Unit 5 Meningitis 71405 Bacterial pyogenic Meningitis n
Unit 5 Meningitis 7/14/05
Bacterial (pyogenic) Meningitis n Causes include: q q q n Haemophilus influenzae b (vacine) Streptococcus pneumoniae Neisseria meningitidis (meningococcus)-readily transmitted via droplet infectiion Most common in newborn q B-hemolytic strep. , E. coli, Listeria monocytogenes.
Meningitis awilt: 10 -15% fatal n n n Predisposition and susceptibility 10 -15% fatality Clinical Manifestations –age related q q q children & adolescents infants & young children Neonates Highest mortality
Pathophysiology q q q Focus of infection elsewhere Direct extension Implantation Release of TNF -> meningeal inflammation Purulent exudate May extend into ventricles
Pathophysiology q q q Focus of infection elsewhere Direct extension Implantation Release of TNF -> meningeal inflammation Purulent exudate May extend into ventricles
Kernig’s Sign KERNIG’S SIGN
Brudzinski’s Sign
Complications n Reduced with earlier & appropriate Tx. q q q Hydrocephalus Subdural effusions Brain abscess Damage to cerebral cortex Damage to cranial nerves Seizures
Complications n n n Meningococcemia Waterhouse-Friderichsen Syndrome Long-term problems q q q cerebral palsy mental handicaps seizures
Diagnosis n Lumbar puncture q q q n Culture (ID organism) Gram stain Cell count ( elevated WBC, low Gl) Blood culture
Treatment n n n Isolation Antimicrobial therapy awilt: Respiratory isolation X 24 hours Hydration post antibiotics Decrease ICP Control seizures, and temperature Manage complications
Nursing n n Prevention Environment Fluids and hydration Family support
Other Meningitis n Aseptic or viral q q q n Varies in onset Manifestations: fever, H/A, GI symptoms Tx: symptomatic Tuberculosis Meningitis q Young immunosuppressed child
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