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Meningitis (Risk Factors (Bacterial endocarditis, Crowding e.g. military…
Meningitis
Risk Factors
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Crowding e.g. military base, university
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Diagnosis
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Blood tests; FBC, U&E, CRP, serum glucose
If there is NON-BLANCHING PETECHIAL or PURPURIC RASH = meningococcal septicaemia . Diagnosis confirmed by blood cultures
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Aetiology
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Neonates
Escheria coli, group B haemolytic streptococcus
Adults & children
Neisseria meningitides (droplet spread), streptococcus pneumonia/pneumococcus, less common is haemophilus influenza (due to vaccine)
Immmunocompromised
Cytomegalovirus, cryptococcus neoformans, TB, HIV, herpes simplex virus
Clinical Presentation
Acute bacterial - sudden onset, papilloedema, malaise, riggers, photophobia
Viral - benign, self limiting for 4-10 days, headache may follow for some months
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Chronic - mycobacterium tuberculosis, long history and vague symptoms, triad are absent or late
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Treatment
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Complications include hearing loss, seizures and developmental
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Epidemiology
Occurs in people of all age groups but more common in infants, young children and the elderly
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Pathophysiology
Microorganisms reach the meninges either by direct extension from the ears, nasopharynx, cranial injury or congenital meningeal defect or by bloodstream spread
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