Meningitis in child

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Meningitis

• 1st 2 months - E.Coli (MC)
• 2months - 12 years - Pneumococcal and Neisseria.

95% Meningitis in child - affects 1month - 5years age group.

Condition	Organism
Defect of complement system C5-8 and properdin system	Meningococcus
Congenital / acquired defect across mucocutaneous barrier	Pneuococcal
T.Lymphocte defect	Listeria
Lumbosacral Myelomeningocele and Dermal sinus	Staphylococcus ; Enteric bacteria
Penetrating CNS trauma ; CSF shunt infection	Coagulase –ve Staph.
Recurrent meningitis in CSF leak patients	Pneumococcal

Investigation : 
85% cases have bacteremia
therefore -

1. Blood culture
2. CxR
3. Lumbar puncture - Increased ICT is absolute contraindication

• Turbid grossly
• Neutrophil leucocytosis
• Protein (normal 50mg%) - raised
• Sugar (normal 2/3 blood sugar) - decreased (permeability to glucose in meninges decreased ; increased anaerobic glycolysis in adjoining brain tissue)

Treatment : 

• 3rd generation cephalosporins - ceftriaxone.
• Pneumococci resistant to cephalosporins - Vancomycin

Complications :

1. SIADH
2. Sub-dural effusions
3. Seizures
4. Increased ICT
5. Cerebral edema

MC Neurological sequelae : Deafness (Sensorineural) , because of labrynthitis.

• Prevented by Dexamethasone (0.15mg/kg) 15-30 mins before antibiotics.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel