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Unit 5 Meningitis. 7/14/05. Bacterial (pyogenic) Meningitis. Causes include: Haemophilus influenzae b (vacine) Streptococcus pneumoniae Neisseria meningitidis (meningococcus)-readily transmitted via droplet infectiion Most common in newborn
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Unit 5 Meningitis 7/14/05
Bacterial (pyogenic) Meningitis • Causes include: • Haemophilus influenzae b (vacine) • Streptococcus pneumoniae • Neisseria meningitidis (meningococcus)-readily transmitted via droplet infectiion • Most common in newborn • B-hemolytic strep., E. coli, Listeria monocytogenes.
Meningitis awilt: 10-15% fatal • Predisposition and susceptibility • 10-15% fatality • Clinical Manifestations –age related • children & adolescents • infants & young children • Neonates Highest mortality
Pathophysiology • Focus of infection elsewhere • Direct extension • Implantation • Release of TNF -> meningeal inflammation • Purulent exudate • May extend into ventricles
Pathophysiology • Focus of infection elsewhere • Direct extension • Implantation • Release of TNF -> meningeal inflammation • Purulent exudate • May extend into ventricles
Kernig’s Sign KERNIG’S SIGN
Complications • Reduced with earlier & appropriate Tx. • Hydrocephalus • Subdural effusions • Brain abscess • Damage to cerebral cortex • Damage to cranial nerves • Seizures
Complications • Meningococcemia • Waterhouse-Friderichsen Syndrome • Long-term problems • cerebral palsy • mental handicaps • seizures
Diagnosis Lumbar puncture Culture (ID organism) Gram stain Cell count ( elevated WBC, low Gl) Blood culture
Treatment • Isolation • Antimicrobial therapy • Hydration • Decrease ICP • Control seizures, and temperature • Manage complications awilt: Respiratory isolation X 24 hours post antibiotics
Nursing • Prevention • Environment • Fluids and hydration • Family support
Other Meningitis • Aseptic or viral • Varies in onset • Manifestations: fever, H/A, GI symptoms • Tx: symptomatic • Tuberculosis Meningitis • Young immunosuppressed child