Meningitis
Inflammation of the meninges (membranes that protect the brain and spinal cord)
Fungal meningitis
Common in children who have AIDS
Viral or aseptic meningitis
Is the most common form and commonly resolve without treatment (no vaccine
available)
Bacterial or septic meningitis
Contagious infection with a high mortality rate
Three different vaccines for different pathogens of bacterial meningitis:
(1) Haemophilus influenzae type b (Hib) vaccine
Ensure infants receive vaccine for bacterial meningitis on schedule
(2) Pneumococcal polysaccharide Vaccine (PPSV)
Vaccinate adults who are immunocompromised, who have a chronic disease, who
smoke cigarettes, or live in a long term care facility
-Give one dose to adults older than 65 who have previously not been vaccinated
nor have hx of disease
(3) Meningococcal vaccine (MCV4)
Ensure adolescents receive vaccine on schedule and prior to living in a residential
setting in college; individuals in other settings IE military should also be vaccinated
Individuals at risk of Bacterial Meningitis
-Immunosuppression
-Invasive procedure, skull fracture, or penetrating head wound (direct access to
CSF)
-Overcrowded or communal living conditions
S/S of Bacterial Meningitis
, Excruciating constant H/A
Nuchal rigidity (Stiff neck)
Photophobia (sensitivity to light)
Other clinical findings of bacterial meningitis
-Fever and chills
-N/V
-Altered LOC- confusion, disorientation, lethargy, difficulty arousing, coma
-Positive Kernig's sign- resistance and pain with extension of the client's leg from a
fixed position
-Positive Brudzinski's sign- flexion of extremities occurring with flexion of the
client's neck
-Tachycardia
-Seizures
-Red macular rash
-Restlessness, irritability
How to Diagnose Meningitis
Cerebrospinal fluid (CSF) analysis- most definite diagnostic; CSF is collected during
a lumbar puncture
Results indicative of
Meningitis:
-Appearance of CSF- Cloudy (bacterial) or clear (viral)
-Elevated WBC, protein
-Decreased glucose (bacterial)
-Elevates CSF pressure
-CT scan or MRI- to identify increased intracranial pressure (ICP) and/or abscess
Nursing interventions with meningitis
Isolate the client as soon as meningitis is expected
Droplet precautions should continue until antibiotics have been taken for 24
hours and when oral and nasal secretions are no longer infectious
Inflammation of the meninges (membranes that protect the brain and spinal cord)
Fungal meningitis
Common in children who have AIDS
Viral or aseptic meningitis
Is the most common form and commonly resolve without treatment (no vaccine
available)
Bacterial or septic meningitis
Contagious infection with a high mortality rate
Three different vaccines for different pathogens of bacterial meningitis:
(1) Haemophilus influenzae type b (Hib) vaccine
Ensure infants receive vaccine for bacterial meningitis on schedule
(2) Pneumococcal polysaccharide Vaccine (PPSV)
Vaccinate adults who are immunocompromised, who have a chronic disease, who
smoke cigarettes, or live in a long term care facility
-Give one dose to adults older than 65 who have previously not been vaccinated
nor have hx of disease
(3) Meningococcal vaccine (MCV4)
Ensure adolescents receive vaccine on schedule and prior to living in a residential
setting in college; individuals in other settings IE military should also be vaccinated
Individuals at risk of Bacterial Meningitis
-Immunosuppression
-Invasive procedure, skull fracture, or penetrating head wound (direct access to
CSF)
-Overcrowded or communal living conditions
S/S of Bacterial Meningitis
, Excruciating constant H/A
Nuchal rigidity (Stiff neck)
Photophobia (sensitivity to light)
Other clinical findings of bacterial meningitis
-Fever and chills
-N/V
-Altered LOC- confusion, disorientation, lethargy, difficulty arousing, coma
-Positive Kernig's sign- resistance and pain with extension of the client's leg from a
fixed position
-Positive Brudzinski's sign- flexion of extremities occurring with flexion of the
client's neck
-Tachycardia
-Seizures
-Red macular rash
-Restlessness, irritability
How to Diagnose Meningitis
Cerebrospinal fluid (CSF) analysis- most definite diagnostic; CSF is collected during
a lumbar puncture
Results indicative of
Meningitis:
-Appearance of CSF- Cloudy (bacterial) or clear (viral)
-Elevated WBC, protein
-Decreased glucose (bacterial)
-Elevates CSF pressure
-CT scan or MRI- to identify increased intracranial pressure (ICP) and/or abscess
Nursing interventions with meningitis
Isolate the client as soon as meningitis is expected
Droplet precautions should continue until antibiotics have been taken for 24
hours and when oral and nasal secretions are no longer infectious
