About encephalitis and meningitis

1. ENCEPHALITIS AND
MENINGITIS
By Alina

2. ■ Meningitis - Inflammation of the
membranes surroundingthe brain and
spinal cord.
■ Encephalitis – Inflammation of brain itself.

3. Causes - Meningitis
Bacterial meningitis - Streptococcus pneumoniae , Neisseria
meningitidis , Listeria monocytogenes , Haemophilus influenza.
Viral meningitis – HSV , Enterovirus.
Fungal meningitis – Cryptococcal.

4. Symptoms - Meningitis & Encephalitis
Fever.
Headache.
Photophobia.
Vomitting.
Chills.
Neck stiffness.
Altered mental status.

5. Key factors – Meningitis & Encephalitis
Young / Old
Splenectomy.
Immunosuppressed.
Recent neurosurgical procedures.
IV drug use.

6. Physical exam
■ Kernig‘s Sign :- Unable to straighten leg greater
than135 degrees without pain.
■ Brudziński's sign :- Severe neck stiffness causes hips
and knees to flex when neck is flexed.
■ Vital signs :- Fever, Tachycardia , Low BP.
■ Altered mental status and Neck stiffness.

7. Evaluation
■ Lab test :- CBC , Electrolytes , Blood culture.
■ Lumbar puncture:- If there is risk of CSF infection.
❑ Increased WBC.
❑ Xanthochromia.
❑ Elevated protein.
❑ Gram stain – positive.
■ Imaging :-
❑ Head CT
❑ MRI

8. Empiric Antibiotic Treatment
■ First ABC’s
■ Ceftriaxone 2 g IV
■ Vancomycin 15 mg/kg
■ Ampicillin: Listeriaconcern
■ Dexamethasone
■ Acyclovir
■ Empiric treatment should be started once there is concern for meningitis or encephalitis.
Lumbar puncture can be performed after antibiotics have been administered.

9. Prophylaxis
■ Rifampin x 4 doses.
■ Ciproflaxin or Ceftriaxone x 1 dose.
■ Prophylaxis should be consideredfor close contacts in the case of Neisseria
meningiditis meningitis.