(A&E) (Infection)

Overview

• Infection of the meninges in the brain or spinal cord, that is most commonly viral or bacterial in origin, but may also be fungal, parasitic or due to noninfectious causes
• In paediatric population, meningitis most often occurs in children <1 years of age. The median age for meningitis among adults is 43 years old.
• Risk Factors → immunocompromise, crowded living conditions, otitis media, sinusitis, CSF leak after head trauma or neurosurgery, sepsis
• Bacterial Meningitis (More Serious)
  • Neonates = Group B streptococcus
  • Children = streptococcus pneumoniae or neisseria meningitidis
    • S.pneumoniae ⇒ gram positive diplococci
    • N.meningitidis ⇒ gram negative diplococci. Will also cause petechial non-blanching rash.
  • Elderly = streptococcus pneumoniae
• Viral Meningitis (More Common) ⇒ enteroviruses (poliovirus, coxsackie A), HSV, VZV, mumps
  • Enteroviruses (Coxsackie, Poliovirus) → most common viral cause
• Causes of Meningitis Buzzwords

Making Diagnosis

Clinical Features:

Features of bacterial and viral meningitis are similar, although viral meningitis is less acute and usually self-limiting within 7–10 days

• Triad ⇒ fever, headache & neck stiffness
• Photophobia
• Nausea & Vomiting
• Altered mental status
• Seizures