Meningitis
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Meningitis is an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It commonly affects children under 4 years old. The etiology depends on age, with common causes in neonates being GBS, E. coli, and Listeria monocytogenes. Symptoms include fever, vomiting, irritability, and neck stiffness. Diagnosis involves lumbar puncture to examine CSF for elevated white blood cells. Treatment involves supportive care and antibiotics targeting the suspected pathogen. Prevention strategies include vaccination against common causes like meningococcus and Hib.
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1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and a bulging fontanelle in infants, while older children may present with headache, neck stiffness, and altered mental status. Lumbar punct
pyogenic meningitis
1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and bulging fontanelle. Diagnosis involves lumbar puncture to examine cerebrospinal fluid for presence of bacteria, white blood cells and
Neisseria meningitidis
This document provides information on Neisseria meningitidis, the bacteria that causes meningococcal meningitis. It describes the morphology and virulence factors of N. meningitidis, including its capsular polysaccharide and outer membrane proteins. The epidemiology, transmission, pathogenesis, clinical features, diagnosis and treatment of meningococcal meningitis are discussed in detail. Serious complications like meningococcemia and Waterhouse-Friderichsen syndrome are also summarized.
CNS disorders in pediatrics
The document discusses central nervous system (CNS) diseases and disorders. It provides information on meningitis and encephalitis, including causes, symptoms, diagnosis, and treatment. For bacterial meningitis, common causes vary by age group. Symptoms of viral meningitis are also described. Diagnosis of meningitis involves lumbar puncture and cerebrospinal fluid analysis. Treatment of bacterial meningitis involves antibiotics while viral meningitis is usually treated symptomatically. Herpes simplex encephalitis commonly affects the temporal lobe and is diagnosed through cerebral spinal fluid analysis and confirmed via PCR or brain biopsy. It is treated with acyclovir administered intravenously. Brain abscesses are also discussed including their
044 Meningitis and encephalitis
This document provides an overview of meningitis and encephalitis. It discusses the different types of bacterial, viral and fungal meningitis including their causes, symptoms, diagnosis and treatment. Key points include that bacterial meningitis can be caused by organisms like pneumococcus, meningococcus and haemophilus influenza. Viral meningitis causes aseptic meningitis while encephalitis involves brain inflammation. Diagnosis involves lumbar puncture and CSF analysis. Treatment depends on the identified organism and may involve antibiotics, antivirals or antifungals.
atypical neonatal infection
This document discusses atypical infections that can affect newborns. It presents 11 case studies of newborns presenting with various infections such as Chlamydia, Ureaplasma, Parvovirus B19, Toxoplasmosis, CMV, Rubella, Syphilis, RSV, HSV, Varicella, and Malaria. For each case, it describes the presenting symptoms, possible infections, diagnostic tests and treatment options. Common atypical infections that can be contracted during pregnancy or birth are caused by bacteria, viruses, protozoa, and fungi and can involve multiple organ systems.
pyogenicmeningitis-150928174212-lva1-app6891-converted.pptx
- Meningitis is defined as inflammation of the membranes surrounding the brain and spinal cord. Bacterial meningitis is most common in infancy and can cause death within hours if not treated. Common causative agents include Escherichia coli, Group B streptococci, Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.
- Clinical features vary depending on age. Newborns may exhibit subtle signs like poor feeding and lethargy while older children typically experience fever, headache, neck stiffness, and seizures. Lumbar puncture of cerebrospinal fluid is important for diagnosis and shows abnormalities such as increased white blood cells and protein with low glucose
Cns tb.namal
Tuberculous meningitis is a serious form of tuberculosis infection that affects the membranes surrounding the brain and spinal cord. It is more common in developing countries and in young children. Clinical features progress from vague symptoms to signs of meningeal irritation and eventually cerebral involvement. Diagnosis involves examination of cerebrospinal fluid showing lymphocytic predominance, low glucose and high protein levels. Imaging shows diffuse brain edema, basal cistern enhancement and infarcts. Treatment involves a combination of antitubercular drugs for at least 10 months along with corticosteroids to reduce inflammation and intracranial pressure.
