Meningitis resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD[2]
Overview
Meningitis is characterized by inflammation of the leptomeninges.Meningitis causes are divided to infectious and non-infectious process.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Bacterial:
- Streptococcus pneumoniae
- Neisseria meningitis
- Hemophilus influenza
- Group B streptococcus
- Listeria monocytogenes
Viral:
Fungal:
- Cryptococcus neoformans
- Aspergillus sp.
- Blastomyces dermatitidis
- Coccidioides immitis
- Candida spp.
- Histoplasma capsulatum
- Sporothrix schencki
Diagnosis
| suspicion for bacterial meningitis | |||||||||||||||||||
| yes | |||||||||||||||||||
| Immuncompromised,new onset seizure,History of CNS dis,altered consciousness,papilledema,focal neuorologic deficit,delay in performance of diagnostic of LP | |||||||||||||||||||
| Yes | No | ||||||||||||||||||
| Blood culture stat,CTscan | Blood culture and LP stat | ||||||||||||||||||
| Negative CTscan | |||||||||||||||||||
| LP | |||||||||||||||||||
Treatment
Adapted from IDSA guidline[1]
| suspicion for bacterial meningitis | |||||||||||||||||||||||||||||||||||||||||
| yes | |||||||||||||||||||||||||||||||||||||||||
| Immuncompromised,new onset seizure,History of CNS dis,altered consciousness,papilledema,focal neuorologic deficit,delay in performance of diagnostic of LP | |||||||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||||||
| Blood culture stat | Blood culture and LP stat | ||||||||||||||||||||||||||||||||||||||||
| Dexamethasone and empirical antibiotic therapy | Dexamethasone and empirical antibiotic therapy | ||||||||||||||||||||||||||||||||||||||||
| Negative CTscan of head | Positive CT scan | Csf findings c/w bacterial meningitis | |||||||||||||||||||||||||||||||||||||||
| Perform LP | Continue therapy or consider alternative diagnosis | Yes | |||||||||||||||||||||||||||||||||||||||
| Continue therapy | |||||||||||||||||||||||||||||||||||||||||
Do's
- The content in this section is in bullet points.
Don'ts
- ↑ Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM; et al. (2004). "Practice guidelines for the management of bacterial meningitis". Clin Infect Dis. 39 (9): 1267–84. doi:10.1086/425368. PMID 15494903.