Pneumococcal Meningitis and HiB Overview

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Questions and Answers

What has been the estimated decrease in pneumococcal meningitis in children since the introduction of the heptavalent pneumococcal vaccine?

77% (correct)

85%

50%

90%

Which organism is a frequent cause of meningitis in children under 5 years old?

Haemophilus influenzae (correct)

Neisseria meningitidis

Streptococcus pneumoniae

Escherichia coli

What percentage of survivors of HiB meningitis may experience permanent neurologic sequelae?

5%–10%

40%–50%

60%–70%

15%–35% (correct)

What should be administered to children suspected of bacterial meningitis while awaiting the results of diagnosis?

A third-generation cephalosporin Signup and view all the answers

What factor has contributed to the decrease in the frequency of HiB meningitis in recent years?

HiB vaccine introduction Signup and view all the answers

Which group is considered a significant cause of meningitis in children globally, alongside HiB?

Streptococcus pneumoniae and Neisseria meningitidis Signup and view all the answers

What is a common consequence of delayed antibiotic therapy in cases of suspected bacterial meningitis?

Higher morbidity and mortality rates Signup and view all the answers

What role does herd immunity play in the decrease of pneumococcal meningitis cases in adults?

It reduces transmission from children to adults. Signup and view all the answers

What is the primary method of transmission for St. Louis encephalitis?

Mosquito bites from Culex genus Signup and view all the answers

Which clinical feature is not commonly associated with St. Louis encephalitis?

Chest pain Signup and view all the answers

What laboratory finding is typically seen in patients with St. Louis encephalitis?

Normal glucose levels in CSF Signup and view all the answers

Which imaging technique typically shows nonspecific edema in patients with St. Louis encephalitis?

MRI scan Signup and view all the answers

What is the primary causative agent of meningitis in neonates related to Group B Streptococcus?

Streptococcus agalactiae Signup and view all the answers

What is the recommended treatment strategy for St. Louis encephalitis?

Supportive care measures Signup and view all the answers

When is a high fever in infants under one year of age considered a potential indicator for meningitis?

Whenever noted, regardless of other symptoms Signup and view all the answers

What percentage of pregnant women in the United States are estimated to be colonized with Group B Streptococcus?

10%–40% Signup and view all the answers

What is a common long-term effect seen in many patients recovering from St. Louis encephalitis?

Irritability and depression Signup and view all the answers

How can diagnosis of St. Louis encephalitis be confirmed?

RT-PCR demonstrating rising antibody titers Signup and view all the answers

Which of the following is a risk factor for early neonatal Group B Streptococcus infection?

History of maternal GBS infection Signup and view all the answers

What percentage of individuals vaccinated with the live attenuated 17-D vaccine develop immunity?

95% Signup and view all the answers

What is the estimated transmission rate of clinically significant neonatal GBS infection from colonized mothers?

1.8 out of every 1,000 live births Signup and view all the answers

What type of antibiotic is acceptable to continue once HiB meningitis is diagnosed?

Third-generation cephalosporin Signup and view all the answers

Which of the following statements is true regarding neonatal GBS infection classification?

Early infections are defined as those occurring within the first 7 days of life. Signup and view all the answers

Which of the following factors has the greatest impact on increasing the risk of neonatal infection with Group B Streptococcus?

Prolonged rupture of membranes exceeding 18 hours Signup and view all the answers

Study Notes

Pneumococcal Vaccine Impact

Introduction of heptavalent pneumococcal vaccine in 2000 led to a 77% reduction in pneumococcal meningitis among children, as reported by the CDC.
Adults also experienced decreased rates due to the herd immunity effect.

Haemophilus influenzae (HiB)

HiB is a common cause of meningitis in children under 5, primarily caused by Haemophilus influenzae serotype B, a gram-negative rod.
HiB infections often arise from direct sinus or bloodstream dissemination.
HiB incidence has significantly declined due to vaccination, now ranking behind streptococcus and meningococcus in prevalence.
Approximately 386,000 deaths per year are attributed globally to HiB meningitis and pneumonia.
15%-35% of HiB meningitis survivors may develop permanent neurological issues, including hearing loss and cognitive impairment.
Corticosteroids can reduce the risk of neurological deficits if given promptly.
Expanding vaccine access in developing nations could further decrease HiB-related impacts on child mortality.
Immediate empiric treatment with a third-generation cephalosporin is critical upon suspicion of bacterial meningitis in children; diagnostics should not delay antibiotic therapy.

Group B Streptococcus (GBS)

GBS, caused by Streptococcus agalactiae, is a leading cause of meningitis in newborns; it is a gram-positive, beta-hemolytic bacterium.
Transmission occurs primarily during childbirth, with 10%-40% of pregnant women colonized in the vaginal canal.
About 1.8 in 1000 live births experience GBS-related complications due to maternal transmission.
Neonatal GBS infection is categorized into early (first 7 days) and late (up to 2 months) onset; early infections are associated with specific risk factors.
High fever in infants under 1 year warrants lumbar puncture for meningitis evaluation.
Supportive care includes isolation, fluid management, and oxygenation to counteract hypotension.
A live attenuated 17-D vaccine provides immunity to 95% of vaccinated individuals.

St. Louis Encephalitis

Transmitted by Culex mosquitoes, St. Louis encephalitis manifests primarily through outbreaks in the central U.S., Texas, Florida, and the Caribbean.
Symptoms include flu-like signs: fever, headache, malaise, myalgia, nausea, vomiting, and photophobia.
Neurological symptoms can present as seizures requiring respiratory support.
MRI scans typically show nonspecific edema; CT scans generally remain normal.
EEG findings usually reveal polymorphic delta activity.
Elevated CSF pressure and mild protein increase with normal glucose levels are common laboratory findings.
Renal damage may be indicated by hematuria or proteinuria, with viral antigens often detected in urinary sediment.
Diagnosis confirmed through ELISA for antibody titers or RT-PCR.
Treatment is mainly supportive; no specific antivirals are available. The mortality rate is below 10%, with many experiencing lingering symptoms post-recovery, such as irritability and insomnia.

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Description

Explore the impact of the heptavalent pneumococcal vaccine introduced in 2000, which significantly reduced the incidence of pneumococcal meningitis among children. Additionally, learn about Haemophilus influenzae (HiB) as a common cause of meningitis in young children, its characteristics and implications.