Week 4

Symptoms Meningismus (neck stiffness),

Flu like symptoms (fever and
Photophobia, Phonophobia, Vomiting
headache)
and Focal neurological signs

Diagnosis
1. Lumbar puncture and CSF analysis 1. Lumbar puncture and CSF analysis
• Many mononuclear cells • Strongly elevated WBCs
• Normal protein count mainly neutrophils
• Normal glucose • Strongly elevated protein
• Decreased glucose
CSF/blood ratio
2. Virus identification in CSF by • Increased lactate
isolation from cultures 2. Bacterial identification by Gram
staining and culture
3. Cranial CT
Main causative Streptococcus pneumoniae
Enteroviruses
organisms (pneumococcus)
Treatment • Antipyretics 1. Antibiotics mosly cephalosporins
of third (ceftriaxone, cefotaxime) and
• Antiviral (if herpes was the cause forth generations (cefepime)+
of meningitis) ampicillin and/or vancomycin
2. Corticosteroids (dexamethasone)
3. Immunization (vaccination)
Complications
• Fatal condition
Mild condition that spontaneously • Major complications include (brain
resolves within 2 weeks edema, hydrocephalus, hearing
loss, vascular complications and
sepsis in addition to neurological
deficits that may become
persistent)
 A three-month-old infant was brought to a clinic for pediatric
evaluation. The infant had had a mild fever (101 °F) for the past 24
hours and was described as very irritable and fussy by the mother.
Physical examination results were normal. A lumbar puncture was
performed, a complete blood cell count and blood cultures were
obtained, and urine was collected for urinalysis and culture. The
results are given in Table I.
Reference ranges in CSF are:
WBCs: 0-300 mm3, Dominant cell type: lymphocytes, Glucose level: 50-100 mg/dL and protein 20-45
mg/dL.

1. What is the type of

meningitis? Why does the
other type rolled out?
2. What key diagnostic test
result in the patient’s
report that helped you to
identify the type?
3. What is the possible
treatment? Should the
mother receive prophylaxis
treatment?
Contrast viral and bacterial meningitis regarding:
1. Diagnostic tests
2. Main causative organism
3. Management
Thank You