Meningitis
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This document discusses bacterial and viral meningitis. It notes that the most common causes of bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Viral meningitis is usually caused by enteroviruses. Symptoms may include decreased consciousness, petechial rashes, and coma. Diagnosis involves CSF analysis, blood cultures, and imaging tests. Treatment involves intravenous antibiotics, managing increased intracranial pressure, and addressing complications.
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A case presentation on pneumonia
This case presentation discusses a 2-year-old female child admitted to the pediatric intensive care unit (PICU) with pneumonia. She presented with a week of fever and wet cough. Initial tests showed left lung consolidation and pleural effusion. She received IV antibiotics and underwent VATS surgery to drain pus from her lungs. Over 10 days in the PICU with nursing care and treatments, her symptoms improved and she was discharged on oral antibiotics to complete her recovery at home.
Meningitis
The document discusses meningitis, which is an inflammation of the meninges - the protective membranes surrounding the brain and spinal cord. It has three layers: the dura mater, arachnoid mater, and pia mater. Meningitis can be caused by bacteria, viruses, fungi or parasites. Common types are bacterial, viral and tuberculous meningitis. Symptoms vary with age but may include fever, headache, stiff neck, vomiting, and altered consciousness. Diagnosis involves examining cerebrospinal fluid obtained via lumbar puncture. Treatment involves antibiotics, anticonvulsants, and supportive care like maintaining fluid and nutrition. Complications can include brain damage if not treated promptly.
Fever
The document discusses fever, its causes, types, and management. It defines fever as an elevation of body temperature above normal (36.5-37.5°C) due to an increased regulatory set-point triggered by the body's immune response to infection. Fever types include continuous, intermittent, and remittent. Hyperpyrexia is an extreme fever over 41.5°C considered a medical emergency. Fever symptoms include lethargy, anorexia, and sleepiness. Management involves reducing temperature through methods like fans, tepid baths, hydration, and antipyretic medications like ibuprofen or acetaminophen.
L3.approach to fever
This document provides information on fever (pyrexia), including:
1. Thermoregulation and how the body maintains a normal temperature of 37°C through the hypothalamus despite environmental variations.
2. Features of a normal body temperature and what constitutes a fever. Fever enhances the immune system and inhibits some microbes.
3. Patterns of fever onset, main phases, and end. Fever's diagnostic features and the importance of taking a thorough medical history are also outlined.
Etiology and approach of the fever
This document discusses the etiology and approach to fever. It lists several potential causes of fever including infection, nervous system diseases, malignancies, blood disorders, heat stroke, dehydration, and trauma. It categorizes fevers based on duration and presence of localizing signs. Evaluation of fever involves obtaining a thorough history, physical exam, and lab tests to determine the underlying cause and guide treatment. Common causes of fever in infants and young children are typically viral infections, but serious bacterial infections like bacteremia or meningitis also need to be considered.
Fever
Fever is an increase in body temperature over an individual's normal temperature, which is typically considered above 100.4°F rectally. Fever is caused by pyrogens like bacteria, viruses, fungi or other pathogens that stimulate the immune system to produce endogenous pyrogens like interleukin-1, TNF, and interferons. Fever evaluation includes a medical history, examination to localize the source of fever, and determining the fever pattern and duration to identify the probable cause. Fever management involves environmental measures, hydration, and antipyretic drugs. Fever of unknown origin (FUO) is defined as fever over 38°C for more than 3 weeks without a diagnosis after initial investigations, and requires extensive
Short febril illness2016 new
SFI ....is a very good intety for all beginer in pediatriv and infection speciality......
it the 1st lecture i was prepare and my 1st presentation
04 fever
This document discusses fever, including its causes, mechanisms, stages, and pathophysiological basis. It begins with an introduction to fever and discusses the causes as pyrogenic activators such as bacteria, viruses, and non-microbial substances that activate endogenous pyrogen-producing cells to release cytokines like interleukin-1, tumor necrosis factor, and interleukin-6. These cytokines act on the hypothalamic thermoregulatory center to increase the set point and cause fever through various central mediators. The document outlines the three stages of a fever and concludes by discussing the pathophysiological basis of fever prevention and treatment.
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This case presentation discusses a 2-year-old female child admitted to the pediatric intensive care unit (PICU) with pneumonia. She presented with a week of fever and wet cough. Initial tests showed left lung consolidation and pleural effusion. She received IV antibiotics and underwent VATS surgery to drain pus from her lungs. Over 10 days in the PICU with nursing care and treatments, her symptoms improved and she was discharged on oral antibiotics to complete her recovery at home.
