Meningitis

meningitis ,inflanmation of the meningeal layers of the brain.

1. meningitis Presented by- mohit Kumar meena b.sc( nsg .) 3 rd year bmchrc college of nursing

2. Introduction:- Meningitis is a disease caused by the inflammation of the protective membrane covering the brain and spinal cord known as meninges . The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord. Meningitis can be life threatening therefore the condition is classified as a medical emergency.

3. Meninges:- Meninges is the protective membrane of the brain and spinal cord, it is lying between skull and the brain. It has 3 layers A . Dura meter (it is made up by 2 layers ) periosteal layer (outer layer) Meningeal layer (inner layer) B. Arachenoid meter C. Pia meter

4. Cont ….:- The dura meter and arachenoid meter are seprated by a potential space,the subdural space. The arachenoid meter and pia meter are seprated by the subarachnoid space , containing cerebrospinal fluid(CSF)

5. Definition:- “Meningitis is the acute inflammation of the protective membrane (meninges) covering the brain and spinal cord”.

6. Incidence:- Over 1.2 million cases of meningitis are estimated to occur worldwide each year. Sub-Saharan African region is known as the “meningitis belt”. Incidence rate in sub-Saharan 10-100 cases per 100,000 population.

7. Meningitis belt epidemic zones sporadic cases only

8. cAUSES :- Bacterial infection Viral infection Physical injury Cancer Drugs(mainly NSAID’S)

9. Route of infection :- Nasopharynx Blood stream Direct spread(skull fracture/accident) Middle ear infection

10. TYPES:- According to infection mainly 2 types of meningitis will be seen Bacterial viral

11. BACTERIAL:- Bacterial meningitis is contagious and caused by infection from certain bacteria.it is fatel if left untreated. Between 5-40% of childrens and 20-50% of adults die with this condition.common microbes include:- Haemophilus influenzae in children between the ages of 2-5 yr. Neisseria meningitidis in those between 5-30 yr , the most common type. Streptococcus pneumoniae in people over 30 yr.

12. Viral :- This is the most common form of meningitis,it is milder and occur more then bacterial meningitis. It affect children and adults under age 30.most infections occur in children under age 5 yr. Duration of illness:- 7-10 days Common viruses are followed Entrovirus

13. Cont … Arboviral(mosquito borne disease) Herpes simplex virus type 2(especially in infants) Varicella zoster Hiv Mumps Measles

14. Pathophysiology :- Due to etiological factor Invasion of blood stream Infection occur in the subarachenoid space(CSF) Inflammation of the meninges Sign & symptoms devlop

15. Sign & symptom 1. Central:- Headache Altered mental status 2. Ears:- Phonophobia ( Ligyrophobia ) 3. Eyes:- Photophobia 4. Neck:- Stiffness (inability to move easily and without pain )

16. Cont …. 5. Others:- High fever Kernig’s sign (it is inability to straighten the legs at knee,when the thigh is flexed at the right angle of the trunk) Brudzinski sign (it is the immediate flexion of the knees and hips on raising the head from the pillow)

17. Diagnostic evaluation :- Csf Examination for cell count, glucose and protein Blood culture Lumbar puncture for CSF examination CT scan of the head Blood cell count Chest X-ray ECG & EEG (electro encephalogram) Gram staining

18. Prevention :- Haemophilus vaccine( HiB vaccine) in childrens Pneumococal conjugate vaccine Household members or others in contact with person who have meningiococal meningitis should preventive antiobiotics . Use preventive measures to ptotect the head .

19. Treatment :- Antibiotics for bacterial meningitis: type very depending on the causing the infection. Antibiotics are not provided in viral meningitis. Anti-inflammatory drugs aspirin ibuprofen naproxen celecoxib

20. Cont ….:- Intravenous fluids Analgesics Anticonvulsive drugs:- diazepam, paraldehyde, phenobarbitone

21. Management :- The bright light and noise should be avoided as the patient have photophobia and headache. The room should be quite. Level of consciousness should be assessed. Vital signs should be monitered frequently. Visual changes and pupillary changes should be observed.

22. Nsg . diagnosis Ineffective tissue perfusion related to:-cerebral edema , hypovolemia. Risk for injury related to-generalised seizures, general weakness, vertigo. Acute pain related to:-inflammatory process, toxin in the circulation. Impaired physical mobility related to:-neuromuscular damage, damage in strength. Anxiety related to:-crisis situation, threat to death.

23. Complications :- Brain damage Hearing loss Seizures Buildup of fluid between the skull and brain(subdural effusion)