an acute attack is lethal for the person

1. It is an inflammation of the meninges that
covers the brain and spinal cord a protective layer

2. 1. Bacterial (Neisseria Meningitidis, streptococcus pneumoniae)
2. Fungal
3. Viral

3. 1. Aseptic Meningitis: causes are virus,leukemia,lymphoma,
brain abscess.
2. Septic Meningitis: bacterial causes/Beta streptococcus,gram
negative and listeria monocytogenes /H.Influenza
/N.Meningitidis/S.Pneumoniea/Meningococal meningitis,

4. 1. Blood stream
2. Cranialstructure
3. Paranasal sinuses
4. Ear infections
5. Nasopharynx
6. Penetrating head wound and skull fractures

5. Due to any etiological factors
Bacteria invade the pia arachnoid and sub arachnoid matter of the
meninges
Contamination of the blood and CSF
Increased blood supply to the infected area
Infiltration of the neutrophils into subarachnoid space and
engulfing of the bacteria

6. Rapid degeneration of the phagocytic cell
Formation of the purulent material in the subarachnoid space
Exudate forms and cause extension upto cranial and spinal nerves
ENCEPHALITIS

7. Diagnostic Findings
1. HC and PE
2. CT and MRI
3. Blood examinations
4. Lumbar puncture
5. CSF analysis

8. CSF characteristics Bacterial Viral
Appearance Cloudy Clear or Turbid
Cells Increased WBC Increased WBC
Protein Increased upto 100-500
mg/dl
Normal
Glucose Decreased <40 mg/dl Normal
Smear and culture Bacteria present No bacteria
Pressure Elevated >180 variable

9. Cardinal manifestation of meningitis
1. Fever
2. Photophobia
3. Positive kernig’s sign
4. Brudzinski’s sign
5. Nuchal rigidity

10. Other features are
1. Generalized convulsion
2. Increased ICP
3. Cranial Nerve Dysfunction
4. Enocrine disorder
(hyponatremia/increased ADH/)

11. Objective of treatment are
1. Adequate nutrition
2. Patent airway
3. Fluid electrolyte balance
4. Managing hypothermia
5. Controlling seizure

12. • IV Ampicillin 200 mg/Kg
• IV cefotaxim 200mg/Kg
• Antimicrobials
• Dexamethazone 0.15 mg/Kg

13. Treatment For Meningitis
1. Early recognition of symptoms and early treatment is essential
2. Use antibiotics that can cross the BBB
3. Combination antibiotic therapy is essential
4. Few examples for antibiotics are (vancomycine/, cephalosporins,
ceftriaxone,cefotaxim sodium) given IV
5. Use antivirals
6. Dexamethasone (10-20 minutes prior the antibiotics)
7. Fluid volume expanders used to treat dehydration
8. Anticonvulsants and anti seizure drugs (phenytoin)

14. Nursing Actions and Management
1. Reducing fever
2. Maintain fluid and electrolyte
3. Improve cerebral perfusion
4. Maintain Calm and quiet place
5. Follow procedure for Lumbar puncture
6. Check LOC regularly
7. Measures to reduce the pain (head end elevation/decrease ICP/)
8. Darken the room to avoid photophobia
9. Comfort measures for neck stiffness/ maintain head and neck allignment