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Diagnosis and treatment

- The diagnosis of meningitis is based on the history, physical examination, and laboratory tests .

- The most important laboratory test for meningitis is the lumbar puncture (LP) or spinal tap, which involves inserting a needle into the lower back to collect cerebrospinal fluid (CSF) for analysis .

- The CSF analysis can reveal the type, cause, and severity of the infection by measuring the following parameters :

  • Appearance: normal CSF is clear and colorless; cloudy or turbid CSF indicates infection; yellow or xanthochromic CSF indicates bleeding; pink or red CSF indicates blood contamination.
  • Pressure: normal CSF pressure is 70-180 mm H2O; increased pressure indicates increased intracranial pressure; decreased pressure indicates dehydration or leakage.
  • Protein: normal CSF protein is 15-45 mg/dL; increased protein indicates inflammation or infection; decreased protein indicates malnutrition or leakage.
  • Glucose: normal CSF glucose is 50-80 mg/dL or 60-70% of blood glucose; decreased glucose indicates bacterial or fungal infection; increased glucose indicates diabetes mellitus or hyperglycemia.
  • Cell count and differential: normal CSF cell count is 0-5 white blood cells (WBCs) per mm3 and 0 red blood cells (RBCs) per mm3; increased WBCs indicate infection or inflammation; increased RBCs indicate bleeding or trauma; differential can identify the type of WBCs present (e.g., neutrophils indicate bacterial infection; lymphocytes indicate viral or fungal infection).

- Other laboratory tests for meningitis include blood culture, urine culture, throat swab, polymerase chain reaction (PCR), antigen detection tests, antibody tests, and imaging tests (e.g., computed tomography scan or magnetic resonance imaging scan).

- The treatment of meningitis depends on the type and cause of the infection.

- Viral meningitis usually requires only supportive care, such as hydration, analgesics (pain relievers), antipyretics (fever reducers), and anticonvulsants (seizure preventers).

- Bacterial meningitis requires prompt administration of antibiotics, such as penicillin, cephalosporin, vancomycin, or rifampin. The choice of antibiotic depends on the type of bacteria, the susceptibility to the drug, and the patient’s condition. Sometimes, corticosteroids (e.g., dexamethasone) are also given to reduce inflammation and prevent complications.

- Fungal meningitis requires antifungal drugs, such as amphotericin B, fluconazole, or voriconazole . The duration of treatment may be long and depends on the type of fungus and the patient’s response.

- Parasitic meningitis requires antiparasitic drugs, such as albendazole, ivermectin, or miltefosine . The prognosis of parasitic meningitis is poor and often fatal.

Questions on Diagnosis and treatment

Correct Answer is ["A","B","C","E"]

Explanation

A stiff neck is a hallmark sign of meningitis, particularly in cases of bacterial meningitis. It is caused by the irritation and inflammation of the meninges surrounding the spinal cord.

Correct Answer is D

Explanation

Viral meningitis is not caused by a fungus, and environmental sources are not the reservoirs for viral meningitis transmission. It is mainly transmitted from person to person.

Correct Answer is B

Explanation

This statement is not appropriate because meningococcal septicemia is a different condition from meningitis. While both can be caused by Neisseria meningitidis bacteria, septicemia is characterized by a bloodstream infection, while meningitis affects the meninges.

Correct Answer is D

Explanation

Photophobia is a common symptom of meningitis, but it is not specific to older adults. It may be present in both younger and older patients with meningitis.

Correct Answer is B

Explanation

This statement is incorrect. During a lumbar puncture, the patient is usually asked to curl up in a fetal position, bringing the knees close to the chest and the chin to the chest. This position helps to widen the spaces between the spinal bones, making it easier for the healthcare provider to insert the needle into the subarachnoid space. It does not involve bending the neck forward.

Correct Answer is C

Explanation

Group B streptococcus is a significant cause of neonatal meningitis but is less commonly responsible for meningitis in adults.

