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Meningitis, Pediatric

Ross Newman, DO, MHPE Reviewed 10/2018
 


BASICS

DESCRIPTION

Inflammation of the membranes of the brain or spinal cord, usually caused by viruses or bacteria and, rarely, fungi or parasites 

EPIDEMIOLOGY

  • Bacterial meningitis

    • Most common agents in...

DIAGNOSIS

HISTORY

  • Bacterial meningitis

    • Older children may complain of classic meningeal inflammation signs including neck pain, headache, or back pain as well as photophobia, anorexia, and myalgias.

    • Naus...

TREATMENT

GENERAL MEASURES

  • Ensure adequate ventilation and cardiac function.

    • Circulation, airway, breathing (CABs)

  • Initiate hemodynamic monitoring and support by achieving venous access and treat shock s...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Neonatal HSV meningitis should be evaluated with a repeat CSF HSV DNA PCR at day 21 and therapy extended if the PCR remains positive.

  • Prophylaxis in Hib:

    • Oral rifam...

ADDITIONAL READING

  • Brouwer MC, McIntyre P, Prasad K, et al. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev.  2013;(6):CD004405. [View Abstract on OvidInsights]

  • Kestenba...

CODES

ICD9

  • 322.9 Meningitis, unspecified

  • 320.9 Meningitis due to unspecified bacterium

  • 047.9 Unspecified viral meningitis

  • 320.2 Streptococcal meningitis

  • 321.0 Cryptococcal meningitis

  • 036.0 Meningococcal men...

FAQ

  • Q: Is a lumbar puncture required before starting antibiotics in the patient with suspected meningitis with unstable vital signs requiring resuscitation?

  • A: No. In the unstable patient, it is contra...

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