Fever with a maculopapular skin rash in children 2021
Fever with a maculopapular skin rash in children
Measles Rubella Dengue Roseola Infantum Scarlet fever
Meningitis.ppt
1) Meningitis can be caused by bacteria, viruses, or fungi. Common bacterial causes include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type B.
2) Bacterial meningitis involves infection of the upper respiratory tract, invasion of the bloodstream, and inflammation of the meninges. Clinical features in infants are non-specific like fever, irritability, and convulsions.
3) Diagnosis involves history, physical exam, and investigations like lumbar puncture of cerebrospinal fluid which shows characteristics like increased white blood cells and low glucose depending on the cause.
Meningitis-By Dr Opiro Keneth
Meningitis is an inflammation of the meninges that can cause significant morbidity and mortality, especially in children. The most common causes are bacterial and include Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis. Symptoms vary by age but may include fever, headache, nausea, and neck stiffness. Lumbar puncture and CSF analysis are important for diagnosis. Empiric antibiotic therapy should cover the most common pathogens. Complications can include neurological deficits, hearing loss, seizures, and hydrocephalus. Prevention through immunization against preventable causes such as Hib, meningococcus, and pneumococcus can reduce the burden of disease.
Lec meningitis dr saima batool .associate professor pediatrics ucm,lhr
This document discusses meningitis and encephalitis. It defines meningitis as inflammation of the meninges and encephalitis as infection of the brain parenchyma. Common signs and symptoms include fever, altered consciousness, vomiting and seizures. Diagnosis is usually made via lumbar puncture and analysis of cerebrospinal fluid. Bacterial meningitis is often caused by Group B Streptococcus in neonates and Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae in older children. Treatment involves antibiotics and management of increased intracranial pressure. Complications can include hydrocephalus, cranial nerve palsies, and mental retardation. Encephalitis is
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meningitis meruoakan penyakit menular yang harus di waspadai
meningitis meruoakan penyakit menular yang harus di waspadai
pyogenicmeningitis-150928174212-lva1-app6891-converted.pptx
pyogenicmeningitis-150928174212-lva1-app6891-converted.pptx
Fever with a maculopapular skin rash in children 2021
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Lec meningitis dr saima batool .associate professor pediatrics ucm,lhr
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Meningitis
- 1. Meningitis
- 2. Definition • Inflammation of meninges (membrane surrounding the brain and spinal cord) • Pachymeningitis : inflammation of dura • Leptomeningitis : inflammation of arachnoid • Common in children less than 4 years old • Peak 3-8 months old • Incidence of encephalitis related to vaccination in childhood
- 3. Etiology • Neonates • GBS,E.Coli,Staph. Aureus,Listeria Monocytogenes,Group A Streptococcus • Infants • GBS,E.Coli,Listeria Monocytogenes • Children • Neisseria Meningitides,Strep. Pneumonia,Haemophilus Influenza,Myco. TB, Staph. Aureus • School age children • Neisseria Menigitides,Strep. Pneumonia
- 4. Pathogenesis 1. Nasopharynx > haematogenous > cross BBB > subarachnoid space 2. Direct through the skull from infected loci (parasinus/middle ear/ PNS/nose > meninges) 3. Direct spread following skull fractur 4. Direct inoculation into CSF • Meningomyelocele • Neurosurgical procedure
- 5. Clinical Features • Neonatal : vague and non specific • Fever • Refuse to feed + vomit • Irritable + drowsiness • Irregular respirations • Neck stiffness > rare and late findings • Tense + bulging fontanelle > late course of illness
