MENINGITIS
PATHOPHYSIOLOGY
DIAGNOSTIC TESTS
MEDICAL MANAGEMENT
- Intravenous therapy
DEFINITION
- Refers to the infection and inflammation of the meninges / coverings of the brain.
CLINICAL MENIFESTATIONS
- Fever
- Neck stiffness
- High-pitched crying in infants.
- seizures
- Photalgia (photophobia).
- Infection causes an increase in CSF production and pressure that is measurable on lumbar puncture.
- The inflammatory reaction causes irritation of cerebral tissues and may cause convulsions.
- Inflammatory exudate increases intracranial pressure
- The inflamed and irritated meninges cause neck stiffness and headache
- Meninges become swollen and inflamed
- Healing may leave scar tissue in the meninges causing epilepsy
- Scar tissue may also block CSF drainage channels causing hydrocephalus.
- Blood studies
- Chest radiography.
- CT Scan
- Cultures and bacterial antigen testing.
- Lumbar puncture.
- Serum procalcitonin testing
- Crystalloid infusion : if patient is in shock or hypotensive
- Seizure precautions : If the patient’s mental status is altered
- Oxygen administration : administer if patient is alert, in stable condition with normal vital signs
PHARMACOLOGICAL MANAGEMENT
- Sulfonamides work together to inhibit bacterial synthesis of tetrahydrofolic acid
- Carbapenems inhibit bacterial cell wall synthesis and can be used for the treatment of meningitis.
- Anticonvulsants are used to help aggressively control seizures (if present).
- Antiviral agents interfere with viral replication; they weaken viral activity; they can be used in viral meningitis.
- Glycopeptides inhibit bacterial cell wall synthesis and are indicated for infections caused by gram-positive bacteria.
NURSING MANAGEMENT
- Assess blood pressure for incipient shock, which precedes cardiac/respiratory failure.
- Reduce high fever to decrease load on heart and brain from oxygen demands.
- Insert cuffed endotracheal tube (or tracheostomy), and position patient on mechanical ventilation as prescribed.
-Protect the patient from injury secondary to seizure activity or altered level of consciousness (LOC).
- Assess neurologic status and vital signs constantly.
