meningitis

• An infection of the meninges-the covering of the brain and spinal cord
• Can be bacterial, viral, parasitical

• Infectious disease
• Basillar skull fx
• Otitis media
• Sinusitis
• Mastoiditis
• Neurosurgery-invasive procedures
• Systemic sepsis
• Impaired immune function

• Infection of meninges & CSF
• Infection causes inflammatory response in meninges
• Results in meningeal congestion, cerebral edema, increased ICP

• Bacterial
• Aseptic
• Fungal
• Viral

• Most common
• Can cause brain damage, hearing loss, learning disabilities- even when treated quickly
• MEDICAL EMERGENCY
• Death can occur within 48 hrs even if treated

• Confusion, altered LOC
• Restlessness, agitation, irritability
• Abd & back pain
• N/V
• Severe headaches
• + Brudzinski's
• + Kernig's
• Photophobia
• Stiff neck-nuchal rigidity
• Fever & chills
• Seizures
• S/S increasing ICP

Pain and/or resistance occurs c flexion of the knee and hip and straightening of the knee in the supine position

Pain, resistance & hip & knee flexion occur when neck is flexed to the chest while lying supine

• A titanic spasm where head and heels are bent backward and body is bowed forward
• In severe cases of meningitis.

• Most significant: change of LOC
• Earliest: blurred vision, decreased visual acuity, diplopia
• Next: headache, papilledema (swelling of optic disc), vomiting

• Assess neuro status/VS regularly
• Assess changes in neuro status, presence of cranial nerve dysfunction
• Assess/prepare for seizures
• Assess for increased ICP
• Admin meds/maintain fluid restrictions
• Assess for fluid volume deficits
• Monitor I&O, DW, skin turgor, labs, urine concentration

• Culture of CSF ID's causative organism
• Culture of blood, urine, nose, throat
• CT scan of head
• Chest/Sinus x-ray
• Increase WBC

• High dose, broad spectrum antibiotics initially
• Anticonvulsants
• Antipyretic
• Antiemetic
• Analgesics
• IV replacement

• Prophylactic antibiotic therapy for close contacts
• Vaccinations for pediatric
• S/S to look for
• Management of present illness