0 Meningitis in child

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Meningitis


  • 1st 2 months - E.Coli (MC)
  • 2months - 12 years - Pneumococcal and Neisseria.


95% Meningitis in child - affects 1month - 5years age group.



Condition
Organism

Defect of complement system C5-8 and properdin system


Meningococcus

Congenital / acquired defect across mucocutaneous barrier


Pneuococcal

T.Lymphocte defect


Listeria

Lumbosacral Myelomeningocele and Dermal sinus


Staphylococcus ; Enteric bacteria

Penetrating CNS trauma ; CSF shunt infection


Coagulase –ve Staph.

Recurrent meningitis in CSF leak patients


Pneumococcal



Investigation : 
85% cases have bacteremia
therefore -
1. Blood culture
2. CxR
3. Lumbar puncture - Increased ICT is absolute contraindication

  • Turbid grossly
  • Neutrophil leucocytosis
  • Protein (normal 50mg%) - raised
  • Sugar (normal 2/3 blood sugar) - decreased (permeability to glucose in meninges decreased ; increased anaerobic glycolysis in adjoining brain tissue)

Treatment : 
  • 3rd generation cephalosporins - ceftriaxone.
  • Pneumococci resistant to cephalosporins - Vancomycin


Complications :

  1. SIADH
  2. Sub-dural effusions
  3. Seizures
  4. Increased ICT
  5. Cerebral edema

MC Neurological sequelae : Deafness (Sensorineural) , because of labrynthitis.


  • Prevented by Dexamethasone (0.15mg/kg) 15-30 mins before antibiotics.




MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

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