Bacterial Meningitis

Bacterial Meningitis
Bacterial Meningitis 

Is an inflammation of the meninges that follows the invasion of the spinal fluid by a bacterial agent.


The organisms most commonly causing bacterial meningitis are E.coli, streptococcus pneumonia, Hemophilus influenza and Neisseria meningitides.


It is almost always preceded by an upper respiratory infection, bacteria circulating in the blood invade the CSF.

May occur as the extension of a local bacterial infection such as otitis media or mastoiditis.

Also gain direct entry through a penetrating wound, spinal tap, surgery or anatomic abnormalities.

The infective process results in inflammation, exudation and varying degree of tissue damage in the brain.

Clinical manifestations:

Signs and symptoms are variables depending on the patient's age, the etiologic agent and the duration of the illness when diagnosed.

1- Infant less than 1 month of age:

Hypothermia or fever, irritability, weight loss, seizures, jaundice, cyanosis, apnea, poor suckling, vomiting, full tense and bulging fontanel, neck usually supply.

2- Infants and up to 2 years of age:

Neck rigidity, bulging fontanel, fever, vomiting, positive kerning's and brudzinski's signs.

3- Children over 2 years:

Vomiting, headache, mental confusion, lethargy, neck rigidity, positive kernings and chills.

Diagnostic evaluation:


Physical examination.

Diagnosis usually established by the performance of lumbar puncture to examine the CSF.

1.cloudy or turbid.

2. elevated CSF pressure.

3. high cell count.

4- low glucose level ( CSF).

5- an elevated protein level (CSF).

6-gram stain.

7- culture and sensitivity.

CBC ( elevated WBCs ).

Serum glucose, urea, creatinine, electrolytes.

Blood culture.


Seizures , cerebral edema , subdural effusion , hydrocephalus.
Brain abscess .


1- I.V antibiotic.

2- supportive management of the comatose child or the child with seizures.

3- Appropriate prophylactic provided for contacts if indicated.


Multiple Pregnancies

Croup and Epiglottitis

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