Meningitis disease

Meningitis disease

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  MENINGITIS: DEFINITION: Meningitis is definedas an inflammation of the meninges covering the brain and spinal cord. 1
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  CLASSIFICATION: Depending upon theetiological agent, meningitis is of three types: a) Bacterial or pyogenic meningitis b) Aseptic meningitis c) Tubercular meningitis 2
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  ETIOLOGY: In infant, acutebacterial meningitis may be caused by variety of bacteria like • E.coli • Pseudomonas • Klebsiella • Streptococcus • Staphylococcus • β hemolytic streptococcus. In infants younger than 2months, group B Streptococci & E.coli account for 70% cases. 3
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  PATHOPHYSIOLOGY: Infection from anypart of the body like nasopharynx Organisms invade surrounding blood vessels Through blood, organisms enter cerebrospinal fluid Infection spread through subarachnoid space Inflammatory process begins 4
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  Increase in CSFexudation in ventricles CSF flow through ventricular aqueduct Thrombophlebitis of cerebral vessels Infection of cerebral cortex, cerebral damage Cont….. 5
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  CLINICAL FEATURES: Clinical featuresin neonates include: i. Poor feeding ii. Vomiting iii. Diarrhea iv. Lethargy v. Weak cry vi. Sleepiness 6
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  Clinical feature ofinfant older than 3 months include: i. Fever ii. Irritability iii. Poor feeding iv. Vomiting v. High pitch cry vi. Seizures vii. Nuchal rigidity 7
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  Clinical features inchildren older than 3 years include: i. Fever, chills and malaise ii. Headache, vomiting, papilledema iii. There are signs of meningeal irritation like:  Nuchal rigidity  Positive Brudzinski’s sign  Positive kernig’s sign  Opisthotonus position iv. Photophobia v. Delirium, deep coma or stupor 8
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  DIAGNOSTIC EVALUATION: 1) Lumbarpuncture 2) CSF examination 3) Blood examination 4) Computed tomography & MRI 10
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  MANAGEMENT: Treatment of meningitisinclude: a) Specific treatment: Treatment is started with antibiotic, commonly used antibiotics are (Cephalosporins, Vancomycin, Cefotaxine) for 7-14 days & 3 weeks for gram negative bacteria. b) Symptomatic treatment:  Seizure management: phenobarbitone, Dilantin & Diazepam  Management of intracranial pressure: Mannitol, Frusemide  Fever and headache: Aspirin or acetaminophen 11
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  c) Supportive care: I/Vfluids to maintain fluid- electrolyte balance, monitor neurological status, in shock condition requires vasoactive drugs like epinephrine and dopamine. 12
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  NURSING MANAGEMENT: 1) Isolatethe child 2) Administration of drugs 3) Control seizures and protect the child from injury 4) Maintain fluid intake and nutrition 5) Provide comfort and rest 6) Monitor the child’s condition 7) Parental guidance and support 13
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