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The document discusses meningitis, which is an inflammation of the meninges - the protective membranes surrounding the brain and spinal cord. It has three layers: the dura mater, arachnoid mater, and pia mater. Meningitis can be caused by bacteria, viruses, fungi or parasites. Common types are bacterial, viral and tuberculous meningitis. Symptoms vary with age but may include fever, headache, stiff neck, vomiting, and altered consciousness. Diagnosis involves examining cerebrospinal fluid obtained via lumbar puncture. Treatment involves antibiotics, anticonvulsants, and supportive care like maintaining fluid and nutrition. Complications can include brain damage if not treated promptly.
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The document discusses fever, its causes, types, and management. It defines fever as an elevation of body temperature above normal (36.5-37.5°C) due to an increased regulatory set-point triggered by the body's immune response to infection. Fever types include continuous, intermittent, and remittent. Hyperpyrexia is an extreme fever over 41.5°C considered a medical emergency. Fever symptoms include lethargy, anorexia, and sleepiness. Management involves reducing temperature through methods like fans, tepid baths, hydration, and antipyretic medications like ibuprofen or acetaminophen.
L3.approach to fever
This document provides information on fever (pyrexia), including:
1. Thermoregulation and how the body maintains a normal temperature of 37°C through the hypothalamus despite environmental variations.
2. Features of a normal body temperature and what constitutes a fever. Fever enhances the immune system and inhibits some microbes.
3. Patterns of fever onset, main phases, and end. Fever's diagnostic features and the importance of taking a thorough medical history are also outlined.
Etiology and approach of the fever
This document discusses the etiology and approach to fever. It lists several potential causes of fever including infection, nervous system diseases, malignancies, blood disorders, heat stroke, dehydration, and trauma. It categorizes fevers based on duration and presence of localizing signs. Evaluation of fever involves obtaining a thorough history, physical exam, and lab tests to determine the underlying cause and guide treatment. Common causes of fever in infants and young children are typically viral infections, but serious bacterial infections like bacteremia or meningitis also need to be considered.
Fever
Fever is an increase in body temperature over an individual's normal temperature, which is typically considered above 100.4°F rectally. Fever is caused by pyrogens like bacteria, viruses, fungi or other pathogens that stimulate the immune system to produce endogenous pyrogens like interleukin-1, TNF, and interferons. Fever evaluation includes a medical history, examination to localize the source of fever, and determining the fever pattern and duration to identify the probable cause. Fever management involves environmental measures, hydration, and antipyretic drugs. Fever of unknown origin (FUO) is defined as fever over 38°C for more than 3 weeks without a diagnosis after initial investigations, and requires extensive
Short febril illness2016 new
SFI ....is a very good intety for all beginer in pediatriv and infection speciality......
it the 1st lecture i was prepare and my 1st presentation
04 fever
This document discusses fever, including its causes, mechanisms, stages, and pathophysiological basis. It begins with an introduction to fever and discusses the causes as pyrogenic activators such as bacteria, viruses, and non-microbial substances that activate endogenous pyrogen-producing cells to release cytokines like interleukin-1, tumor necrosis factor, and interleukin-6. These cytokines act on the hypothalamic thermoregulatory center to increase the set point and cause fever through various central mediators. The document outlines the three stages of a fever and concludes by discussing the pathophysiological basis of fever prevention and treatment.
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Fever lecture note
General outline including aetiology, history taking, examination, investigation & management of a fever patient.
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Fever is defined as a body temperature above the normal range due to an increase in the body's temperature set point. There are different types of fevers classified by their temperature patterns, including continuous, intermittent, remittent, and hyperpyrexia (extreme fever over 106.7°F). Fever has many potential causes, including infections by viruses, bacteria, parasites, and fungi, as well as non-infectious conditions like autoimmune diseases, cancers, and metabolic disorders. Treatment focuses on reducing fever through conservative measures like rest, fluids, and antipyretic medications like acetaminophen and ibuprofen.
An approach to a child with fever
Here are the answers to the questions:
1. D
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3. A
4. A
5. A, B
6. D
7. D
8. B
Fever in infants and children
This document provides information on fever in infants and children, including:
1) It describes the differences between true fever caused by the body's set point being increased due to infection or inflammation, versus false fever which does not directly increase the set point.
