Bacterial meningitis - Organisms
• Most caused by Group B Streptococci
• E coli, enterococci, Klebsiella, Enterobacter,
Samonella, Serratia, Listeria
Older infants and children
• Neisseria meningitidis, S. pneumoniae,
tuberculosis, H. influenzae
• Meningococcal infection with rifampicin or
• MenC, a meningococcal C conjugate vaccine.
• A combined A and C meningococcal vaccine is
sometimes used prior to travel to endemic regions, e.g.
Africa, Asia; and a quadrivalent ACWY vaccine .
• pneumococcal vaccine is used after recurrent
meningitis, e.g. after a CSF leak following skull fracture.
• Hib (Haemophilus influenzae).vaccine.rifampin
• Encephalitis means inflammation of brain
parenchyma, usually viral.
Acute viral encephalitis: The usual organisms are
• herpes simplex,
• mumps and
• Epstein-Barr viruses
• Adenovirus, varicella zoster, influenza,
measles and other viruses are rarer.
• Many encephalitides are mild .
• In a minority, serious illness develops with
high fever, headache, mood change and
drowsiness over hours or days.
• Focal signs, seizures and coma ensue. Death,
or brain injury follows.
• CT and MR imaging show diffuse areas of
oedema, often in the temporal lobes.
• Viral serology .
• Brain biopsy
• Supportive measures
• Prophylactic immunization against Japanese
encephalitis is advised for travelers to
endemic areas in Asia.