Meningitis

Definition

Meningitis is inflammation of the protective membranes (meninges) covering the brain and spinal cord, usually caused by infection. Bacterial meningitis is a medical emergency.

Types

• Bacterial (emergency): Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae. High mortality without treatment.
• Viral (aseptic): Usually self-limited.
• Fungal: Cryptococcus in immunocompromised.

Classic Signs

• Headache, fever, nuchal rigidity
• Photophobia
• Altered mental status
• Positive Kernig's and Brudzinski's signs
• Petechial rash (meningococcal)

Diagnosis and Treatment

LP (lumbar puncture) with CSF analysis. Bacterial: low glucose, high protein, elevated WBC with neutrophils. DROPLET PRECAUTIONS initially. Start empiric IV antibiotics (ceftriaxone + vancomycin + dexamethasone) within 30 minutes. Do not delay for LP. Close contacts: prophylaxis with rifampin or ciprofloxacin.

NCLEX Relevance

Droplet precautions, seizure precautions, antibiotics ASAP.