1. Meningitis
Inflammation of meninges.
Can be caused by bacteria,viral,and fungal.
INVESTIGATION
 Lumbar puncture
 CSF pressure (elevated in all types of meningitis >200 mmH20
 Staining of CSF:
gram stain- gram + & gram -
Ziehl Neelsen Stain- AFB
India ink stain- Fungi
Clinical Features
Headache
Neck stiffness
High fever
Rash
Kernig's sign
Impaired conciousness {indicates cerebral swelling}
Seizures
Tuberculosis meningitis (TBM)
chronic with hydrocephalus - coat basal meninges and
block flow of CSF
Fungal meningitis,'most common'
Cryptococcal,associated with immunocompromised(HIV)
¡Bacterial meningitis
Neisseria meningitidis,particularly in children below 2 yr
Management
1. Bacterial - IM penicilin,ceftriaxone or cefotaxime
2.Viral - usually benign and self limiting.Treatment is symptomatic.
3.TBM and fungal - at least 9 months with 3 or 4 agents:
INH,with pyridoxine cover,Rifampicin,Pyrazinamide,Ethambut
ol.
Family or close contact with patient need prophylaxis with oral Rifampic
Reference : in
Clinical medicine,Cambridge Or Ciprofloxacin.
Page 294 -296

2. By : Atiqah Sapiyan
BMD 104611, MD AUCMS