A child with a stiff neck

A child with a stiff neck

1. Anatomy

   • skull
   • meninges
   • ventricular system
     • is a set of four interconnected cavities known as cerebral ventricles in the brain
       • Within each ventricle is a region of choroid plexus
         • which produces the circulating
           • cerebrospinal fluid (CSF).
             • CSF INTERPRETATION
               • WBC LEVELS
                 • Increased
                   • polymorphs (nuetrophils)
                   • lymphocytes

2. meningitis

   • is an inflammation (swelling) of the protective membranes covering the brain and spinal cord
   • infectious
     • bacterial
       • Streptococcus pneumoniae
       • Neisseria meningitidis
       • Haemophilus influenzae
       • Listeria monocytogenes
     • viral
       • Enterovirus
       • Echovirus
     • fungal
       • mostly affects people with immune deficiencies
   • non-infectious
     • due to injury \cancer\drugs
   • signs & symptoms
     • headache
     • fever
     • neck stiffness
     • photophobia
     • vomiting
       • physiology of vomiting
       • Types
         • projectile
           • gastric outlet obstruction
         • non-projectile
   • Investigation
     • physical examination
       • Kernig's sign
       • brudzinski sign
     • lumbar puncture
       • Is where a thin needle is inserted between the bones in the lower spine.
         • in infants : L4-L5 interspace
         • on adult : L3-L4 interspace
       • indications
         • diagnostic
         • therapeutic
         • anesthetic
       • contraindication
         • increased intercranial pressure
         • skin infections at the level of insertion
       • complications
         • back pain
         • hemorrhage
   • Management
     • Newborn
       • Ampicillin + 3ed generation cephalosporin + aminoglycoside
     • Adult
       • Vancomycin + 3ed generation cephalosporin
     • Elderly
       • Ampicillin + Vancomycin + 3ed generation cephalosporin

3. isolation methods

   • there are three categories of Transmission-Based Precautions
     • Airborne Precautions
     • Droplet Precautions
     • Contact Precautions

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