Meningitis

a brief word about etiologies

  • Bacterial most feared/thought about
  • Viral possible
  • "Aseptic" = negative cultures. Autoimmune, malignancy, viral, drug-induced.
Bacterial edition
Etiology As sequelae of ENT infection - leaky BBB, venous system with no valves makes it more possible, e.g. mastoiditis, orbital cellulitis.
Epidemiology
Clinical presentation Fever, nuchal rigidity, delirium (all 3 present in only about 40%). Headache.
If seizure, consider Encephalitis
Pathogenesis
Diagnostic investigations Blood glucose
LP
CT - usually normal; consider CT venogram
MRI only if LP impossible
Management Notifiable disease
Steroids only if suspected or proven pneumococcus
Neisseria meningitidis requires droplet isolation (see public health things in that page)
Complications: stroke, venous sinus thrombosis