5. Bacterial causes of meningitis
Age of onset Common Less common
Neonate G-vebacillia Listeria monocytogenes
Group B streptococci
Pre-school child H-influenzae Mycobacterium
N-meningitidis tuberculosis
St-pneumonia
Older child N-Meningitidis L monocytogenous
St-pneumonia T.B
Crypto
Adult St-pneumonia L monocytogenous
N-Meningitidis T.B
Crypto
6. Bacterial Menigitis
Age less than 3 months
– Group B strep
- E. coli
– L. Monocytogenes
- Strep. pneumoniae
7. Bacterial Meningitis
3 Months to 1 year
– S. pneumoniae
– H. influenzae
– N. meningitidis
8. Bacterial Meningitis
Age 18 to 50 years
– S. pneumoniae
– N. meningitidis
– H. influenzae
9. Bacterial Meningitis
Over age 50 years
– S. pnemoniae
– L. monocytogenes
– Gram (-) bacilli
10. Symptoms
– Fever (hypothermia in children)
– Headache
– lethargy to coma
– Nausea
– Vomiting
- Constitutional symptoms
11. Signs
– Altered mental status (lethargy to coma).
– Meningeal signs (neck stiffness, kering sign and
brudzinski sign).
- Focal neurological signs.
– Increased intracranial pressure ( papilledema,
nausea/vomiting, abducens palsies, bulging fontanelle
in infants
- Skin rash.
- Adrenal insufficiency.
- Signs of systemic diseases.
12. LP
glucose and protein
cell count and differential
gram stain and rountine culture
Cyrptococcal antigen
AFB stain and culture
VDRL, or viral studies (PCR)
13. CSF Characteristics
Bacterial Viral Fungal TB
Opening Elevated Slightly Normal Ususally
Pressure elevated or High high
Glu Very Low Normal Low Low
Pro Very high Normal High Very
High
Rbcs Few None None None
Wbcs 1000-100 <200 <50 500-1000
(c/mm3) 00
14. Treatment of Bacterial
Meningitis
3rd generation cephalosporin
Steroids – Dexamethasone IV q6 for 4 days
Antpyertic
Treatmebt of seizure
Treatment of complications