MENINGITITS BY NWALI,ANTHONY CHIDIEBERE, A 5TH YEAR MEDICAL STUDENT.

1. MENINGITIS
Nwali Chidiebere .A.

2. BACKGROUND
 Infections of the central nervous system (CNS) can be divided into 2 broad
categories: those primarily involving the meninges (meningitis) and those
primarily confined to the parenchyma (encephalitis).
 Meningitis is a clinical syndrome characterized by acute inflammation of the
meninges (composed of 3 layers of membranes that enclose the brain and spinal
cord).

13.  Extremes of age (<5 or >60 years)
 Diabetes mellitus, chronic kidney failure, adrenal insuffiency,
hypoparathyroidism or cystic fibrosis
 Splenectomy and SCD; which increase the risk of meningitis secondary to
encapsulated organisms
 Alcoholism and cirrhosis
 Recent exposure to others with meningitis with or without prophylaxis
 Dural defect (eg, traumatic, surgical or congenital)
 IV drug abuse
 Bacterial endocarditis
 Malignancy
 Ventriculoperitoneal shunt
 Thalassemia major

24.  Tuberculin skin test
 Viral culture of throat swab, nasopharyngeal aspirate and stool OCP (ova cyst
parasite)
 Blood glucose compared to CSF glucose
 Procalcitonin:- it has been suggested as a potentially useful predictor for
distinguishing between bacterial and viral meningitis but not yet widely available

32. DDx
 Brain tumor
 Brain abcess
 Cerebral malaria caused by malaria parasite plasmodium falciparum
 Viral encephalitis

33. Prevention
 Vaccination :- e.g. -Haemophilus influenza type B
-Meningococcus vaccines against grps A,B,C,Y & W135
-Pneumococcal conjugate vaccine (PCV)
 Antibiotics :- short term antibiotic prophylaxis e.g. rifampicin, ciprofloxacin,
ceftriaxone
 Behavioral :- avoid transmission

34. Prognosis
 It depends on the age of the patient, the duration of illness, complications, micro-
organism and immune status.
 Patients with viral meningitis usually have a good prognosis for recovery.
 A seizure during an episode of meningitis also is a risk factor for mortality or
neurologic sequelae.
 Acute bacterial meningitis is a medical emergency & delays in instituting effective
anti-microbial therapy results in increased mortality.
 The prognosis of meningitis caused by opportunistic pathogens depends on the
underlying immune function of the host as may require lifelong suppressive
therapy.