Condition Info - BotMed Application

ConditionName

Meningitis

ConditionDescription

Symptoms

Headache;
Neck stiffness and pain;
Photophobia;
Malaise;
Vomiting;
Confusion;
Fever;
Change in mental status
Seizures
Decreased consciousness
Petechiae, purpura (Nassirian m.)

PhysicalFindings

(+)Brudzinski’s Sign (neck flexion)
(+)Kernig Sign
Both can’t R/O meningitis!

ClinicalTests

↑WBC with left shift 1000 neutrophils;
Lumbar puncture;
CSF culture – diagnostic;

CSF:
Bacterial;
↑WBC(neutrophils);
↑CSF pressure;
↓glucose;
↑protein;

Serum Protein: sensitive, best initial;
Low glucose – not sensitive;
Blood Culture – most specific and accurate;

Viral:
↑some WBC(lymphocytes);
↑CSF pressure;
Normal glucose;
Normal protein;

Fungal or TB:
↑WBC(lymphocytes);
↑CSF pressure;
↓glucose;
↑protein;

If seizures or focal neurological defects or papilledema – order CT before CSF;

RiskFactors

Ear infections
Sinusitis
Immunocompromised
Neural surgery

IsRedFlag

IsNPLEX

Consequence

Complications of bacterial m. (acute):
Seizures
↑intracranial pressure
Subdural effusion
Empyema
Brain abscess
Hearing loss
Mental impairment

Long term complications:
Hearing loss
Seizure disorder
Intellectual disability
Spastic paralysis
Death

ProgressionFromCondition

Maternal group B strep infections (antibiotic for mother during delivery)

Gram (+) diplococci S.pneumo
Gram (-) diplococci
N.Meningitidis
Coccobacilli
H.influenzae (type B)
Gram(+) and Coccobacilli
Listeria
TB : very high protein level

Enterovirus family:
Echovirus
Human enterovirus
Coxsackievirus
Mumps
Lymphocytic choriomeningitis virus

TreatmentOptions

For viral:
IV fluid as needed
Empirical antibiotics until bacterial root R/O

PharmOptions

Antibiotics;
Steroids;

Prophylactic of Nassirian m. 
Rifampin, Ciprofloxacin

For TB: Rifampin
Isoniazid

For viral:
Acetaminophen for pain

WebLink

https://www.merckmanuals.com/en-ca/professional/neurologic-disorders/meningitis/acute-bacterial-meningitis