Bacterial Meningitis

Modifiable Factors: Non-Modifiable Factors:

• Vaccination Status • Age

• Hygiene • Medical Condition (Congenital abnormalities)
• Avoiding close contact • Premature birth
• Genetics

Streptococcus Pneumonia
Neisseria meningitidis

Organisms gain entry into CNS through Inflammatory response

upper respiratory tract via blood stream
• Increase cerebrospinal fluid
• Increased intracranial pressure
May enter through penetrating wounds of
the skull or fractured sinuses in basilar skull
fractures Increased ICP early signs

• Altered LOC, restless, irritability,

Purulent secretions spread throughout agitation, decreased mental
brain through the cerebrospinal fluid and status
cover cranial nerves and other intercranial
structures

If extends to brain parenchyma or if Observe for signs of increased ICP, it can

concurrent encephalitis is present, cerebral be increased from swelling and increased
edema and increased intracranial pressure cerebrospinal fluid volume
become a problem

SIGNS AND SYMPTOMS:

• High pitch cry LABS & DIAGNOSTIC PROCEDURE:

• Bulging fontanels
Cranial UTZ: (benign enlargement of the
• Hard stiff neck (nuchal rigidity)
subarachnoid space hydrocephalus)
• High temp (fever)
• Photophobia Hematology: (low HCT, low RBC, low EO, high MCH)
• Increased intracranial pressure (could lead to seizure, CT scan
coma, death)
• Agitation
• Altered/decrease Level of Consciousness
• Severe headache
• Nausea
• vomiting

If Yes Management If No

Persistent or recurrent infections

Nursing Management: Medical Management:

• Monitor vital signs closely, including • Initiate empiric antibiotic therapy

temperature, heart rate, respiratory
rate, and blood pressure.
• Assess neurological status regularly,
including level of consciousness,
pupillary response, and motor
function.
• Implement strict infection control
measures to prevent the spread of
bacterial meningitis to other patients
and healthcare workers.
• Provide comfort measures, such as
positioning the infant for optimal
comfort and administering pain relief
as needed.
immediately upon suspicion of Enlargement of ventricles and increased ICP
bacterial meningitis, based on
local antimicrobial resistance
patterns.
Neurologic complications (motor
• Perform lumbar puncture for
cerebrospinal fluid (CSF) analysis impairments, sensory deficits, cognitive
to confirm the diagnosis of dysfunction, damage to cerebral cortex or
bacterial meningitis and guide basal ganglia)
antibiotic selection.
• Administer appropriate antibiotics
Neurologic complications (motor
intravenously for a duration
determined by the specific impairments, sensory deficits, cognitive
organism and clinical response. dysfunction)
• intensive care teams to optimize
management and outcomes.
Vision and hearing impairments
• Educate parents or caregivers about
the signs and symptoms of bacterial
meningitis and hydrocephalus, as
well as the importance of follow-up
care.
• Provide emotional support to parents
or caregivers during this challenging
time, offering reassurance and
information as needed.
• Ensure adequate hydration and
nutrition, possibly through
nasogastric or intravenous routes if
necessary.
• Monitor for signs of increased
intracranial pressure (ICP), such as
irritability, bulging fontanelle, or
changes in level of consciousness.
• infectious disease, and pediatric
• Consider placement of an external
Developmental delays and disabilities
ventricular drain (EVD) or
ventriculoperitoneal shunt (VP
shunt) for management of
hydrocephalus if indicated by
imaging studies or clinical
Recurrent seizure and epilepsy
symptoms.
• Provide supportive care for
complications such as seizures,
respiratory distress, or
disseminated intravascular
coagulation (DIC). Chronic health conditions
• Perform regular neurologic
assessments to monitor for
changes in status and response to
treatment.
• Coordinate multidisciplinary care Mortality
involving neurology, neurosurgery,
intensive care teams to optimize
management and outcomes.