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Meningitis and tubercular meningitis, Slides of Nursing

Meningitis is inflammatory disease of the brain and spinal cord. Most common infectious disease seen children

Typology: Slides

2021/2022

Available from 11/12/2022

athirapm-vinayan
athirapm-vinayan 🇮🇳

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Meningitis

Definition

Meningitis refers to the inflammation of the

meninges overlying the brain and spinal cord.

It is one of the most dreadful emergencies met

with in pediatric practice.

The fatality rate is high

Types

Pyogenic or bacterial meningitis : H.

Influenzae, pneumococcal, meningococcal,

staphylococcal, streptococcal and E.coli

infection

Tuberculous meningitis

Aseptic meningitis : viral, fungal and protozoal

Pyogenic meningitis

Pyogenic meningitis is caused by bacterial

infections

It results from either primary infection of the

meninges or spread from a near pyogenic focus.

Major cause of morbidity and mortality in children

Risk factors

Young age

Close contact

Overcrowding, Low socioeconomic status

  • Patients with DM and malignancies

Immunocompromised – babies of HIV positive mothers

Children on immunosuppressive drugs

Asplenia: Absence of normal spleen function

Congenital defects

CSF leak

Pathophysiology

The infection spreads hematogeneously to

meninges from bacterial sepsis or distant foci

Infection spreads through subarachnoid space

Inflammatory process begins

Increase in CSF exudation in ventricles

Clinical features

Neonates:

Poor feeding

Vomiting

Diarrhoea

Lethargy

Weak cry

Sleepiness

Bulging fontanel

Infants > 3 months

◦ Fever

◦ Irritability

◦ Poor feeding, Vomiting

◦ High pitched cry

◦ Seizures

◦ Bulging fontanel

◦ Nuchal rigidity

Contd...

Children older than 3 years

Fever, chills and malaise

Headache

Vomiting

Papilledema

Contd...

Positive kerning’s sign – patient supine with hip

flexed 90 degree. Knee can not be extended.

Special features

Pneumococcal meningitis

Occur at any age except in the first few months of

life.

Usually follows infections such as pneumonia,

otitis media, sinusitis, head injury etc.

Subdural effusion is the complication

Highest mortality rate

Vaccine is available for prevention

Staphylococcal meningitis

In neonates found to be associated with

umbilical sepsis, pyoderma and septicemia.

In older children – associated with otitis media,

mastoiditis, pneumonia etc