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Meningitis
Meningitis
ETIOLOGY
Bacterial (most common) – Neisseria meningitides, Haemophilus influenza,
Streptococcus pneumonia or Escherichia coli
Viral (most common) – Angiostrongylus cantonensis and Gnathostoma
spinigerum. Tuberculosis, syphilis, cryptococcosis, and coccidiodomycosis
Protozoal – Toxoplasma Gondii (Toxoplasmosis)
Fungal – cryptococcal meningitis
Various non-infectious causes. – spread of cancer to the meninges (malignant
meningitis) and certain drugs (mainly non-steroidal anti-inflammatory drugs,
antibiotics and intravenous immunoglobulins).
II. MANIFESTATION
The cardinal signs and symptoms of meningitis are those of infection and
increased ICP:
Headache
Stiff neck and back
Malaise
Chills
Photophobia
Phonophobia
Fever
Vomiting
Twitching
Seizures
Altered Level of Consciousness, such as confusion or delirium
Age
Education
MICROORGANISMS
al
(bacteria, fungal, virus,
Enter to the nasal cavity or to the skin Attainmen
protozoa)
t
Gender
Environm
Reach the meninges through direct Reach the meninges through the
contact between the meninges bloodstream
Subarachnoid Space
Inc. blood-brain barrier Inc. no. of WBC in CSF Vasculitis of cerebral vessels
permeablity
Fluid leakages from vessels Inflammation of Meninges Dec. cerebral blood flow
(MENINGITIS)
Inc.cranial pressure.
Dec. Cerebral blood
flow, Ischemia,
apoptosis (Brain
Death
IV. MANAGEMENT AND COMPLICATION
Nursing Management:
Administered prescribed medications, which include I.V. antibioitics. If
seizures occur, anticonvulsants are prescribed. If cerebral edema occurs,
osmotic diuretics are prescribed.
Prevent respiratory complications resulting from altered consciousness.
Implement such measures as oxygen therapy, arterial blood gases,
pulmonary toileting, and pulse oximetry.
Apply a hypothermia blanket to relieve hyperthermia as prescribed.
Promote measures to help prevent recurrence of meningitis.
o Persons in close contact with the client should be considered for
prophylactic antibiotic therapy if appropriate.
o Administer vaccinations as indicated. A vaccination can be administered
to prevent meningitis in pediatric clients; one type is currently prescribed
for military recruits.
Intervene as appropriate to reduce increased ICP.
Preventions:
For some causes of meningitis, prophylaxis can be provided in the long term
with vaccine, or in the short term with antibiotics
Have immunization against Streptococcus pneumoniae with the
pneumococcal conjugate vaccine (PCV), which is active against seven
common serotypes of this pathogen, significantly reduces the incidence of
pneumococcal meningitis. Childhood vaccination with Bacillus Calmette-
Guérin has been reported to significantly reduce the rate of tuberculous
meningitis
Short-term antibiotic prophylaxis is also a method of prevention, particularly
of meningococcal meningitis. In cases of meningococcal meningitis,
prophylactic treatment of close contacts with antibiotics (e.g. rifampicin,
ciprofloxacin or ceftriaxone) can reduce their risk of contracting the condition,
but does not protect against future infections.
References:
Hargrove-Huttel,Ray A. (2005). Lippincott’s Reviewer Series. The Ideal
Study Aid. Medical Surgical Nursing.(4th Ed.) pp.360-361.
Lippincott William and Wilkins. Pathophysiology made Incredibly Easy!
(3rd ed.) pp. 272-276.
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