Meningitis, CNS infections, bacteria, virus, fungus

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Presentation Description

A clinical approach to meningitis for medical professionals, physicians, medical students, residents

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Presentation Transcript

Meningitis : 

Meningitis Dr Rahul Chakor MD DM

Slide 2: 

Inflammation of the Leptomeninges Various Etiologies Microbial Autoimmune Granulomatous Drugs Other

Slide 3: 

Bacterial Group B Streptococcus L monocytogenes S pneumoniae N meningitides H influenzae Gram-negative bacilli Staphylococci Mycobacterial

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Viral Echovirus, Coxsackie, HSV 2, Mumps, LCMV, Adenovirus, HIV Arboviruses Fungal Cryptococcal Autoimmune disorders SLE, Vasculitis Sarcoidosis

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Drugs NSAIDS,Immunoglobulins Others Mollaret recurrent Meningitis, Parasitic Vogt Koyanagi Harada syndrome Parameningeal Focus Neoplastic Invasion

Pyogenic Meningitis : 

Pyogenic Meningitis Hematogenous spread Local spread Inflammatory reaction Complications Resolution

Symptoms : 

Symptoms Fever Severe Headache Vomiting Convulsions Disturbed Consciousness Focal Cerebral deficits

Specific Features : 

Specific Features Meningococcal Meningitis Epidemic.Rapid evolution to delirium, stupor within hours. Petechial, purpuric rash on feet, circulatory shock. Pneumococcal Meningitis Preceeded by pneumonia,endocarditis.In adults,sporadic, recurrent, alcoholic, splenectomized pts. H influenzae Children following upper respiratory and ear infection.

Physicial Signs : 

Physicial Signs Cerebral dysfunction- delirium to coma Focal deficits-occasionally Cranial nerve deficits-3rd 6th 7th Neck Stiffness, Kernig’s sign, Brudzinski’s sign Classical signs absent in Neonates, Elderly and Immunocompromised

Likely Pathogen : 

Likely Pathogen

Investigations : 

Investigations Blood Tests Neuroimaging CSF study Blood Culture

Approach : 

Approach Suspicion of Meningitis Papilloedema or focal Neurological signs CBC, Blood Culture Head CT No Mass Lesion CSF Analysis

Approach : 

Approach Causative Organism Detected Treatment as per Microorganism Prophylaxis of Contacts Look for Complications Adjunctive Therapy

Antibiotic Choice : 

Antibiotic Choice

Antibiotic Choice : 

Antibiotic Choice

Adjunctive Therapy : 

Adjunctive Therapy Dexamethasone 3months and above (Tunkel and Scheld) simultaneously or before antibiotics Children with H influenzae Pneumococcal meningitis in adults CSF study in 24-48 hrs.

Adjunctive Therapy : 

Adjunctive Therapy ICP monitoring Vigorous Treatment of ICP Treatment of Seizures Treatment of Shock and DIC

Complications : 

Complications Septic Venous Thrombophlebitis Arteritis with Infarcts Subdural Empyma Hydrocephalus Cerebritis and Brain abscess

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Thank You