Clinical Features and Complications (1).pptx

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1. Clinical Features and Complications Sardo Shreerajya Gurung

2. Headache Neck stiffness Change in mental status Meningitis Fever

3. Bacterial meningitis Systemic inflammatory response Meningeal irritation Infection of the endothelium (esp. in meningococcus ) Fever, tachycardia Lethargy, stupor, confusion, delirium Inflammation of the brain parenchyma Stimulates dural nociceptors Headache, stiff neck Resulting immune response creates vasculitis that causes local clotting abnormalities Petechia , purpural rashes Cranial nerves exiting inflamed meninges get inflamed themselves Cranial nerve palsies Photophobia

4. Other associated symptoms Nausea and vomiting Signs of increased intracranial pressure Hemiplegia/Hemiparesis Papilledema Seizures Aphasia

5. Physical Examination Kernig’s sign

6. Physical Examination 2) Brudzinski’s sign

7. Clinical presentation of meningitis in children In infants (symptoms may be difficult to identify) irritability fever poor feeding high-pitched cry (meningeal cry) arching back inconsolable crying bulging fontanelle seizures

8. Clinical presentation of meningitis in older children In children older than 1 year neck and/or back pain headache sleepiness confusion irritability fever refusing to eat decreased level of consciousness seizures sensitivity to light nausea and vomiting

9. Complications Hydrocephalus Cranial nerve deficits Epilepsy Amputation of limbs Cerebral edema

10. Complications 6. Waterhouse- Friderichsen Syndrome Acute adrenal insufficiency due to bilateral haemorrhage in adrenals Neisseria meningitidis septicaemia Rapid progressive hypotension – shock DIC associated with widespread purpura Adrenals turned into “sacs of blood”