MENINGITIS

Vicjane A. Gabuco BSN 3A-Group 2 Manuel S. Enverga University Foundation San Lazaro Hospital

OVERVIE W

‡Meningitis is an infection of the coverings around the brain and spinal cord. The infection occurs most often in children, teens, and young adults. Also at risk are older adults and people who have long-term health problems, such as a weakened immune system.

‡ An inflammatory process that affects the meninges and spinal cord of the brain = ICP ‡Common interference with neurological functioning in children ‡This is the most common infection of the CNS.

There are two main kinds of meningitis: ‡Viral meningitis is fairly common. It usually does not cause serious illness. In severe cases, it can cause prolonged fever and seizures. ‡Bacterial meningitis is not as common but is very serious. It needs to be treated right away to prevent brain damage and death. The two kinds of meningitis share the same symptoms. It¶s very important to see a doctor if you have symptoms, so that he or she can find out which type you have.

SOURCE

How Does Someone Get Meningitis? The body has natural defenses against infections ² and usually even if someone comes across a virus or bacteria that can cause meningitis, the body can fight it off. Everyone has lots of germs living on and in their bodies. Most of the time, these germs don't cause any illness. In fact, some of them, like some of the bacteria normally found in the intestines, help the body to work properly. However, some germs do cause infections. If a person gets an infection, the body's immune system will go to work to fight it. That's why you might feel sick one day, but then you start to feel better. The immune system is doing its job. Some germs, however, are tricky. They can outsmart the body's defenses and spread inside of the body. Some of these germs can even invade the central nervous system, infecting the meninges and causing meningitis.

CAUSATIVE AGENT

‡Streptococcus ‡Staphylococcus ‡Pneumococcus ‡Tubercle Bacillus ‡ Viral meningitis is caused by viruses. Bacterial meningitis is caused by bacteria. Meningitis can also be caused by other organisms and some medicines, but this is rare. Meningitis is contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact.

SIGNS & SYMPTOMS

The most common symptoms among teens and young adults are: ‡A stiff and painful neck, especially when you try to touch your chin to your chest. ‡Fever. ‡Headache. ‡Vomiting. ‡Trouble staying awake. The most common symptoms among teens and young adults are: ‡A stiff and painful neck, especially when you try to touch your chin to your chest. ‡Fever. ‡Headache. ‡Vomiting. ‡Trouble staying awake. ‡Seizures.

Children, older adults, and people with other medical problems may have different symptoms: ‡Babies may be cranky and refuse to eat. They may have a rash. They may cry when held. ‡Young children may act like they have the flu. They may cough or have trouble breathing. ‡Older adults and people with other medical problems may have only a slight headache and fever. It is very important to see a doctor right away if you or your child has these symptoms. Only a doctor can tell whether they are caused by viral or bacterial meningitis. And bacterial meningitis can be deadly if not treated right away.

PATHOGNOMONIC SIGN

Three signs of meningeal irritation: 1. Opisthotonus ± state of severe hyperextension & spasticify in w/c the individuals head, neck & spinal column enter into a complete arching position. 2. Brudzinski¶s sign ± place the patient in dorsal recumbent position & then put hands behind the patient¶s neck & bend it forward. If the patient flexes the hips & knees in response to the manipulation, the patient is positive for meningitis. 3. Kernig¶s sign ± place the patient in supine position, flex his leg at the hip & knee then straighten the knee, pain & resistance indicates meningitis.

MODE OF TRANSMISSION

‡Respiratory droplet - contagious
INCUBATION PERIOD

‡Incubation period varies from 1-10 days.

DIAGNOSI S

Your doctor will ask questions about your health, do an exam, and use one or more tests. Lumbar puncture is the most important lab test for meningitis. It is also called a spinal tap. A sample of fluid is removed from the spine and tested to see if it contains organisms that cause the illness. Your doctor may also order other tests, such as blood tests, a CT scan, or an MRI.

PATHOPHYSIOLOGY

· The common route of infection is by vascular dissemination from a focus of infection elsewhere. · Organisms also enter by direct implantation through various entries such as open fractures, surgical procedures, lumbar puncture, anatomic abnormalities such as Spina Bifida, Ear infections. · The infectious process may extend to the ventricles with resulting adhesions causing obstructive hydrocephalus and brain abscesses.

· If infection in the brain ± A purulent exudates covers the brain and may cause increased ICP. · Most common route is through the blood stream from a focus of infection elsewhere. · Can occur as direct extension from invasive procedures or devices. · Meningococcal ± direct contact ± droplets and discharge from nose and throats of carriers.

COMPLICATION S

‡An increased intracranial pressure is a known and a potentially fatal complication of bacterial meningitis. The main sign of an increased intracranial pressure is an altered state of consciousness, which may vary from lethargy to confusion to coma. ‡Otitis media (hearing impairment)

TREATMENT

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NURSING INTERVENTION

‡ FIRST thing - is ISOLATE the patient ‡ Lumbar Puncture ‡ Blood work is drawn ‡ Start Antibiotic Therapy - Penicillin drug of choice it crosses the blood brain barrier ‡ Close assessment for ICP ‡ Maintenance of optimal hydration - due to high fever - Careful not to overload
PREVENTION

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· Prophylactic antibiotic to anyone who has been contact or who has TB · RIFAMPIN

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