Correct Answer is C

Explanation

Contact with contaminated soil is not a typical mode of transmission for viral meningitis. It might be relevant for some soil-transmitted infections but not for viral meningitis.

Correct Answer is A

Explanation

Meningitis of unknown origin refers to cases where the cause of meningitis remains unidentified after thorough investigations. It is not a specific type of meningitis but rather a descriptive term for cases with uncertain etiology.

Correct Answer is C

Explanation

A computed tomography (CT) scan is a diagnostic imaging test that uses X-rays to create detailed cross-sectional images of the body. While it can help identify structural abnormalities in the brain, such as bleeding or tumors, it is not the primary test for confirming meningitis. CT scans may show signs of inflammation, but they cannot definitively diagnose meningitis or distinguish between bacterial, viral, or fungal causes.

Correct Answer is ["A","C","D","E"]

Explanation

Monitoring vital signs and neurological status is crucial for a client with meningitis. Vital signs such as temperature, heart rate, respiratory rate, and blood pressure should be closely monitored to assess for any signs of worsening condition or complications. Neurological assessments help identify changes in the client's mental status, reflexes, and cranial nerve function.

Correct Answer is C

Explanation

Elevated protein levels in the CSF can be seen in various conditions, including meningitis. While it indicates increased inflammation and breakdown of cells, it is not specific to bacterial or fungal infection and can be present in viral or other forms of meningitis.

Correct Answer is B

Explanation

Dehydration does not typically cause pink-colored CSF. Dehydration may lead to a higher concentration of solutes in the CSF, but it does not affect its coloration.

Prophylactic corticosteroids may be used in certain cases of bacterial meningitis to reduce inflammation and prevent complications, but they are not indicated for the treatment of viral meningitis.

Practicing good hygiene habits, such as regular handwashing, can help prevent the spread of meningitis. Since meningitis can be transmitted through respiratory secretions, practicing good hygiene is essential in reducing the risk of infection transmission.

Avoiding close contact with people with respiratory infections is a good practice to reduce the risk of various respiratory infections, including those that can cause meningitis. However, it is not the recommended specific preventive measure for a client planning to travel to a high-risk area for me

Voriconazole is a broad-spectrum antifungal medication that is also used to treat fungal meningitis. It is particularly effective against Aspergillus species, which can cause invasive fungal infections, including meningitis.

Parasitic meningitis is not prevalent in temperate regions during the summer. Parasitic meningitis is rare and is usually associated with specific parasitic infections, such as those caused by Naegleria fowleri or Angiostrongylus cantonensis, which are typically found in tropical or subtropical regi

Parasitic meningitis is primarily caused by parasites and is not typically associated with any specific season or region. It is a rare form of meningitis and is not more prevalent in tropical regions during winter.

The statement comparing meningococcal meningitis with fungal meningitis' mortality rate is not accurate. While meningococcal meningitis can be severe, fungal meningitis is generally associated with a higher mortality rate, especially in individuals with weakened immune systems.

With appropriate and timely treatment, the mortality rate of pneumococcal meningitis can be relatively low. However, it is still a severe and potentially life-threatening condition, and prompt medical attention is crucial to avoid complications.

A chest X-ray is not directly related to diagnosing meningitis. It is used to evaluate lung and heart conditions, making it irrelevant in confirming meningitis.

<p>Parasitic meningitis is not a common form of meningitis and is usually associated with specific parasitic infections, which are less likely to occur in immunocompromised patients.</p>

<p>Hygiene practices, such as regular handwashing and proper respiratory etiquette, play a significant role in preventing meningitis transmission. By reducing the spread of respiratory and oral pathogens, the risk of meningitis can be lowered. However, it is important to note that not all forms of m

<p>Vaccination against Neisseria meningitidis is not directly relevant to preventing Haemophilus influenzae type b meningitis. These are two different types of bacteria that cause different forms of meningitis, and vaccination against Neisseria meningitidis would not protect against Haemophilus infl
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