Initial therapy and prognosis of bacterial meningitis in adults. Enteroviruses account for of the majority of cases of aseptic meningitis in children. Managing meningitis epidemics in africa world health organization. Meningitis is usually a result of fungi, viruses, parasites, bacteria, or noninfectious inflammation. Cognitive and executive function 12 years after childhood. Draft for consultation bacterial meningitis and meningococcal septicaemia. Early distinction between the two conditions is critical. In response to infection breeching the bloodbrain barrier, the immune system causes the meninges to swell which in turn can result in damage to the brain and nervous system. The intensified regimen used higher doses rifampicin and the addition of. The aim of this guideline is to outline the nursing care of an infant, child or. Jan 27, 2018 meningitis is an infectious disease of central nervous system.
People with meningitis may need to stay in hospital for a few days, and in certain cases treatment may be needed for several weeks. Acute bacterial meningitis ubc critical care medicine, vancouver. When both the brain and spinal cord are involved, the disorder is called encephalomyelitis. The physical examination can exclude the diagnosis of. Even after going home, it may be a while before you feel completely back to normal.
Both diseases usually manifest with acute severe headache often described as the worst ever and fever. However, bacterial meningitis is a more severe form leading to numerous complications and early treatment is key. Getting students vaccinated a webinar with lynn bozof, president of the national meningitis association january 21, 20. Viral meningitis is less severe and symptoms can resolve without treatment. Neurophysiotherapy list of high impact articles ppts. Meningitis part 5 nursing assessment flashcards quizlet. Most episodes of meningitis result from hematogenous seeding of infection from other sites to the meninges. An aim of meningitis treatment should be to control the inflammatory response. Management of bacterial meningitis in children and young. Bacterial meningitissepticaemia is a serious infection with sometime fatal or lifechanging consequences. See treatment of bacterial meningitis caused by specific pathogens in adults. Meningitis is an inflammation of the meninges, the membranes covering the brain and spinal cord. Google scholarthomas karen e, hasbun rodrigo, jekel james, quagliarello vincent j. In order to make a diagnosis, the doctor will ask a number of questions especially about recent travel and contact with ill people, perform a.
In general, meningitis due to bacteria bacterial meningitis is more severe than meningitis caused by viruses viral meningitis. What is meningitis meningitis neurological disorders. Bacterial meningitis will be treated very differently to viral meningitis although the diagnosis of the disease can be quite similar. Diagnosis, initial management, and prevention of meningitis. Algorithm for the initial management of suspected acute meningitis. Meningitis is known as inflammation of the meninges, which are membranes that surround the spinal cord and brain. Physiotherapist can play an important role in management of secondary complications through various therapeutic tools during the. Overview of meningitis summary of relevant conditions. Cook is admitted to the hospital for treatment and care. It is estimated that there are around 3 500 confirmed cases annually in the united kingdom and, as such, widespread campaigns and national guidelines have been developed and adopted throughout nhs. Meningitis rapid assessment worksheet please refer to the disease investigation guideline for additional guidance. Weight and head circumference should be monitored on a daily basis. Meningitis treatment will vary depending on the type and strain of the disease. Parini is an infection control manager at paradise valley hospital, national city, calif.
Among patients at low risk, meningitis can be ruled out by absence of fever, neck stiffness, or altered mental status. Meningococcal septicaemia is a potentially lifethreatening disease process which requires early recognition and rapid management in both prehospital and hospital phases of patient care. Treatment for bacterial meningitis is antibiotics, with or without steroids. Introduction meningitis is an inflammation of the meninges, the protective membranes that surround the brain and. No benefit for intensified treatment of tb meningitis by dylan tierney moderator emeritus 22 jan, 2016 a study of intensified treatment of tb meningitis was recently published in the new england journal of medicine. Meningitis lecture notes philip gothard, consultant in infectious diseases, ucl hospitals, london fever and headache are commonly associated, for example in influenza, and most patients presenting with these two alone do not.
This article discusses the evidence based management wellthe best available evidence for muscle. Research ean guidelines guideline reference center. This case highlights the potential importance of newonset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm. Cognitive and executive function 12 years after childhood bacterial meningitis. Over recent decades new vaccines have led to a change in epidemiology of the disease. This article discusses the infectious disease meningitis a notifiable disease since 1912 payling, 1994. Its important to diagnose meningitis quickly, because symptoms can quickly escalate to brain damage, hearing loss, and even death. Understanding the process and treatment of meningitis and. Other factors that might suggest the likely etiology include a patients immune status, travel history, and demographic factors such as their age. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The who strategy for the control of epidemic meningitis is based on three key pillars. Spot the signs and understand the treatment options for meningitis, an infection that has several possible causes. She had a subarachnoid hemorrhage 21 days later, at which time. Immediate recognition and treatment of the condition may improve the end result but the only preventative approach is vaccination, which is now available against certain types and strains of bacteria.
