Bacterial Meningitis Management
18 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the mortality rate of untreated bacterial meningitis?

  • Between 50% and 75%
  • Around 10%
  • Approaches 100% (correct)
  • Up to 25%

Which of the following symptoms are commonly associated with bacterial meningitis?

  • Nausea and vomiting
  • Nuchal rigidity (correct)
  • Severe abdominal pain
  • Altered mental status (correct)

Which historical factor is NOT indicated as significant before initiating antibiotic therapy for bacterial meningitis?

  • Recent use of anticoagulants (correct)
  • Recent travel to the Hajj
  • Recent exposure to someone with meningitis
  • A history of injection drug use

What is the potential impact of dexamethasone in managing bacterial meningitis?

<p>It helps reduce morbidity (C)</p> Signup and view all the answers

What should be evaluated in the history of a patient suspected to have bacterial meningitis?

<p>Signs of potential drug allergies (A), Recent exposure to antibiotic-resistant bacteria (B)</p> Signup and view all the answers

Which organism should be suspected if there is a progressive petechial or ecchymotic rash present?

<p>Neisseria meningitidis (B)</p> Signup and view all the answers

Which of the following is a characteristic of healthcare-associated meningitis?

<p>Is often due to resistant organisms (A)</p> Signup and view all the answers

Which bacterial pathogen is commonly associated with recent illness of sinusitis or otitis media in cases of meningitis?

<p>Streptococcus pneumoniae (A)</p> Signup and view all the answers

What condition warrants a head CT before performing a lumbar puncture in adults with suspected bacterial meningitis?

<p>History of central nervous system disease (A)</p> Signup and view all the answers

Which of the following tests is NOT typically performed on cerebrospinal fluid obtained via lumbar puncture?

<p>Blood urea nitrogen (C)</p> Signup and view all the answers

What is one of the characteristic findings in bacterial meningitis based on cerebrospinal fluid analysis?

<p>WBC count above 1000/microL primarily composed of neutrophils (A)</p> Signup and view all the answers

When should empirical antimicrobial therapy begin in suspected bacterial meningitis cases?

<p>After obtaining blood cultures (B)</p> Signup and view all the answers

What is the typical effect of performing a head CT scan when it is not indicated in patients with suspected bacterial meningitis?

<p>Has no clinical benefit and delays lumbar puncture (B)</p> Signup and view all the answers

Which patient factor does NOT increase the risk of bacterial meningitis warranting a head CT prior to LP?

<p>Recent vaccination history (D)</p> Signup and view all the answers

What is the role of obtaining blood cultures in suspected bacterial meningitis cases?

<p>They should be obtained immediately before starting therapy (A)</p> Signup and view all the answers

What CSF finding would indicate low risk for bacterial meningitis?

<p>All of the above (D)</p> Signup and view all the answers

What is the initial step in managing a patient suspected of bacterial meningitis?

<p>Perform a lumbar puncture (B)</p> Signup and view all the answers

Which of the following is a sign that lumbar puncture may be contraindicated after head CT?

<p>Presence of a mass lesion (B)</p> Signup and view all the answers

Flashcards

Meningitis

A serious infection of the membranes surrounding the brain and spinal cord. It can be caused by bacteria, viruses, fungi, or parasites.

Bacterial Meningitis: Mortality Risk

Bacterial meningitis is particularly dangerous because it can be fatal if left untreated.

Classic Meningitis Symptoms

A group of symptoms that suggest the presence of bacterial meningitis. These symptoms include fever, headache, stiff neck, altered mental status, and sometimes a rash.

Injection Drug Use and Meningitis

A history of recent injection drug use may increase the likelihood of Staphylococcus aureus as the cause of bacterial meningitis.

Signup and view all the flashcards

First Line Treatment: Antibiotics

Antibiotics are often the first line of treatment for suspected bacterial meningitis.

Signup and view all the flashcards

Prior Antibiotic Use and Resistance

The effectiveness of antibiotic treatment may be influenced by whether the individual has recently received antibiotics, as this can increase the likelihood of drug-resistant bacteria.

Signup and view all the flashcards

Neisseria meningitidis Meningitis Transmission

Meningitis may be caused by the bacterium Neisseria meningitidis, which can spread rapidly among close contacts.

Signup and view all the flashcards

Meningitis: Differentiating from Other Conditions

Headache, fever, and stiff neck are common symptoms of meningitis, but they can also be present in other conditions. Therefore, a careful medical evaluation is necessary to determine the cause.

