Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord. It is usually caused by a viral or bacterial infection of the cerebrospinal fluid surrounding the brain and spinal cord. Meningitis can be life-threatening due to the inflammation's proximity to the brain and spinal cord, making it a medical emergency. Common symptoms include severe headache, stiff neck, fever, nausea, and altered mental status. Diagnosis involves examination, history, and cerebrospinal fluid analysis. Treatment focuses on antibiotics for bacterial meningitis and managing symptoms such as seizures and swelling.

1. Meningitis
Shafaat Ullah
BSN. Gen
Khyber Medical University
4/3/2017 1

2. Clinical description
 Meningitis is the inflammation of the protective membranes
covering the brain and spinal cord known as the meninges.
 The inflammation is usually caused by an infection of the fluid
surrounding the brain and spinal cord.
 Meningitis can be life-threatening because of the
inflammation's proximity to the brain and spinal cord;
therefore the condition is classified as a medical emergency.
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3. Meninges
The meninges is the system of membranes which envelops the
central nervous system.
It has 3 layers:
1. Dura mater
2. Arachnoid mater
3. Pia mater
Subarachnoid space -
is the space which
exists between the
arachnoid and the pia
mater, which is filled
with cerebrospinal
fluid.
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4. Causes of Meningitis
- Bacterial
- Viral
- Fungal
- Parasitic/ protozoal
- Physical injury
- Cancer
- Certain drugs ( mainly, NSAID’S)
- Head injury
- Cerebral abscess
- Middle ear infection
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5. Bacterial
- Haemophilus influenzae
- Listeria
- Meningococcus
- Mumps
- Pneumococcus
- Certain Streptococcus
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6. Viral
- Enterovirus (coxsackie, echovirus)
- Arboviral (mosquito-borne diseases)
- Influenza
- Herpes simplex virus type2 ( especially in infants)
- Varicella zoster
- HIV
- Mumps
- measles
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7. Fungal
Cryptococcus
Coccidiodes
Histoplasma
Mucormycosis
Aspergillus
Candida (yeasts)
Parasitic/protozoal
Angiostrongylus
Toxoplama
Hydatid
Amoeba
Plasmodium
Cysticercosis
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8. Risk factors
• Age- children younger than 5 years
• Use of immunosuppressive drugs
• Chronic malnutrition
• AIDS
• CSF Shunt
• Chronic alcoholism
• Diabetes
• Pneumonia
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9. Pathophysiology
Causative
organism
enters the
blood stream
Cross the
blood
barriers
Inflammatory
reaction in
meninges
Inflammation of
subarachnoid
space and pia
meter occur
Inflammation
may cause ICP
CSF flows in
subarachnoid
space
CSF cloudness
or infected
CSF cell count
increase
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10. Sign and symptoms
• Severe headache
• Irritability
• Restlessness
• Stiffness of neck
• Malaise
• Nausea/vomiting
• High grade fever
• Tachypnea
• Seizures
• Disorientation
• Tachycardia
• Coma
• Sleeplessness
• Phonophopia
• Photophobia
• Altered mental
status(confusion)
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11. Diagnostic evaluation
• By +ve signs
• Physical examination
• History collection
• CSF evaluation for
pressure, proteins,
glucose and leukocytes.
• Blood test
• CBC
• Blood culture
• MRI
• CT scan
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12. Clinical manifestation
Confirmative sign:
• Positive kernig’s sign
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13. Brudzinski’s Sign
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14. COMPLICATIONS
• Brain damage
• Cerebral edema
• Hearing loss
• Tissue damage
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15. Treatment
• Antibiotics for bacterial meningitis :Type vary depending on the
bacteria causing the infection.
• Antibiotics are not effective in viral meningitis.
• Other medications and intravenous fluids will be used to treat
symptoms such as brain swelling, shock, and seizures.
Prevention
• Haemophilus vaccine (HiB vaccine) in children.
• The pneumococcal conjugate vaccine is now a routine childhood
immunization and is very effective at preventing pneumococcal
meningitis.
• Household members and others in close contact with people who
have meningococcal meningitis should receive preventive antibiotics.
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16. Nursing managements
• Altered body temp.
related to infectious
process.
Interventions:
• Monitor temperature
continuously
• Administer antipyretic
drugs as prescribed.
• Switch on fan and open
the windows.
• Cold sponge
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17. Cont…..
• Ineffective tissue
perfusion R/T infectious
process and cerebral
edema.
Interventions:
• Assess level of
consciousness
• Assess inc. ICP signs
• Provide calm and quit
environment
• Prepare patient for LP
for CSF evaluation.
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