Meningitis (peds): Difference between revisions
(Created page with "==Background== *<3months old **1% incidence of bacterial meningitis **E. coli, Group B strep, listeria *>3months old **S. pneumo, meningococcus, staph ==Diagnosis== Bacterial Me...") |
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==Background== | ==Background== | ||
*Meningismus is difficult to discern if <6mo, (esp if <2mo) | |||
*<3months old | *<3months old | ||
**1% incidence of bacterial meningitis | **1% incidence of bacterial meningitis | ||
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==Work-Up== | ==Work-Up== | ||
CBC | #CBC | ||
CSF | #CSF | ||
==DDx== | ==DDx== | ||
Revision as of 01:28, 14 June 2011
Background
- Meningismus is difficult to discern if <6mo, (esp if <2mo)
- <3months old
- 1% incidence of bacterial meningitis
- E. coli, Group B strep, listeria
- >3months old
- S. pneumo, meningococcus, staph
Diagnosis
Bacterial Meningitis Score for >2mo and well-appearing
- Risk Factor
- Peripheral blood ANC >10K
- Seizure
- CSF
- CSF ANC >1000
- CSF protein >80
- CSF Gram stain (if + 61% Sn, 99% Sp)
- Any risk factor = high risk for bacterial meningitis
- Very low risk if infant lacks all risk factors
Work-Up
- CBC
- CSF
DDx
Treatment
Disposition
- Admit despite negative meningitis score if:
- Age <2mo w/ any degree of pleocytosis
- Appear ill
- Infants w/ aseptic meningitis
- If likely viral meningitis still give CTX x 1, f/u in 24hr
See Also
Source
Tintinalli