Neuro physiotherapists are involved in treating individuals with such neurological impairments in order to maximize or enhance their functional ability. A 61yearold caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis. If tb meningitis in the differential diagnosis, refer to nice cg117 before administering steroids. The physical examination can exclude the diagnosis. Effect of acute neurologic complications and age of onset vicki anderson, phd all correspondence concerning this article should be addressed to vicki anderson, phd, department of psychology, university of melbourne, victoria 3010, australia. Because meningitis affects the brain, you may need help recovering from the aftereffects of the infection. Encephalitis definition encephalitis is an inflammation of the brain, usually caused by a direct viral infection or a hypersensitivity reaction to a virus or foreign protein. Fluid restriction not recommended for children with bacterial meningitis except in. It can be caused by a variety of organisms that include bacteria, fungi or viruses. Most children with viral meningitis recover completely. Meningitis is usually caused by bacterial, viral, or fungal infection, but can also result from injury, cancer, or drugs. Who practical guidelines, control of epidemic meningococcal disease.
Management of other aspects of sepsis, eg circulation, should follow the sepsis guidelines. Immediate recognition and treatment of the condition may improve the end result but the only preventative approach is vaccination, which is now. Jul 16, 2019 infections of the central nervous system cns can be divided into 2 broad categories. To develop and validate a simple multivariable model to distinguish bacterial meningitis from aseptic meningitis in children using objective parameters available at the time of patient presentation. Other factors that might suggest the likely aetiology include a patients immune status, travel history, and demographic factors such as their age. Bacterial meningitis occurs in about 3000 infants, children and adults in the uk each year. Brain inflammation caused by a bacterial infection is sometimes called cerebritis. Bacterial meningitis and meningococcal septicaemia. Best effect if steroid dexamethasone is given before or with first antibiotic dose 2. Some children with meningitis may have longterm problems, but this depends on the cause of the infection and the age of the child. Management of bacterial meningitis in children and young people incorporates nice bacterial meningitis and meningococcal septicaemia guideline cg102. Quite obviously, this is something that sports physiotherapists will commonly encounter, particularly those involved with the aforementioned sports. Acute communityacquired meningitis and encephalitis. A flow chart for the management of suspected bacterial meningitis is provided in figure 1.
Tuberculous meningitis tbm is the most severe form of infection caused by mycobacterium tuberculosis, causing death or disability in more than half of those affected. Strengthening exercises to help improve muscle function. Demyelinating encephalitis definition of demyelinating. Feb 26, 2011 meningitis nursing, medical managements 1. Start studying meningitis part 5 nursing assessment. Within the united states, almost 30 percent of strains of pneumococci, the most common etiologic agent of bacterial meningitis, are not susceptible to penicillin. Different than bacterial meningitis as symptoms emerge over a few days. Acute communityacquired meningitis and encephalitis the. Bacterial meningitis, is very serious and is classed as a medical emergency, if left untreated it can cause blood infections and damage to the brain. Neurophysiotherapy, or neurological physiotherapy is used to treat motor deficits arising from pathology in the nervous system which include traumatic multiple sclerosis, brain injury or stroke, parkinsons disease and spinal cord injury. Overview of meningitis summary of relevant conditions bmj. These guidelines provide comprehensive information on epidemiology and standard techniques for diagnosis, treatment, prevention and control of meningococcal. Cooks isolation room, she sees him thrashing about in the bed,talking incoherently,and becoming more agitated.
Monitor temperature, pulse, blood pressure, respiratory rate 4 hourly 3. Mumps has recently reemerged as a public health problem among young adults in the uk meningitis is a severe potential complication of. Meningitis is an infectious disease of central nervous system. It is mostly caused by bacteria, viruses and fungi. A recent metaanalysis of dexamethasone use in meningitis showed benefit in management of childhood h. Oct 18, 20 this case highlights the potential importance of newonset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm. Bacterial meningitis septicaemia is a serious infection with sometime fatal or lifechanging consequences.
Dedicated to educating families, medical professionals and others about meningococcal disease and prevention. Neurological observations including blood pressure should be performed every 15 minutes for the first two hours and then at intervals determined by the childs conscious state. Brain tumors may be benign or malignant, primary or metastatic, and intracerebral or extracerebral. She had a subarachnoid hemorrhage 21 days later, at which time the aneurysm. Paediatric bacterial meningitis is a neurological emergency which, despite advances in medical management, still has a significant morbidity and mortality. Viral meningitis is more common, but it is less serious than bacterial meningitis. Oct 02, 2016 what adjunctive therapies, if any, are effective in the treatment of bacterial meningitis. The public health management of meningitis march 2005 1. Practice guidelines for the management of bacterial meningitis.
