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Questions and Answers
What is the most severe type of meningitis that requires urgent treatment?
What is the most severe type of meningitis that requires urgent treatment?
Which pathogen is most commonly associated with viral meningitis?
Which pathogen is most commonly associated with viral meningitis?
What mode of transmission is typically associated with bacterial meningitis?
What mode of transmission is typically associated with bacterial meningitis?
Which of the following is a non-infectious cause of meningitis?
Which of the following is a non-infectious cause of meningitis?
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What is a common risk factor that increases the likelihood of developing viral meningitis?
What is a common risk factor that increases the likelihood of developing viral meningitis?
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Which type of meningitis is often caused by parasites?
Which type of meningitis is often caused by parasites?
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What is a characteristic feature of inflammatory cytokines in meningitis?
What is a characteristic feature of inflammatory cytokines in meningitis?
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In which demographic group is the risk of meningitis the highest?
In which demographic group is the risk of meningitis the highest?
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What are the classic symptoms of meningitis represented in the classic triad?
What are the classic symptoms of meningitis represented in the classic triad?
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Which of the following is NOT a symptom of meningitis in infants?
Which of the following is NOT a symptom of meningitis in infants?
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Which lumbar puncture finding is characteristic of bacterial meningitis?
Which lumbar puncture finding is characteristic of bacterial meningitis?
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What is the first-line empiric antibiotic treatment for bacterial meningitis in neonates?
What is the first-line empiric antibiotic treatment for bacterial meningitis in neonates?
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Which vaccination is NOT typically used for the prevention of meningitis?
Which vaccination is NOT typically used for the prevention of meningitis?
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In which type of meningitis would you expect the cerebrospinal fluid to appear clear or cloudy?
In which type of meningitis would you expect the cerebrospinal fluid to appear clear or cloudy?
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Which complication is commonly associated with bacterial meningitis?
Which complication is commonly associated with bacterial meningitis?
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What is the primary rationale for administering dexamethasone in cases of bacterial meningitis?
What is the primary rationale for administering dexamethasone in cases of bacterial meningitis?
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Study Notes
Meningitis Overview
- Meningitis is an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord.
- It can result from infections (bacterial, viral, fungal, parasitic) or non-infectious causes (autoimmune diseases, cancer, drug reactions).
Types of Meningitis
Bacterial Meningitis
- Pathogens: Commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type B (Hib), and Listeria monocytogenes.
- Severity: Life-threatening, requiring urgent treatment.
- Transmission: Respiratory droplets or direct contact.
Viral Meningitis
- Pathogens: Often caused by enteroviruses, but also herpes simplex virus, varicella-zoster virus, or arboviruses.
- Severity: Less severe than bacterial; typically self-limiting.
- Transmission: Fecal-oral route, respiratory droplets, or insect bites.
Fungal Meningitis
- Pathogens: Usually caused by Cryptococcus neoformans or Histoplasma capsulatum.
- Risk Factors: Immunosuppressed individuals (e.g., HIV/AIDS).
- Transmission: Rare, typically through environmental exposure.
Parasitic Meningitis
- Pathogens: Caused by parasites like Naegleria fowleri (amoebic meningitis).
- Severity: Often fatal.
- Transmission: Associated with exposure to warm freshwater.
Non-infectious Meningitis
- Causes: Autoimmune diseases, malignancies, medications (e.g., NSAIDs, antibiotics), and trauma.
Pathophysiology
- Pathogens invade the central nervous system (CNS) via the bloodstream or direct extension from infected tissues.
- Inflammatory cytokines increase blood-brain barrier permeability, causing edema (brain swelling), increased intracranial pressure (ICP), altered cerebral perfusion, and neurological dysfunction.
Risk Factors
- Demographics: Infants and elderly are at higher risk. Community living (e.g., dormitories, military barracks) can increase risk.
- Medical Conditions: Immunosuppression (e.g., HIV/AIDS, cancer) and recent neurosurgery/head trauma increase risk.
- Vaccination Status: A history of inadequate vaccination against pathogens like Hib, meningococcal, or pneumococcal bacteria makes a person more susceptible.
Clinical Features
- Classic Triad: Fever, neck stiffness (nuchal rigidity), and altered mental status (confusion, drowsiness).
- Other Symptoms: Severe headache, photophobia (sensitivity to light), nausea, vomiting, and seizures (in severe cases).
- Infant Signs: Bulging fontanelle, poor feeding, irritability, and hypotonia.
Clinical Examination
- Kernig's Sign: Pain with knee extension when the hip is flexed.
- Brudzinski's Sign: Involuntary hip and knee flexion when the neck is flexed.
Diagnosis
- Lumbar Puncture: Analyses cerebrospinal fluid (CSF) to measure white blood cell count, glucose levels, protein levels, and presence of pathogens.
- Imaging: CT or MRI may be performed to rule out brain abscess or elevated ICP prior to lumbar puncture.
CSF Findings in Different Types of Meningitis
- CSF appearance, WBC count, glucose levels, and protein levels are characteristic of each type (bacterial, viral, fungal, tuberculous). See the table for further details
Management
- Bacterial Meningitis: Empiric antibiotics (based on age and risk factors). Neonates: Ampicillin + Cefotaxime or Gentamicin; Adults: Ceftriaxone + Vancomycin. Adjunct therapy includes dexamethasone to reduce inflammation.
- Viral Meningitis: Supportive care (hydration, pain relief, fever management) and antivirals (e.g., acyclovir for herpes-related cases) as appropriate.
- Fungal Meningitis: Antifungal therapy (e.g., Amphotericin B + Flucytosine).
Prevention
- Vaccinations: Hib, pneumococcal, and meningococcal vaccines.
- Prophylactic antibiotics for close contacts during outbreaks (e.g., rifampin in meningococcal exposure).
- Hygiene Measures: Frequent handwashing and avoidance of contact with infected individuals.
Complications
- Seizures
- Hydrocephalus
- Hearing loss
- Cognitive impairment
- Death (severe cases of bacterial meningitis)
Prognosis
- Bacterial Meningitis: High mortality without treatment; survivors may have lasting neurological deficits.
- Viral Meningitis: Generally good prognosis; resolves within 7-10 days.
- Fungal/Chronic Meningitis: Variable prognosis; depends on timely treatment and underlying immune status.
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Description
Explore the different types of meningitis, including bacterial, viral, and fungal forms. Understand the causes, severity, and transmission methods of this serious condition. This quiz will enhance your knowledge about the pathogens involved and their impact on health.
