Powerpoint Presentation on Meningitis (Nursing)

Meningitis is an acute inflammation of the meningeal tissues surrounding the brain and the spinal cord.
Meningitis mainly refers to infection of the arachnoid mater and the CSF.

1. MENINGITIS prepared by Arunima Roy

2. INTRODUCTION: Although meningitis is a  notifiable disease  in many countries, the exact  incidence  rate is unknown.  In 2013 meningitis resulted in 303,000 deaths

3. MENINGES : The  meninges  refer to the membranous coverings of the brain and spinal cord. There are three layers of  meninges , known as the dura mater, arachnoid mater and pia mater. Subarachnoid space:It is the space between the arachnoid mater and piamater and is filled by cerebrospinal fluid(CSF)

4. DEFINITION: Meningitis is an acute inflammation of the meningeal tissues surrounding the brain and the spinal cord. Meningitis mainly refers to infection of the arachnoid mater and the CSF.

5. RISK FACTORS: Physical injury Head injury Mid ear infection(otitis media) Cancer Chronic malnutrition Diabates Pneumonia AIDS Use of immunosuppressive drugs Children below 5 years of age sinusitis

6. ETIOLOGY: 1. BACTERIAL: Haemophilus influenzae Streptococcus pneumonia Neisseria meningitidis 2 . VIRAL: Enterovirus(coxsackie) Arbo viruses Influenzae Herpes simplex virus Varicella zoster

7. 3. FUNGAL: Cryptococcus Aspergillus Candida 4. PARASITIC/ PROTOZOAL Toxoplasma Plasmodium Amoeba

8. PATHOPHYSIOLOGY: Entry of Causative organisms( bacteria,viruses,fungi and parasite) through wounds or primary infection (sinusitis) Colonisation and penetration in the blood stream Survival of bacteria and transportation via circulation Crosses blood brain barrier and invade the central nervous system Reach lateral ventricle and enter the subarachnoid space Bacteria gets access to CSF Rapid multiplication in CSF

9. Inflammatory reaction Inflammation of the meninges Causes increase in ICP due to increase in CSF flow resistance Headache,nuchal rigidity,and altered mental status

10. CLINICAL MANIFESTATION: Fever 2. Severe headache 3.Nausea and vomiting 4. Nuchal rigidity (neck stiffness) 5. Positive Kernig’s sign 6.Positive Brudzinki’s sign

11. 7 . Photophobia 8.Altered mental status 9.Seizures 10.Tachypnea 11.Tachycardia 12. Irritability 13.Skin rashes 14.Drowsiness 15.Malaise

12. DIAGNOSTIC EVALUATION: History taking Physical assessment MRI CT Scan Blood culture and sensitivity CSF analysis: For protein(more in bacterial than viral),glucose(decreased in bacterial), WBC,platelet count and culture.CSF looks purulent and turbid in bacterial meningitis whereas looks clear in viral meningitis CBC: Increase in WBC count X ray: To detect infected sinuses

13. Positive kernigs’s sign :  The test for  Kernig sign  is done by having the person lie flat on the back, flex the thigh so that it is at a right angle to the trunk, and completely extend the leg at the knee joint.  Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip  is flexed to 90 degrees.

14. Positive brudzinski’s sign: Automatic flexion of the knees are seen when the examiner flexes the neck while the patient is in supine position.

15. COMPLICATION: Increased ICP Cerebral edema , causing hypertensive coma and death Hearing loss Paralysis Memory loss Blindness due to increased ICP.

16. MANAGEMENT : Definitive treatment: 1. Antibiotic therapy: Third generation cephalosporin such as cefotaxime and ceftriaxone are mainly prescribed. Benzyl penicillin is given for 10-14 days in case of streptococcus pneumoniae. For tubercular meningitis patient is put on anti tubercular drug therapy.

17. 2. Anti-inflammatory drugs: Dexamethasone 10 mg evry 6 hourly is given. 3. ICP lowering agent: Mannitol is given. 4. Anticonvulsants: Phenytoin is given if patient develops seizure. Diazepam and lorazepam is used as seizure prophylaxis. 5. Antipyretics are given for fever Supportive treatment: 1.Put patient on mechanical ventilation if loss of consciousness is present or in case of respiratory failure 2.Intravenous fluid therapy,if the patient is in shock or hypotension 3.Monitor vital signs and neurologic status regularly 4.Adequate bed rest is recommended.