

mechanism of infection

Answer 13

When pathogen gets into your bloodstream from your sinuses, ears or throat. Pathogen travel through. Bloodstream to brain.

Haemophilus influenza and Meningococcal meningitis can spread via respiratory droplets

Question 14

prevention

Answer 14

vaccinations
Men A
Men B
Men ACWY

Question 15

prophylaxis

Answer 15

for people who have been in close contact

Question 16

to get a CSF culture

Answer 16

lumbar puncture

Question 17

how to take a lumbar puncture

Answer 17

• Spinal cord ends at L1, below this level the nerve roots of the cauda equina float in CSF
• Needles passed between the spinous process of two adjacent lower lumbar vertebrae to enter the spinal canal by puncturing the dura
• Small amount of CSF remove and sent to lab

Question 18

normal CSF

Answer 18

• clear
• WBC <5 CELLS/UL
• protein <0.4
• GLUCOSE 2.6-4.6 mol/l

Question 19

bacteria CSF

Answer 19

• often cloudy
• increased WBC >5-500
• neutrophils dominant
• increased protein
• low glucose

Question 20

tuberculous meningitis

Answer 20

• clear/ cloudy
• increased WBC 5-1000
• lymphocytes
• moderate protein increase
• glucose normal/ slightly decreased

Question 21

viral meningitis

Answer 21

• clear
• increased WBC 5-1000
• lymphocytes
• moderate protein increase
• glucose normal

Question 22

fungal meningitis

Answer 22

• clear/cloudy
• increased WBC 5-500
• lymphocytes
• protein increased
• glucose low

Question 23

antibiotics

Answer 23

ceftriaxone (cephalosporin) IV 2g every 12 hours

Question 24

if pt severely ill

Answer 24

do not wait for lumbar puncture give ceftriaxone

Question 25

outcome of infection

Answer 25

- Brain swelling - Permanent disability - Coma - Death - Sepsis - Complete resolution