Meningitis.ppt

for doctors and nurses especially for bachelors students

1. Meningitis Shafaat Ullah BSN. Gen Khyber Medical University 3/31/2017 1

2. Clinical description Meningitis is the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a  medical emergency . 3/31/2017 2

3. Meninges The meninges is the system of membranes which envelops the central nervous system. It has 3 layers: Dura mater Arachnoid mater Pia mater Subarachnoid space - is the space which exists between the arachnoid and the pia mater, which is filled with cerebrospinal fluid. 3/31/2017 3

4. Causes of Meningitis - Bacterial Viral Fungal - Parasitic/ protozoal - Physical injury - Cancer Certain drugs ( mainly, NSAID’S ) Head injury Cerebral abscess Middle ear infection 3/31/2017 4

5. Bacterial - Haemophilus influenzae - Listeria - Meningococcus   - Mumps - Pneumococcus - Certain Streptococcus   3/31/2017 5

6. Viral - Enterovirus ( coxsackie , echovirus) - Arboviral (mosquito-borne diseases) - Influenza Herpes simplex virus type2 ( especially in infants) Varicella zoster HIV Mumps measles 3/31/2017 6

7. Fungal Cryptococcus Coccidiodes Histoplasma Mucormycosis Aspergillus Candida (yeasts) Parasitic/ protozoal Angiostrongylus Toxoplama Hydatid Amoeba Plasmodium Cysticercosis 3/31/2017 7

8. Risk factors Age- children younger than 5 years Use of immunosuppressive drugs Chronic malnutrition AIDS CSF Shunt Chronic alcoholism Diabetes Pneumonia 8

9. Pathophysiology 3/30/2017 9

10. Sign and symptoms Severe headache Irritability Restlessness Stiffness of neck Malaise Nausea/vomiting High grade fever Tachypnea Seizures Disorientation Tachycardia Coma Sleeplessness Phonophopia Photophobia Altered mental status(confusion) 3/30/2017 10

11. Diagnostic evaluation By + ve signs Physical examination History collection CSF evaluation for pressure, proteins, glucose and leukocytes. Blood test CBC Blood culture MRI CT scan 3/30/2017 11

12. Clinical manifestation Confirmative sign: Positive kernig’s sign 3/30/2017 12

13. Brudzinski’s Sign 3/30/2017 13

14. COMPLICATIONS Brain damage Cerebral edema Hearing loss Tissue damage 3/31/2017 14

15. Treatment Antibiotics for bacterial meningitis :Type vary depending on the bacteria causing the infection. Antibiotics are not effective in viral meningitis. Other medications and   intravenous   fluids will be used to treat symptoms such as brain swelling,   shock, and   seizures. Prevention Haemophilus vaccine ( HiB vaccine) in children. The  pneumococcal conjugate vaccine  is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis. Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics. 3/31/2017 15

16. Nursing managements Altered body temp. related to infectious process. Interventions: Monitor temperature continuously Administer antipyretic drugs as prescribed. Switch on fan and open the windows. Cold sponge 3/30/2017 16

17. Cont….. Ineffective tissue perfusion R/T infectious process and cerebral edema. Interventions: Assess level of consciousness Assess inc. ICP signs Provide calm and quit environment Prepare patient for LP for CSF evaluation. 3/30/2017 17

18. THANK YOU 3/31/2017 18