Meningitis
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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
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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