Meningitis
An Outline
Categories
Pyogenic
meningitis
Bacteria
Aseptic
meningitis
Viral TB
Aetiology by Age
<3 Months
Group B streptocooci
Listeria monocytogenes
Escherichia coli
Streptococcus pneumoniae
3 Months to 18 Years
Streptococcus pneumoniae
Haemophillus influenzae
Neisseria meningitidis
18 – 50 Years
Streptococcus pneumoniae
Neisseria meningitidis
Haemophillus influenzae
> 50 Years
Streptococcus pneumoniae
Listeria monocytogenes
Escherichia coli
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
CSF and blood
for culture
collection done
prior to empirical
antibiotic
therapy
Empirical Treatment
Ceftriaxone/
Cefotaxime
+
Vancomycin
Guided
with ABST
report
Meninigococcal
Treatment Penicillin Ceftriaxone
Prophylaxis Ciprofloxacin Rifampicin
Meningococcal vaccine
Routine
vaccination
• Conjugate
vaccine
Outbreak
control
• Polysaccharide
vaccine
Haemophillus
Treatment Ceftriaxone
Prophylaxis Rifampicin
Haemophillus vaccine
Conjugated
polysaccharide
vaccine
Pneumococcal
Ceftriaxone
Newer
quinolones
Levofloxacin Moxifloxacin
Pneumococcal vaccine
Conjugate
vaccine
• <2 years
• >65 years
• Patients with risk
factors
Polysaccharide
vaccine
• >65 years
• Cigarette
smokers
TB meningitis
Gradual onset
Fungal meningitis
Cryptococcal
meningitis
Aspergillosis
Viral meningitis
• Echo
• Coxsackie
• Polio
Enteroviruses Mumps HSV HIV
Thank you

Meningitis