Meningitis

Shafaat Ullah
BSN. Gen
Khyber
4/3/2017 Medical 1
 Clinical description
 Meningitis is the inflammation of the protective membranes
covering the brain and spinal cord known as the meninges.
 The inflammation is usually caused by an infection of the
fluid surrounding the brain and spinal cord.
 Meningitis can be life-threatening because of the
inflammation's proximity to the brain and spinal cord;
therefore the condition is classified as a medical emergency.

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 Meninges
The meninges is the system of membranes which envelops the
central nervous system.
It has 3 layers:
1. Dura mater
2. Arachnoid mater
3. Pia mater
Subarachnoid space -
is the space which
exists between the
arachnoid and the pia
mater, which is filled
with cerebrospinal
fluid.
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 Causes of Meningitis
- Bacterial
- Viral
- Fungal
- Parasitic/ protozoal
- Physical injury
- Cancer
- Certain drugs ( mainly, NSAID’S)
- Head injury
- Cerebral abscess
- Middle ear infection

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 Bacterial
- Haemophilus influenzae
- Listeria
- Meningococcus
- Mumps
- Pneumococcus
- Certain Streptococcus

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 Viral
- Enterovirus (coxsackie, echovirus)
- Arboviral (mosquito-borne diseases)
- Influenza
- Herpes simplex virus type2 ( especially in infants)
- Varicella zoster
- HIV
- Mumps
- measles

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 Fungal Parasitic/protozoal
Cryptococcus Angiostrongylus
Coccidiodes Toxoplama
Histoplasma Hydatid
Mucormycosis Amoeba
Aspergillus Plasmodium
Candida (yeasts) Cysticercosis

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 Risk factors
• Age- children younger than 5 years
• Use of immunosuppressive drugs
• Chronic malnutrition
• AIDS
• CSF Shunt
• Chronic alcoholism
• Diabetes
• Pneumonia
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 Pathophysiology
Causative Cross the blood barriers
organism Inflammatory
enters the reaction in
blood stream meninges

Inflammation
CSF cloudness
may cause ICP
or infected Inflammation of
subarachnoid
space and pia
meter occur

CSF flows in
CSF cell count subarachnoid
increase space

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 Sign and symptoms
• Severe headache • Disorientation
• Irritability • Tachycardia
• Restlessness • Coma
• Stiffness of neck • Sleeplessness
• Malaise • Phonophopia
• Nausea/vomiting • Photophobia
• High grade fever • Altered mental
• Tachypnea status(confusion)
• Seizures
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 Diagnostic evaluation
• By +ve signs • Blood test
• Physical examination • CBC
• History collection • Blood culture
• CSF evaluation for • MRI
pressure, proteins, • CT scan
glucose and leukocytes.

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 Clinical manifestation
Confirmative sign:
• Positive kernig’s sign

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 Brudzinski’s Sign

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 COMPLICATIONS
• Brain damage
• Cerebral edema
• Hearing loss
• Tissue damage

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 Treatmen
•Antibiotics for bacterial meningitis :Type vary depending on the
t
bacteria causing the infection.
• Antibiotics are not effective in viral meningitis.
•Other medications and intravenous fluids will be used to treat
symptoms such as brain swelling, shock, and seizures.

Prevention
• Haemophilus vaccine (HiB vaccine) in children.
•The pneumococcal conjugate vaccine is now a routine childhood
immunization and is very effective at preventing pneumococcal
meningitis.
•Household members and others in close contact with people who
have meningococcal meningitis should receive preventive antibiotics.
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 Nursing managements
• Altered body temp. Interventions:
related to infectious • Monitor temperature
process. continuously
• Administer antipyretic
drugs as prescribed.
• Switch on fan and open
the windows.
• Cold sponge

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 Cont…..
• Ineffective tissue Interventions:
perfusion R/T infectious • Assess level of
process and cerebral
edema. consciousness
• Assess inc. ICP
signs
• Provide calm and quit
environment
• Prepare patient for LP
for CSF evaluation.
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