2) Evaluation of the febrile infant or child involves obtaining a thorough history, physical exam, and screening tests like CBC, blood cultures, and lumbar puncture if meningitis is suspected, to identify potential causes and focus of infection.
3) Management depends on the age of the child. Neonates less than 1 month require full sepsis workup and antibiotics if febrile. Infants 1-3 months can potentially be treated as out
Pathogenesis of fever
pathogenesis of fever
reference- Harrison's Principles of internal medicine
& other ppt from slideshare...
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This document discusses body temperature regulation and fevers. It defines key terms like core temperature, surface temperature, and fever. Fever is caused by the hypothalamus setting a higher temperature set point in response to infections or other stimuli. Types of fevers include intermittent, remittent, sustained, and relapsing. Treatment involves antipyretics and addressing the underlying cause. Hyperthermia is an unintentional elevated temperature while hypothermia is a subnormal temperature. Frostbite results from freezing of tissues, especially the extremities. Proper first aid involves slowly rewarming while avoiding further injury.
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Fever
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Fever
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FEVER IN ICU
The hypothalamus controls body temperature through neurons that receive signals from temperature receptors in the skin and blood. These signals are integrated in the hypothalamus' temperature regulation center to maintain a normal temperature of around 37°C. Fever is defined as a temperature greater than 37.2°C in the morning or 37.7°C in the afternoon. Common causes of fever in the ICU include infections like ventilator-associated pneumonia as well as non-infectious causes like drug reactions. Blood cultures, sputum cultures, urine cultures and imaging tests may help diagnose the cause, and treatment is aimed at the underlying condition.
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Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding fever, and its management. Highly recommended for II B.Sc Nursing Students
Approach to patient with fever
The document provides details on evaluating a patient presenting with fever. It includes sections on taking a thorough history with perspectives on biomedical factors, the patient's experience, and contextual background. A review of systems explores all major organ systems for localizing symptoms. The physical exam findings note vital signs and examination of different body systems. Analyzing symptoms like fever patterns, associated issues, and past medical history are essential for determining the underlying cause.
Case study pn
1. An 80-year-old man was admitted to the MICU with pneumonia and a history of old CVA and hypertension.
2. A chest x-ray showed airspace consolidation in the right lung consistent with bacterial pneumonia.
3. The patient received antibiotics, oxygen therapy, and nursing care focused on improving respiratory status and reducing infection risk.
Fever ppt by DR GIRISH JAIN
Fever is an elevation of body temperature regulated by the hypothalamus in response to pyrogens. It is a common symptom of infection or inflammation. Fever has various stages as temperature rises and falls, and can be classified by pattern of temperature changes. Fever benefits the immune response by enhancing immune cell activity and inhibiting microbial growth at higher temperatures. Management involves identifying and treating the underlying cause while controlling temperature.
Approach to history taking in a patient with fever
The document provides an overview of fever (pyrexia), including its definition, pathophysiology, types, and differential diagnosis. It discusses how fever is regulated by the hypothalamus and the role of pyrogens and cytokines in initiating the febrile response. Common causes of fever are described, such as infections, malignancies, and autoimmune conditions. Different patterns of fever are also outlined, including continuous, intermittent, and remittent fever. The evaluation of pyrexia of unknown origin is summarized. Factitious fever is defined as fever intentionally fabricated by the patient. The importance of a thorough history is emphasized when evaluating a febrile patient.
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The document discusses fever in infants and children. It notes that fever is common in young children and can be caused by minor or life-threatening infections. While most pediatric infections are viral, some may be bacterial. The medical history, physical exam, and complementary tests usually allow for prompt diagnosis and reassurance or treatment as needed. For febrile infants under 3 months, further testing such as blood and urine cultures as well as lumbar puncture may be required depending on factors like age, appearance, and symptoms to check for potential serious bacterial infections. Management depends on risk level, with higher risk infants often needing admission and parenteral antibiotics.
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This document provides an overview of fever in the ICU setting. It defines fever and discusses the causes, timing, and workup based on suspected source. Key points include:
- Fever in the ICU is typically defined as a temperature over 38.3°C.
- Fever can be caused by infection, inflammation, or antigen-antibody complexes which induce pyrogenic cytokines like IL-1, IL-6, and TNF.
- These cytokines trigger the hypothalamus to raise the temperature set point.
