36 Meningitis

Structure

• 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