Pyogenic meningitis Bacteria Aseptic meningitis Streptococcus pneumoniae Haemophillus influenzae Neisseria meningitidis Viral TB Aetiology by Age

1. Meningitis
An Outline

4. Categories
Pyogenic
meningitis
Bacteria
Aseptic
meningitis
Viral TB

5. Aetiology by Age

6. <3 Months
Group B streptocooci
Listeria monocytogenes
Escherichia coli
Streptococcus pneumoniae

7. 3 Months to 18 Years
Streptococcus pneumoniae
Haemophillus influenzae
Neisseria meningitidis

8. 18 – 50 Years
Streptococcus pneumoniae
Neisseria meningitidis
Haemophillus influenzae

9. > 50 Years
Streptococcus pneumoniae
Listeria monocytogenes
Escherichia coli

10. Laboratory Investigations
• CSF full report
• CSF gram stain
• CSF culture and ABST
• Blood culture and ABST
• If culture negative or prior to Rx,
• Antigen detection – Rapid assay/ Particle agglutination
• PCR

11. CSF and blood
for culture
collection done
prior to empirical
antibiotic
therapy

12. Empirical Treatment
Ceftriaxone/
Cefotaxime
+
Vancomycin

13. Guided
with ABST
report

14. Meninigococcal
Treatment Penicillin Ceftriaxone
Prophylaxis Ciprofloxacin Rifampicin

15. Meningococcal vaccine
Routine
vaccination
• Conjugate
vaccine
Outbreak
control
• Polysaccharide
vaccine

16. Haemophillus
Treatment Ceftriaxone
Prophylaxis Rifampicin

17. Haemophillus vaccine
Conjugated
polysaccharide
vaccine

18. Pneumococcal
Ceftriaxone
Newer
quinolones
Levofloxacin Moxifloxacin

19. Pneumococcal vaccine
Conjugate
vaccine
• <2 years
• >65 years
• Patients with risk
factors
Polysaccharide
vaccine
• >65 years
• Cigarette
smokers

20. TB meningitis
Gradual onset

21. Fungal meningitis
Cryptococcal
meningitis
Aspergillosis

22. Viral meningitis
• Echo
• Coxsackie
• Polio
Enteroviruses Mumps HSV HIV

23. Thank you