- Accurately measuring temperature is important, though methods vary by ICU.
- Fever often complicates critical illness and can increase mortality, though higher peaks may be protective against
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Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteria in the blood occurring in the first month of life. It can be early-onset within the first week of life, usually acquired during birth from the mother, or late-onset between 1 week to 1 month of life, often from the hospital environment. Symptoms are non-specific but can include temperature irregularities, poor feeding, or respiratory distress. Treatment involves blood cultures, antibiotics like ampicillin and gentamicin, and supportive care for complications involving various organ systems. Future treatments may involve immunotherapies and blocking inflammatory responses.
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Meningitis
Meningitis is an inflammation of the meninges that cover the brain and spinal cord. It can be life-threatening due to its proximity to the brain and spinal cord. Meningitis is usually caused by a bacterial or viral infection that enters the fluid surrounding the brain and spinal cord. Common symptoms include fever, headache, and neck stiffness. Diagnosis involves examination of cerebrospinal fluid obtained via lumbar puncture. Treatment focuses on antibiotics, antivirals, or antifungals depending on the cause. Vaccines can help prevent certain types of meningitis.
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1. Electrolyte balance assists in regulating water balance, neuromuscular activity, and acid-base balance. The body can actively move electrolytes in and out of cells to maintain electrolyte balance in the right concentrations, which is important for fluid balance between compartments. Imbalanced electrolytes can cause issues like dehydration from exercise or illness.
2. Hyperkalemia, a high level of potassium, can cause lethal cardiac arrhythmias. It is defined as a serum potassium concentration higher than 5.5 mEq/L. Severe electrolyte imbalances can cause problems like coma and can be fatal if untreated.
3. Nursing interventions for a child at risk of infection
Fever lecture note
General outline including aetiology, history taking, examination, investigation & management of a fever patient.
Fevers
Fever is defined as a body temperature above the normal range due to an increase in the body's temperature set point. There are different types of fevers classified by their temperature patterns, including continuous, intermittent, remittent, and hyperpyrexia (extreme fever over 106.7°F). Fever has many potential causes, including infections by viruses, bacteria, parasites, and fungi, as well as non-infectious conditions like autoimmune diseases, cancers, and metabolic disorders. Treatment focuses on reducing fever through conservative measures like rest, fluids, and antipyretic medications like acetaminophen and ibuprofen.
An approach to a child with fever
Here are the answers to the questions:
1. D
2. C
3. A
4. A
5. A, B
6. D
7. D
8. B
Fever in infants and children
This document provides information on fever in infants and children, including:
1) It describes the differences between true fever caused by the body's set point being increased due to infection or inflammation, versus false fever which does not directly increase the set point.
2) Evaluation of the febrile infant or child involves obtaining a thorough history, physical exam, and screening tests like CBC, blood cultures, and lumbar puncture if meningitis is suspected, to identify potential causes and focus of infection.
3) Management depends on the age of the child. Neonates less than 1 month require full sepsis workup and antibiotics if febrile. Infants 1-3 months can potentially be treated as out
Pathogenesis of fever
pathogenesis of fever
reference- Harrison's Principles of internal medicine
& other ppt from slideshare...
Fever
This document discusses body temperature regulation and fevers. It defines key terms like core temperature, surface temperature, and fever. Fever is caused by the hypothalamus setting a higher temperature set point in response to infections or other stimuli. Types of fevers include intermittent, remittent, sustained, and relapsing. Treatment involves antipyretics and addressing the underlying cause. Hyperthermia is an unintentional elevated temperature while hypothermia is a subnormal temperature. Frostbite results from freezing of tissues, especially the extremities. Proper first aid involves slowly rewarming while avoiding further injury.
Clinical Cases Study for Meningitis
This document discusses four cases of meningitis. The first case involves a 67-year-old female presenting with confusion, somnolence, and stiff neck. Examination finds nuchal rigidity and Gram-positive diplococci in CSF. The second case involves a 4-week old premature infant with poor feeding, fever, and drowsiness. Lumbar puncture finds elevated white blood cells in CSF. The third case discusses a 70-year-old man with pneumococcal meningitis resistant to penicillin who is not improving with cefotaxime. The fourth case involves an 18-year-old man referred for suspected meningitis who was given IV penicillin.
Fever
etiology, pathogensis , types of fever. pharmacotheray for fever, non pharmacological management for fever.