It is estimated that there are around 3 500 confirmed cases annually in the united kingdom and, as such, widespread campaigns and national guidelines have. Strategy for managing meningitis epidemics in africa. Oily chloramphenicol has been successfully used to treat mostly epidemic meningococcal meningitis, but it has also been used for treatment of meningitis due to. Meningitis medical management idealdiagnostic evaluation complete blood count cbc with differential detect an elevated leukocyte count in bacterial and viral meningitis, with a greater percentage of polymorphonuclear leukocytes 90% in bacterial and less than 50% in viral meningitis normal 0% to 15% blood cultures indicate the organism. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Meningitis is usually caused by bacterial, viral, or fungal infection, but may also result from injury, cancer, or drugs. In order to make a diagnosis, the doctor will ask a number of questions especially about recent travel and contact with ill people, perform a physical exam, and possibly order various tests. Diagnosis and management of bacterial meningitis in the. Review the eight most common varieties of meningitis and how to identify and treat each one. The presence of at least 1 of fever, neck stiffness, and change in mental status had a sensitivity of 99% to 100%. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs. The public health management of meningitis revised march.
Includes csf shunts, hydrocephalus, trauma, spaceoccupying lesions or recent neurosurgery, immunocompromised state, papilledema, or focal neurological signs. Severity and extent of the infection causes a wide range of neurologic signs and symptoms, generally nonfocal in nature. This article discusses the infectious disease meningitisa. Adjunctive therapies in bacterial meningitis icm case. No benefit for intensified treatment of tb meningitis. Sep 24, 2017 meningitis is an inflammation of the lining around the brain and spinal cord caused by bacteria or viruses bacterial meningitis is caused by bacteria. Find out about support services we offer at meningitis now. Meningococcal meningitis and a negative cerebrospinal. The physiotherapy management plan is to assess for neurological deficits and then treat accordingly.
Acute meningitis and encephalitis are medical emergencies that require prompt assessment and treatment. Practice guidelines for acute bacterial meningitidis. Hsv meningoencephalitis is the most serious form of viral meningitis. Meningitis medical management idealdiagnostic evaluation complete blood count cbc with differential detect an elevated leukocyte count in bacterial and viral meningitis, with a greater percentage of polymorphonuclear leukocytes 90% in bacterial and less than 50% in viral meningitis normal 0% to 15% blood cultures indicate the.
Meningitis bangalore bangalore occupational therapy. Cerebral aneurysm presenting with aseptic meningitis. Physiotherapy treatment is often needed for the secondary complications to meningitis such as. Guidelines for the early clinical and public health management of. A rehabilitation team can help you retrain your brain and redevelop functions lost as a result of meningitis. The incidence of bacterial meningitis in infants and children has decreased since the routine use of conjugated vaccines targeting. Archives of physiotherapy is an open access journal disseminating research covering all aspects of physiotherapy. Among adults in developed countries, the mortality rate from bacterial meningitis is 21 percent. This report, however, goes beyond that of the task force by indicating the new. Apr, 2012 introduction meningitis is an inflammation of the meninges, the protective membranes that surround the brain and spinal cord. Guidelines for the management of suspected and confirmed.
Meningitis any inflammation of protective membranes covering the brain and spinal cord can be caused by different types of bacteria or viruses meningococcal disease an infection that can lead to meningitis or sepsis blood infection caused by a specific bacteria neisseria meningitidis bacterial meningitis is different than viral meningitis. Meningococcal meningitis is of particular importance as it has the potential to cause large epidemics. Medical diseases are assessed by medical tests and treated with medical interventions, e. In communitydwelling adults, the most common causative organisms are streptococcus pneumoniae and neisseria meningitidis. Duration of symptoms and outcome in bacterial meningitis. Meningitis from ancient greek, membrane and the medical suffix itis, inflammation is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Bacterial meningitis is a medical emergency, and immediate steps must be. Meningitis is defined as inflammation of the meninges, protective membranes of the brain and spinal cord. Meningococcal meningitis is an acute form of bacterial meningitis caused by neisseria meningitidis.
For a more complete discussion concerning diagnosis and management of meningitis, the reader is referred to a recently published report by a task force appointed by the american academy of pediatrics. Additional treatment and longterm support may also be required if any complications of meningitis occur, such as hearing loss. This can be in the form of simple exercises such as sit to stand or walking. Adjunctive therapies in bacterial meningitis icm case summaries. A client with bacterial meningitis the client with a brain tumor brain tumors are growths within the cranium, including tumors in brain tissue, meninges, pituitary gland, or blood vessels. Nursing care plan a client with bacterial meningitis. Meningitis can be the primary reason a patient is hospitalized or can develop during hospitalization. Meningitis nursing, medical managements slideshare. Acute bacterial meningitis, in view of the new escmid guideline ean. If meningococcal disease is suspected in primary care, guidelines recommend that benzylpenicillin be. Inflammation of the meninges can either be a result of a bacterial or viral infection.