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Questions and Answers
What is a characteristic of HIV Associated Cryptococcal Meningitis?
Viral Meningitis is caused by Bacterial infections.
False
What is the name of the sign that indicates severe neck stiffness in patients with Meningitis?
BRUDZINKI'S SIGN
The BCG vaccine offers approximately ______________ protective effect against Tubercular Meningitis in children.
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Match the following types of meningitis with their characteristics:
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What is the name of the sign that indicates severe stiffness of the hamstrings in patients with Meningitis?
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What is the main treatment approach for Viral Meningitis?
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Cortisone is used to treat bacterial meningitis.
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What is the percentage of newborns that may die from bacterial meningitis?
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Meningitis is a notifiable disease.
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What are the two main problems that can occur in adults after recovering from meningitis?
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Meningitis is an acute inflammation of the _______________.
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What is the route of entry of bacteria into the CNS through?
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Match the following bacterial infections with their corresponding percentage range:
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TB meningitis is caused by Streptococcus Pneumonia.
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In adults, _______________ of all cases emerge without disability.
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Study Notes
Meningitis Definition and Incidence
- Meningitis is an acute inflammation of the meninges, caused by bacteria or viruses.
- The exact incidence rate is unknown, but in 2010, there were 420,000 deaths, and in 2013, there were 303,000 deaths.
- Newborns have a 20-30% mortality rate from bacterial meningitis, while adults have a 66% chance of recovery without disability.
Route of Entry into CNS
- Skull or backbone fractures (trauma)
- Medical procedures
- Along peripheral nerves
- Blood or lymphatic system
Etiology
- Bacterial infections
- Viral infections
- Fungal infections
- Inflammatory diseases (e.g. SLE)
- Cancer
- Trauma to head or spine
Pathophysiology
- Bacteria enter the bloodstream or mucosal surface/cavity
- Breakdown of normal barriers
- Crossing the blood-brain barrier
- Proliferation in the CSF
- Inflammation of the meninges
- Increased ICP
Bacterial Meningitis
- Also known as septic meningitis
- Extremely serious and requires immediate care
- Can lead to permanent brain damage or death
- Spreads through coughing or sneezing
- Treatment: antibiotics based on the causative organism
- Causative agents:
- Streptococcus Pneumonia (30-80%)
- Neisseria meningitis (15-40%)
- Hemophilus Influenza (2-7%)
Viral Meningitis
- Causative agents:
- Enterovirus
- Measles virus
- Herpes simplex virus
- Treatment: mostly supportive and no specific medicines are prescribed
- Symptoms: haemorrhagic spots
Fungal Meningitis
- Rare in healthy people, but more common in those with impaired immune systems
- Risk factors:
- Systemic infections
- Viral RTIs
- Tobacco use
- Impaired immune system
- Overcrowding
Preventive Factors
- Vaccinations: TB, measles, seasonal vaccinations
- Winter and spring vaccinations
Clinical Manifestations
- In infants:
- In adults:
Signs and Symptoms
- KERIG'S SIGN: severe stiffness of the hamstrings
- BRUDZINSKI'S SIGN: severe neck stiffness
Assessment and Diagnosis
- History taking
- Physical assessment
- CT and MRI
- Blood culture and sensitivity
- Lumbar Puncture
CSF Findings
- Sensori-neural hearing loss
- Epilepsy/seizures
- Memory loss
- Paralysis
- Learning difficulty
- Death
Medical Management
- Bacterial meningitis:
- Antibiotics: cefalosporin
- ATT medications: Isoniazid
- Cortisone
- Dehydration and shock treatment: fluid therapy
- Phenytoin for seizure management
- Viral meningitis:
- Treatment is mostly supportive
- Symptomatic treatment: antiseizure, decrease ICP
- Rest is advised
- Antipyretics
- Anti-emetics
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Description
Learn about meningitis, an acute inflammation of the meninges caused by bacteria or viruses, its incidence rate, and its complications.