Pediatric Meningitis Case Presentation
A 5-year-old boy presented with 2 days of fever and headache followed by vomiting. On examination, he had neck stiffness. Labs showed elevated white blood cell count and c-reactive protein. Cerebrospinal fluid analysis grew Streptococcus pneumoniae resistant to ceftriaxone. The most likely diagnosis was pneumococcal meningitis. Treatment was started with vancomycin and meropenem. Pneumococcal meningitis can occur in vaccinated children due to non-vaccine serotypes.
Fever
Fever is defined as a core body temperature above normal ranges. A thorough history and physical exam is important to determine the cause of fever. Syndromic and general approaches can help identify potential infectious or non-infectious etiologies like sepsis, which requires early recognition and treatment. Initial resuscitation focuses on airway, breathing, circulation while gathering relevant history on travel, medications, surgeries to guide diagnostic testing and management.
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The hypothalamus controls body temperature through neurons that receive signals from temperature receptors in the skin and blood. These signals are integrated in the hypothalamus' temperature regulation center to maintain a normal temperature of around 37°C. Fever is defined as a temperature greater than 37.2°C in the morning or 37.7°C in the afternoon. Common causes of fever in the ICU include infections like ventilator-associated pneumonia as well as non-infectious causes like drug reactions. Blood cultures, sputum cultures, urine cultures and imaging tests may help diagnose the cause, and treatment is aimed at the underlying condition.
Fever
Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding fever, and its management. Highly recommended for II B.Sc Nursing Students
Approach to patient with fever
The document provides details on evaluating a patient presenting with fever. It includes sections on taking a thorough history with perspectives on biomedical factors, the patient's experience, and contextual background. A review of systems explores all major organ systems for localizing symptoms. The physical exam findings note vital signs and examination of different body systems. Analyzing symptoms like fever patterns, associated issues, and past medical history are essential for determining the underlying cause.
Case study pn
1. An 80-year-old man was admitted to the MICU with pneumonia and a history of old CVA and hypertension.
2. A chest x-ray showed airspace consolidation in the right lung consistent with bacterial pneumonia.
3. The patient received antibiotics, oxygen therapy, and nursing care focused on improving respiratory status and reducing infection risk.
Fever ppt by DR GIRISH JAIN
Fever is an elevation of body temperature regulated by the hypothalamus in response to pyrogens. It is a common symptom of infection or inflammation. Fever has various stages as temperature rises and falls, and can be classified by pattern of temperature changes. Fever benefits the immune response by enhancing immune cell activity and inhibiting microbial growth at higher temperatures. Management involves identifying and treating the underlying cause while controlling temperature.
Approach to history taking in a patient with fever
The document provides an overview of fever (pyrexia), including its definition, pathophysiology, types, and differential diagnosis. It discusses how fever is regulated by the hypothalamus and the role of pyrogens and cytokines in initiating the febrile response. Common causes of fever are described, such as infections, malignancies, and autoimmune conditions. Different patterns of fever are also outlined, including continuous, intermittent, and remittent fever. The evaluation of pyrexia of unknown origin is summarized. Factitious fever is defined as fever intentionally fabricated by the patient. The importance of a thorough history is emphasized when evaluating a febrile patient.
Hod ppt
The document discusses fever in infants and children. It notes that fever is common in young children and can be caused by minor or life-threatening infections. While most pediatric infections are viral, some may be bacterial. The medical history, physical exam, and complementary tests usually allow for prompt diagnosis and reassurance or treatment as needed. For febrile infants under 3 months, further testing such as blood and urine cultures as well as lumbar puncture may be required depending on factors like age, appearance, and symptoms to check for potential serious bacterial infections. Management depends on risk level, with higher risk infants often needing admission and parenteral antibiotics.
Clinical guidelines Fever in the Picu
This document provides an overview of fever in the ICU setting. It defines fever and discusses the causes, timing, and workup based on suspected source. Key points include:
- Fever in the ICU is typically defined as a temperature over 38.3°C.
- Fever can be caused by infection, inflammation, or antigen-antibody complexes which induce pyrogenic cytokines like IL-1, IL-6, and TNF.
- These cytokines trigger the hypothalamus to raise the temperature set point.
- Accurately measuring temperature is important, though methods vary by ICU.
