Meningitis

Bacterial causes - medical emergency:

IM Benpen in GP

When in hospital - if <3 months or >50 years = IV cefotaxine + amox

Otherwise in hospital IV cefotaxine

Contact trace all close contacts within 7 days and offer oral ciprofloxacin

• Neisseria meningitidis
• Streptococcus pneumoniae (pneumococcus)
• Haemophilus influenzae
• Group B streptococcus (GBS) (particularly in neonates as GBS may colonise the vagina)
• Listeria monocytogenes (particularly in neonates)

Viral causes:

• Enteroviruses (e.g., coxsackievirus)
• Herpes simplex virus (HSV)
• Varicella zoster virus (VZV)

Typical symptoms of meningitis are:

• Fever
• Neck stiffness
• Vomiting
• Headache
• Photophobia
• Altered consciousness
• Seizures

There are two special tests you can perform to look for meningeal irritation:

• Kernig’s test - slowly straighten knee while on back keeping hip flexed - +ve spinal pain and resistance to movement
• Brudzinski’s test - lift head and neck off bed - causes +ve patient to flex hips and knees