Meningitis

Definition:
Inflammation of meninges covering brain& spinal cord
Bacterial, viral, fungal & tuberculosis
Transmission:
Droplet infection
Clinical picture:
Symptoms:
 High fever
 Convulsion
 Poor feeding
 Blurring of vision
 Severe headache
 Projectile vomiting
 Lethargy or irritability
Signs:
 Bulging tense AF
 Neck rigidity (stiffness)
 Babiniski sign: flaring of toes
 Kernig’s sign: inability to extend leg
 Brudziniski neck signs: flexion of neck flexion of leg
 Brudziniski neck signs: flexion of 1 leg
st
flexion of 2nd leg
 Bradycardia, hypertension& hypertonia ( cushinoid triad)
Pathogens:
H.influenza, N.meningitidis, GBS,…etc
Types:
 Meningitic form
 Fulminant meningitis: meningococcal
 Septicemic form: waterhouse friedrichson syndrome
Complications:
 SIADH
 Effusion
 Hydrocephalus
 Cranial nerve lesions
 Motor or mental deficits
Investigations:
 CBC
 CRP& ESR
 LP& CSF analysis
Contraindication of LP:
 Signs of ICP
 Cardiopulmonary compromise
 Infection of skin overlying site of LP

Dr. Noura Noraddin 2020 1

CSF result interpretation:

Organism Protein Sugar Cells

Virus Low High/normal Lymphocytes

Bacteria High Low Neutrophils

Tuberculosis High Low Lymphocytes

Treatment:
Supportive:
 NPO& IVF
 Decrease ICP
 Anticonvulsants
Specific:
 Steroids
 Antibiotic therapy
 3rd generation cephalosporins
 +/- vancomycin

Dr. Noura Noraddin 2020 2