- Fever often complicates critical illness and can increase mortality, though higher peaks may be protective against
Neonatal Sepsis
Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteria in the blood occurring in the first month of life. It can be early-onset within the first week of life, usually acquired during birth from the mother, or late-onset between 1 week to 1 month of life, often from the hospital environment. Symptoms are non-specific but can include temperature irregularities, poor feeding, or respiratory distress. Treatment involves blood cultures, antibiotics like ampicillin and gentamicin, and supportive care for complications involving various organ systems. Future treatments may involve immunotherapies and blocking inflammatory responses.
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Approach to history taking in a patient with fever
Approach to history taking in a patient with fever
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Encephalitis ppt
This document discusses acute encephalitis syndrome. It defines encephalitis as an acute inflammatory process involving brain tissue and meningoencephalitis as inflammation of both the meninges and brain tissue. Japanese encephalitis is identified as one of the most common causes of acute encephalitis syndrome. It is a mosquito-borne viral infection spread between pigs and birds as amplifying hosts, with humans as incidental hosts. The clinical presentation involves an initial prodromal stage of fever and headache, followed by an encephalitic stage with altered mental status such as confusion or coma. Treatment involves supportive care and empiric antiviral therapy with acyclovir and antibiotics until causative organisms are identified.
initial assessment of critically ill patients(PRESENTED AT IMA HOUSE,CUTTACK)
1. A 52-year-old male presented with severe breathlessness and sweating for 5 hours and was admitted to the ICU in a critically ill state.
2. Initial assessment and resuscitation focused on the ABCDE approach to address airway, breathing, circulation, disability and exposure/environment. Basic investigations were sent.
3. The patient was diagnosed with an acute exacerbation of COPD. He was treated with oxygen, steroids, bronchodilators and antibiotics. Due to worsening, non-invasive ventilation was added and the patient showed gradual improvement.
Farshidmokhberi
Neonatal seizures are common in the neonatal period due to decreased seizure thresholds and transient overdevelopment of the excitatory system compared to the inhibitory system. Seizures in neonates can be classified as epileptic, non-epileptic, or EEG-only seizures based on clinical presentation and EEG correlation. Common etiologies of neonatal seizures include perinatal events like hypoxic-ischemic encephalopathy, intracranial hemorrhage, metabolic derangements, infections, and developmental problems. Evaluation involves a detailed history, examination, and investigations including blood glucose, electrolytes, imaging, and EEG. Management involves identifying and treating the underlying cause as well as acute seizure control with antiepileptic drugs
MENINGITIS.pptx
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord known as the meninges. It can be caused by bacterial, viral, fungal or non-infectious etiologies. Bacterial meningitis requires urgent treatment to prevent high mortality. Common symptoms include fever, headache, neck stiffness, nausea and altered mental status. Diagnosis involves lumbar puncture and analysis of cerebrospinal fluid. Treatment involves intravenous antibiotics, steroids, anticonvulsants and supportive care like hydration and fever control. Nursing care focuses on monitoring for complications, maintaining fluid balance and facilitating recovery.
新生儿窒息（英文）2009
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initial assessment of critically ill patients(PRESENTED AT IMA HOUSE,CUTTACK)
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Meningitis
- 1. Mrs.ASHA ELDHO CLINICAL NURSE EDUCATOR MANGALORE
- 3. ◦ Pyogenic infection that involves the pia matter, the archnoid, and the subarchnoid space including the cerebrospinal fluid which is associated with a CNS inflammatory reaction
- 4. Organisms - world census meningococcal – 2501 cases /yr pneumococcal – 1-2 /100000 population cryptococcal – 5/million population viral - 75000cases /yr
- 5. WHO – DEATH STATISTICS 20000 DEATHS -- Africa 18000 deaths - America 73000 deaths - South east asia
- 8. .BACTERIAL MENINGITIS 1. Streptococcus Pneumoniae - otitis media - sinusitis - head trauma Mortality - 20%
- 9. 2. Neisseria Meningitidis Naso pharyngeal infections Community settings Transmission – aerosol 3. HEMOPHILUS INFLUENZA incidence - Hib vaccine
- 10. 4.STAPHYLOCOCUS AUREUS - Invasive neuro surgical procedures 5. LISTERIA MONOCYTOGENES - food contamination- milk, cheese, fast foods - Newborns,pregnant women, >60yrs, immuno compromised
- 11. VIRAL MENINGITIS 1. ENTERO VIRUS – 85% 2. ARBO VIRUS 3. HERPES SIMPLEX 4. HIV 75 – 90 % 4- 10 Days Self limiting Secondary to viral respiratory infections
- 12. Immuno compromised patients HIV infection Otitis media Pneumonia Sinusitis contd…
- 13. SURGERY – BRAIN /SPINAL ELDERLY CLIMATE CHANGES TONGUE PIERCING DM
- 16. Decreased level of consciousnes – - 75% patients
- 19. Petechial rashes coma Restlessness , agitation, irritability
- 20. Signs of increased ICP altered level of consciousness Papilledema Dilated pupils – non reactive Decerebrate posturing
- 21. Nuchal rigidity Brudzinski’s sign – positive Kernig’s sign – positive
- 22. To elicit this sign, the examiner places one hand on the patient's chest and the other hand behind the patient's neck. The examiner then passively flexes the neck forward and assesses whether the knees and hips flex. Upon passive neck flexion, a positive test results when the patient flexes his knees and hips.
- 24. CSF analysis GRAM STAIN OF CSF CBC & BLOOD CULTURE LP CT, MRI SPUTUM CULTURE X-RAY
- 25. CSF ANALYSIS APPEARANCE Cloudy, turbid Clear WBC PROTEIN GLUCOSE CSF PRESSURE Increased ( 100- 10000/cm) Increased ( over 100mg/dl) Decreased (<40mg/dl) Elevated ( > 180 mm H2O) Increased Slightly increased Mostly normal ,sometimes decreased. Varies FINDING B.MENINGITIS VIRAL MENINGITIS
- 26. SURGICALMEDICAL
- 27. 1. ANTI- BIOTIC THERAPY - Ampicillin, pencillin ,vancomycin, cefuroxime, cefotaxim, ceftazidine,ceftriaxone Intravenously given large doses -4-6times /day – 10 days Dexamethasone prior to first dose antibiotic
- 28. 2. TREATMENT FOR INCREASED ICP Elevation of head – 30 º - 40º Intubation & hyperventilation Inj.Mannitol Minimize the suctioning Minimize other stimuli ICP monitoring
- 29. 3. ANTI –CONVULSANTS 4. IV FLUIDS 5. NEUROLOGICAL STATUS HOURLY
- 30. FOR PRIMARY FOCUS EG. Parasinuses, Mastoid, Cranial , Osteomyelitis
- 31. Vaccination - varivax (live vaccine) - inactivated vaccine for transplant patients - Hib vaccine - children
- 32. 1.. NEUROLOGICAL DYSFUNCTIONS Optic nerve - BLINDNESS Oculomotor, trochlear, abducens nerves - occular movements affected - ptosis , diplopia - unequal pupils Trigeminal nerve – loss of corneal relux & sensory loss
- 33. Facial nerve - facial paresis Vestibulocochlear – vertigo, deafness, tinnitus 2. Altered level of consciousness - coma 3. Hydrocephalous
- 34. History Physical examination - neurological exam - signs of increased icp - seizure - vascular status
- 35. 1.Ineffective tissue perfussion (cerebral) decresed intra cranial adaptive capacity related to the pathological changes secondary to meningitis. 2. Disturbed sensory perception related to altered cognitive functions as evidenced by signs of fear, anxiety, disorientation.
- 36. 3.Acute pain related to headaches and muscle aches as evidenced by general discomfort of muscles. 4. Hyperthermia related to infection and abnormal temperature regulation by hypothalamus from increased ICP as evidenced by increased body temperature.
- 37. 5. Risk for imbalanced fluid volume related to fever and decreased intake. 6. Impaired mobility related to prolonged bedrest.
- 38. 1. Enhancing cerebral perfusion Neurological assessment Assess signs of increased ICP Maintain calm environment Notify deterioration to physician – seizure , temperature, consciousness
- 39. 2. Enhancing sensory perception Neurological status assessment Low stimulation environment Approach the patient in a soft manner Reorient the patient.
- 40. 3. Reducing pain Assessment Administer analgesics Darken the room in case of photophobia Comfortable position Elevate head of the bed to decrease ICP.
- 41. 4.Reducing fever Assessment of vital signs Administer anti pyretic, antibiotics on time Other cooling measures Increased intake of oral fluids.
- 42. 5. Fluid balance Monitor intake and output Monitor cvp Iv fluids with caution – avoid overload to prevent cerebral edema Encourage oral fluids