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Meningitis
Dr Swapnil Pawar
Meningitis
Organisms Implicated in Meningitis
Bacteria
| Age | Likely Organisms |
| < 1 Month |
|
| 1 – 3 Months |
|
| 3 Months – 18 Years |
|
| 18 – 50 Years |
|
| > 50 Years |
|
Viruses
Other
CSF Findings
| Bacterial | Viral | TB/Fungal | |
| Glucose | Decreased | Normal | Decreased |
| Protein | ++ | Mildly elevated or normal | ++ |
| WCC | ++, neutrophil predominant | +, lymphocyte predominant | +, lymphocyte predominant |
Antibiotics Choice in Meningitis
Empirical Therapy:
Ceftriaxone 2g IV q12h + Dexamethasone 10mg IV (before or with first dose of antibiotic) and then q6h for 4 days
If > 50 y/o, immunocompromised, pregnant or history of ETOH use, add:
Benzypenicillin 2.4g q4h for Listeria cover
If Gram Positive Cocci identified on gram stain, add:
Vancomycin (25-30mg/kg) as loading dose
References
Farkas, J. (2017). Meningitis and Encephalitis. The Internet Book of Critical Care. Retrieved May 26th, 2021 from https://emcrit.org/ibcc/meningitis/
Tunkel, A.R. (2018). Aseptic Meningits. UpToDate, Retrieved May 26th, 2021 from https://www.uptodate.com.acs.hcn.com.au/contents/aseptic-meningitis-in-adults
Hasbun, R. (2021). Treatment of bacterial meningitis caused by specific pathogens in adults. Retrieved May 26th, 2021 from https://www.uptodate.com.acs.hcn.com.au/contents/treatment-of-bacterial-meningitis-caused-by-specific-pathogens-in-adults.
play_arrow Post-Polypectomy Bleeding Dr Swapnil Pawar Blog Written by – Dr Hyriem Suh References Assessment of lower gastrointestinal bleeding, https://bestpractice.bmj.com.acs.hcn.com.au/topics/en-gb/457/diagnosis-approach, BMJ Best Practice, 2021
