usefull for BSc nursing students

1. MENINGITIS:
DEFINITION:
Meningitis is defined as an inflammation of the
meninges covering the brain and spinal cord.
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2. CLASSIFICATION:
Depending upon the etiological agent, meningitis is of
three types:
a) Bacterial or pyogenic meningitis
b) Aseptic meningitis
c) Tubercular meningitis
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3. ETIOLOGY:
In infant, acute bacterial meningitis may be caused by
variety of bacteria like
• E.coli
• Pseudomonas
• Klebsiella
• Streptococcus
• Staphylococcus
• β hemolytic streptococcus.
In infants younger than 2months, group B
Streptococci & E.coli account for 70% cases. 3

4. PATHOPHYSIOLOGY:
Infection from any part of the body like nasopharynx
Organisms invade surrounding blood vessels
Through blood, organisms enter cerebrospinal fluid
Infection spread through subarachnoid space
Inflammatory process begins 4

5. Increase in CSF exudation in ventricles
CSF flow through ventricular aqueduct
Thrombophlebitis of cerebral vessels
Infection of cerebral cortex, cerebral damage
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Cont…..

6. CLINICAL FEATURES:
Clinical features in neonates include:
i. Poor feeding
ii. Vomiting
iii. Diarrhea
iv. Lethargy
v. Weak cry
vi. Sleepiness
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7. Clinical feature of infant older than 3 months
include:
i. Fever
ii. Irritability
iii. Poor feeding
iv. Vomiting
v. High pitch cry
vi. Seizures
vii. Nuchal rigidity
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8. Clinical features in children older than 3 years
include:
i. Fever, chills and malaise
ii. Headache, vomiting, papilledema
iii. There are signs of meningeal irritation like:
 Nuchal rigidity
 Positive Brudzinski’s sign
 Positive kernig’s sign
iv. Photophobia
v. Delirium, deep coma or stupor
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10. DIAGNOSTIC EVALUATION:
1) Lumbar puncture
2) CSF examination
3) Blood examination
4) Computed tomography & MRI
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11. MANAGEMENT:
Treatment of meningitis include:
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a) Specific treatment:
Treatment is started with antibiotic, commonly used
antibiotics are (Cephalosporins, Vancomycin, Cefotaxine)
for 7-14 days & 3 weeks for gram negative bacteria.
b) Symptomatic treatment:
 Seizure management:
phenobarbitone, Dilantin & Diazepam
 Management of intracranial pressure:
Mannitol, Frusemide
 Fever and headache:
Aspirin or acetaminophen

12. c) Supportivecare:
I/V fluids to maintain fluid- electrolyte balance,
monitor neurological status, in shock condition
requires vasoactive drugs like epinephrine and
dopamine.
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13. NURSING MANAGEMENT:
1) Isolate the child
2) Administration of drugs
3) Control seizures and protect the child from injury
4) Maintain fluid intake and nutrition
5) Provide comfort and rest
6) Monitor the child’s condition
7) Parental guidance and support
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