- 6. Clinical Features • Infant • Fever + vomiting • Marked irritability + convulsion + somnolence • Tense + bulging fontanelle > late course of illness
- 7. Clinical Features • Children • Fever + chills • Headache + photophobia + vomiting • Stiff neck + lethargy • Convulsion + delirium + drowsiness + irritability
- 8. Physical Examination • General • GCS • Level of consciousness • Vital signs • Febrile • Shock • Hypertension • Bradycardia/apnea • Head • Bulging and tense fontanelles • Eye • papilledema • Skin • Purpuric rash (meningococcal rash) • Brudzinki's : Knee automatically brought up toward body when neck is bent forward or pain in the legs when bent • Kernig's : Inability to straighten a child's knee after hip flexion 90 degree • Focal neurological sign
- 9. Differential diagnosis • Intracranial infection • Brain abscess • Cerebral malaria • Metabolic disorder • Acid-base disorder • Inherited metabolic disease (urea cycle disorder and lactic acidosis) • Seizure disorder • Status epilepticus • Hemiconvulsion-hemiplegia syndrome • Increase ICP • Tumor • Hematoma • Acute hydrocephalus • Lead poisoning • Subarachnoid haemorrhage
- 10. Investigations • Full blood count • BUSE • Blood C&S • Urine C&S • RBS • LP • Imaging • CT brain • MRI • Throat swab • Rapid antigen test in body fluid • CSR and Mantoux test
- 11. Lumbar puncture Appearance Cell Type CSF:serum glucose ratio Protein (mg/dL) Normal Clear 0-5 Mononuclear cell High >0.5 10-50 Bacterial Turbid 10-10000 PMN Low <0.4 High Viral Clear or slightly turbid 10-2000 Lymphocytes Normal Normal or high TB and fungi Clear or slightly turbid 10-1000 Lymphocytes Low High Encephalitis Clear 10-2000 Lymphocytes Normal Normal or high
- 12. Management • Supportive 1. Vital sign monitoring 4 hourly 2. Input and output chart 3. KNBM in unconscious 4. Fluid therapy : maintenance fluid • If SiADH occur : reduce to 2/3 maintenance for initial 24h,may need more fluid if dehydrated 5. Daily head circumference 6. Daily CNS assessment 7. Observe 24h after stopping therapy > no complications,discharged
- 13. Management • General 1. Increase ICP : rapid administration of IV mannitol 2. Seizures : anticonvulsant drugs (IV diazepam in acute phase) • Anti-microbial therapy • 0-1 months : C.Penicillin + Cefotaxime for 3 weeks • 1-3 months : C.Penicillin + Cefotaxime for 3 weeks • >3 months : C.Penicillin + Cefotaxime or Ceftriaxone • HiB : 10 days • S.Pneumonia : 2 weeks • N.Meningitides : 1 weeks
- 14. Management • Steroid therapy • Dexamethasone 0.15mg/kg 6hourly for 4 days or 4mg/kg 12hourly for 2 days • Improve meningeal inflammation and reduce hearing impairment • Tubercular meningitis • Triple therapy : isoniazid + rifampicin + ethambutol ± pyrazinamide (excellent penetration into CSF)
- 15. Follow-up • Development of child • Head circumference • Occurrence of fit or behaviour abnormalities • Assessment of vision,hearing and speech
- 16. Complications • Meningococcemia – shock + DIVC • Neurologic - hemi/quadriparesis,facial palsy or visual defects • Seizures • Subdural collection of fluid • Arthritis(Hib) • Buccal cellulitis • Pericarditis • Pneumonia
- 17. Prognosis • Worse in younger patients • Duration of illness prior to effective antibiotics • More complications in HiB and Strep. Pneumoniae • Worse when presence of focal sign
- 18. Prevention • Immunization : N.Meningitis,Strep. Pneumonia,Hib • Chemoprophylaxis : intrapartum ampiccilin for GBS,rifampicin for HiB contact,azithromycin/ciprofloxacin for meningococcal carriage in adult
Editor's Notes
- If fever persists: Thrombophlebitis and intramuscular abscess Intercurrent infection : pneumonia,UTI or nosocomial infection Resistant organism Subdural effusion,empyema or brain abscee Antibiotic fever