Sunday 3 February 2013

Bacterial meningitis (in Adults)


Bacterial meningitis (in Adults)

Clinical Features: A patient will present with
Ø  High fever
Ø  Severe headache
Ø  Stiff neck
Ø  Sensitivity to bright light

D/Ds
§Cerebral Malaria
§  Brain Abscess
§  Encephalitis
§  SAH

Investigations
·         Lumbar puncture
·         Blood Glucose
·         M.P
·         Base Line Investigation
·         Blood culture

NOTE: If question say that patient is confuse and having neurological deficit then ASK for CT scan first.


Treatment:

A.   Supportive
Vary according to the patient complaint i-e For Fever give anti-pyretic etc

B.   Specific

Depends upon culture result, initially give empiric therapy with CEFTRIAXONE + Vancomycin + Dextamethasone



Complications

So many complication but write down these two in exam (if question has given 2 

 marks to the complication part)

  1. 8th cranial nerve palsy (Deafness)
  2. Hydrocephalus

MEDICOLE EXTRA: 
  1. If a rash (along with above syproms) is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash. Give rifampin OR ciprofloxacin ORceftriaxone OR minocycline OR spiramycin to all those who are in close contact with patient.
  2. Patient Age above 50 years. Add Ampicillin to the Emperic Therapy
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