Meningitis

Meningitis

1. Definition: An acute life-threatening infection of viral, bacterial, or fungal origin. Which progresses through the blood brain barrier causing inflammation of the meninges.

   • References: Parini, S. (2002). The meningitis mind-bender. Nursing Management; Chicago, 33(8), 21–25.
   • Meningitis
     • Inflammation of the tissue and membranes covering the brain.
     • Caused by bacteria, viruses or fungi.
     • Can exist in single form only
     • Diagnosis by bloods and cultures.
     • Treatment with Penicillin, aminoglycoside or cephalosporin
   • Encephalitis
     • Acute inflammation of the brain parenchyma
     • Caused by viral agents
     • Can occur as primary or secondary type
     • Requires neuroimaging for diagnosis.
     • Treated with IV Acyclovir for 10 days.

2. Meningococcal

   • Signs: Petechial rash with pink macules
     • Treatment: Penicillin or Chloramphenicol and Trimethoprimsulfamethoxazol
   • Cause: Bacterium Neisseria meningitidis, also called meningococcus

3. Viral (Aseptic)

   • Signs: respiratory or gastrointestinal symptoms such as enterovirus.
     • Treatment: Comfort measures and treatment of causative virus. Can be prevented with childhood immunisations.
   • Cause: Coxsackie or Echovirus groups of enteroviruses

4. Haemophilus

   • Signs: Sudden onset
     • Treatment: Ceftriaxone and systemic corticosteroid treatment
   • Cause: Haemophilus influenzae, type B bacteria

5. Pneumococcal

   • Signs: Underlying conditions such as otitis media, bacteremia, mastoiditis, basilar skull fracture, pneumonia or infective endocarditis.
     • Treatment: Penicillin, Cefotaxime or Ceftriaxone.
   • Cause: Streptococcus pneumonia crossing the blood brain barrier.

6. Neonatal

   • Signs: Contact with Listeria monocytogenes or Escherichia coli during birth or nosocomially just after delivery.
     • Treatment: Penicillin and 3rd Generation Ceflasporin or Aminoglycoside then antimicrobial treatment based on cultures.
   • Cause: Group B Streptococcus, Escherichia coli, and Listeria monocytogenes

7. Syphilitic

   • Signs: Psychologial state change, altered vision or sensation, ataxia, cerebrovascular accident, seizures, tremors and Charcot joints. Previous history of Syphilis infection.
     • Treatment: Aqueous crystalline IV Penicillin G.
   • Cause: Treponema pallidum, syphilis infection.

8. Cryptococcal

   • Signs: Known immune deficiency or reticuloendothelial system disorders. Lung, kidney, prostate, or bone infections
     • Treatment: Amphotericin B, often in combination with 5-fluorocytosine
   • Cause: Cryptococcus neoformans and Cryptococcus gattii fungus

9. Tuberculous

   • Signs: Known immune deficiency disorder, alcohol abuse or history of Tuberculosis.
     • Treatment: 4-drug therapy consisting of Isoniazid, Rifampin, Ethambutol, and Pyrazinamide, then with improvement, a 3-drug therapy based on susceptibility patterns.
   • Cause: Mycobacterium tuberculosis.

10. Common symptoms: Fever, severe headache, nausea and vomiting, stiff neck, photophobia , mental status changes, behavioural changes, arching back, blank stare, lethargy, refusing food, bulging fontanele, pale or blotchy skin and seizures

    • Common complications: Hearing or vision loss, brain damage, hydrocephalus, and muscle paralysis.