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DOM Morning Report: Bacterial Meningitis

Objectives. To know the most common causes of bacterial meningitis in the United StatesTo understand cerebrospinal fluid diagnosis of bacterial meningitisTo choose appropriate empiric antibiotic coverage. Background. Streptococcus pneumoniaeMost common cause in US (47%)Mortality rate = 19-26%H

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DOM Morning Report: Bacterial Meningitis

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    1. DOM Morning Report: Bacterial Meningitis Week of February 16, 2009

    2. Objectives To know the most common causes of bacterial meningitis in the United States To understand cerebrospinal fluid diagnosis of bacterial meningitis To choose appropriate empiric antibiotic coverage

    3. Background Streptococcus pneumoniae Most common cause in US (47%) Mortality rate = 19-26% Heptavalent conjugate vaccine 97.4% effective Recommended in all infants < 2yo

    4. Background Neisseria meningitidis Second most common cause in US Mortality rate = 3-13% Quadrivalent polysaccharide vaccine All 11-12 year olds catch-up for unvaccinated adolescents Microbiologists Travelers to hyperendemic areas Splenectomy and functionally asplenic pts

    5. Background Listeria monocytogenes 8% of cases in United States Mortality = 15-29%

    6. Background Associations Extremes of age Alcoholism Malignancy Immunosuppression Diabetes mellitus Pregnancy Hepatic disease Renal disease Iron overload Collagen vascular disorders HIV infection

    7. Background Other organisms Haemophilus influenzae type b Staphylococcus aureus Coagulase-negative staphylococci Aerobic gram-negative bacilli Klebsiella species Escherichia coli Serratia marcescens Pseudomonas aeruginosa

    8. Diagnosis Classic presentation Fever Headache Nuchal rigidity Signs of cerebral dysfunction

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