2. MENINGITIS:
SEPTIC: caused by bacteria
• Streptococcus pneumoniae
• N. Meningitidis:
- Transmitted by secretions or
aerosol contamination.
- Droplet precautions.
- Infection is most likely in dense
community groups (such as
college campuses).
- Usually require a meningitis
vaccine before attending school.
• More severe than viral.
ASEPTIC: caused by viral infection:
• Lymphoma
• Leukemia
• Brain abscess
• Enteroviruses
• Most common type.
• Less severe than bacterial.
Inflammation of the membranes & CSF surrounding the brain and spinal cord.
3.
4. MANIFESTATIONS:
• HA
• Fever
• Changes in LOC
• Behavioral changes
• Nuchal rigidity (stiff neck)
• Positive Kernig's sign
• Positive Brudzinski’s sign
• Photophobia (light sensitivity)
5. ASSESSMENT:
• Fever
• HA
• N/V
• Nuchal rigidity meningeal irritation
• Photophobia
• Decreased LOC
• Petechial rash if meningococcal organism
MENINGITIS:
6.
7. KERNIG’S SIGN
PAIN IN THE LOWER BACK AND RESISTANCE TO STRAIGHTENING THE LEG
AT THE KNEE. PAIN INCREASES AS LEG IS LIFTED & FLEXED.
12. DIAGNOSTICS:
• Urine, throat, nose, and blood cultures (viral or bacterial?)
• Lumbar puncture
• May do CT scan before LP
CSF tested for:
• Elevated WBC count
• Decreased glucose (bacterial)
• Elevated protein
• CSF may be cloudy (bacterial) OR clear (viral)
BACTERIAL MENINGITIS
13. MEDICAL MANAGEMENT
PREVENTION: vaccination for all children and at-risk adults against…
• haemophilus influenzae
• S. Pneumoniae
• Meningococcal
• Early administration: high doses of appropriate IV ABX.
• Dexamethasone (anti-inflammatory)
• TX of dehydration, shock, and seizures.
Unfavorable outcomes: tachycardia, elderly, decreased GCS
14. • Frequent or continual neuro. assessment
• HOB up 30 degrees (lowers ICP)
• Report to the public health dept highly
communicable / DROPLETS
• Infection control precautions (isolation,
droplet precautions)
NURSING CARE OF BACTERIAL MENINGITIS
• Monitor for increased ICP
• Safety – bed rails up and padded (seizures)
• Decrease environmental stimuli (dim lights)
• Serum electrolytes, fluid balance
• Regular diet if no decreased LOC
• If decreased LOC, NPO
• Measures to facilitate coping of patient / family.