36 Meningitis

  • dura: durable, cover skull
  • arachnoid/pia: leptomeninges

Symptoms and Diagnosis

  • fever from inflammation
  • headache from inflammation of meninges
  • photophobia: bright lights bothersome

  • spinal cords ends at conus medullaris, L1-L2
  • does not pierce pia

  • check when first put needle in
  • measures CSF pressure

  • normal should be sterile with very few cells

Complications

  • hydrocephalus: scarring of arachnoid villi ability to absorb fluid
  • hearing loss: scarring of nerve
  • seizures: scarring of cx surface
  • bacterial: more exudates/pus, more scarring

Meningitis Causes and Treatment

  • listeria: poor cell mediated immunity, children and elderly
  • S. pneumo most common from children to elderly

Bacterial Causes

  • listeria: poor cell mediated immunity, children and elderly
  • S. pneumo most common from children to elderly

  • encapsulated organism: asplenic and sickle cell high risk

  • meningococcemia: bacteremia with meningitis
  • hypotension

  • droplet precaution: wear a mask

  • almost never cause meningitis anymore

  • tumbling motility: instead of swimming around, tumbles from side to side in petri dish
  • pasteurization: warm milk up and cool off to kill bacteria

  • can't complain of headache, photophobia
  • failing to thrive symptoms, do LP to rule out meningitis

Viral Causes

  • like cold of spinal canal

  • very rare

Encephalitis

  • if these symptoms present: encephalitis, not meningitis

  • measles: subacute encephalitis years later