care of apatient with meningities

Meningitis
• Aseptic: caused primarily by
– Viruses: echovirus, coxsackievirus, nonparalytic polio,mumps, herpes 1
• Fungal: chronic and less ordinary; associated with immunosuppression
– Histoplasmosis, candidas, aspergillosis
– Syphillis, TB, Lyme disease
• TB: is on the rise once again in U.S.
headache, low-grade fever, stiff neck, seizures
Clinical Presentations
• Bacterial:
– Systemic: fever, tachycardia, chills, petechial rash
– Irritation: general throbbing h/a, photophobia, nuchal rigidity
– Neurological: cranial nerve damage and irritation
– CN II: papilledema (> ICP), blindness
– CN III, IV, VI: ptosis, diplopia, visual field problems
– CN V: photophobia
– CN VII: facial paresis
– CN VIII: deafness, tinnitus, vertigo
Signs of Meningitis
• Brudzinski’s: passive flexion of the neck produces pain & increased rigidity
• Kernig’s: Flex hip and knee and then straighten the knee…pain or resistance?
• Opisthotonos: back & extremities arch backward in a spasm & the body rests on head & heels

Current Findings
• Meningococcal Disease
– Risk: crowded living quarters, cold or flu, active or passive tobacco use, deficient immune system, alcohol consumption
• Meningococcemia
– More deadly disease; symptoms mimic flu;
» Telltale “purple rash”
– Size of a pinhead or as a large as a quarter
– Medical attention is imperative
• Future improvement in current vaccine
» Conjugate vaccine: sets off a stronger immune response