Signup and view all the flashcards

Lumbar Puncture (LP)

A procedure to collect cerebrospinal fluid (CSF) from the spinal canal, often used to diagnose meningitis.

Signup and view all the flashcards

Head Computed Tomography (CT) Scan

Imaging test that uses X-rays to create detailed images of the brain and surrounding structures. May be used to rule out structural abnormalities in the brain before lumbar puncture.

Signup and view all the flashcards

Dexamethasone

A steroid medication that can be given to reduce inflammation in the brain and spinal cord, potentially improving outcomes in bacterial meningitis.

Signup and view all the flashcards

Empiric Antimicrobial Therapy

Antibiotics that are given to kill bacteria and treat bacterial meningitis.

Signup and view all the flashcards

Increased Intracranial Pressure

A condition where the pressure inside the skull is increased, often due to inflammation or fluid buildup.

Signup and view all the flashcards

Abnormal Level of Consciousness

A decrease in a person's level of consciousness, ranging from drowsiness to coma.

Signup and view all the flashcards

Meningoencephalitis

A type of infection that involves the brain and spinal cord, often caused by bacteria.

Signup and view all the flashcards

Cerebrospinal Fluid (CSF) Analysis

A test that examines the fluid surrounding the brain and spinal cord (CSF).

Signup and view all the flashcards

Elevated Cerebrospinal Fluid (CSF) White Blood Cell Count

A high number of white blood cells (WBC) in the CSF, indicating a bacterial infection.

Signup and view all the flashcards

Low Cerebrospinal Fluid (CSF) Glucose Concentration

A low level of glucose (sugar) in the CSF, often seen in bacterial meningitis.

Signup and view all the flashcards

Study Notes

Bacterial Meningitis Management

  • Urgent Condition: Bacterial meningitis is a medical emergency requiring immediate intervention. Untreated, it's nearly fatal; even with treatment, significant morbidity and mortality are possible.

  • Suggestive Symptoms: Fever, altered mental status, headache, and stiff neck (nuchal rigidity) may indicate bacterial meningitis, though symptoms may vary.

  • Initial Treatment Focus: This review focuses on community-acquired bacterial meningitis in adults, including its initial therapy and prognosis. Other forms, like healthcare-associated meningitis, are discussed elsewhere.

Pretreatment Evaluation

  • History: A medical history can point to potential pathogens. Factors to consider include allergies to medications, recent exposure to meningitis, recent infections (sinus/ear), antibiotic use, travel history (Hajj/Umrah), injection drug use, rash, and head trauma. HIV infection or any immunodeficiency also needs assessment.

  • Pretreatment Testing: A lumbar puncture (LP) to examine cerebrospinal fluid (CSF) is crucial.

    • Head CT: A head CT is typically not needed but may be performed if the patient has risk factors: immunocompromised status, prior CNS issues, recent seizures, papilledema, altered consciousness, or focal neurological symptoms. If CT is necessary, blood cultures and dexamethasone plus empiric antibiotics start immediately before the CT.
    • Alternative Concerns: A head CT could reveal a contraindication for LP in which case a different diagnosis approach is needed.
    • Without Risk Factors: If there are no concerning risk factors, blood cultures and LP can proceed without a CT, as CT in these cases adds no benefit and delays the LP.
    • CSF Testing Immediate: When the LP is performed, opening pressure is recorded. Dexamethasone and empiric antibiotics should be started immediately after the CSF sample is obtained (and before results are available).

  • CSF Analysis: Collected CSF is examined for:

    • Cell count and differential (cell types)
    • Glucose concentration (critical marker)
    • Protein concentration
    • Gram stain and bacterial culture (identifying the pathogen)
    • Other tests for possible non-bacterial causes.

  • Bacterial Meningitis Characteristics: High CSF white blood cell (WBC) count (typically >1000/microL, often neutrophils), and low CSF glucose (often <50mg/dL) are indicative of bacterial meningitis.

  • Predicting Disease Risk: A risk score can evaluate a patient's likelihood of bacterial meningitis based on CSF and blood parameters (WBCs). Low-risk would be characterized by exclusion of certain conditions: high serum WBC, high CSF WBC/granulocytes, or elevated CSF protein/glucose.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

Explore urgent interventions and treatment strategies for bacterial meningitis, a critical medical emergency. This quiz reviews the initial therapy, prognosis, and key suggestive symptoms. Understand the importance of thorough pretreatment evaluation including patient history and potential pathogens.

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser