Prepared by Francis Adrian Palalon

Meningitis is an inflammation of the lining

(meninges) around the brain and spinal cord caused
by bacteria and viruses.
 Brain - an organ of soft nervous tissue contained in the skull of
vertebrates, functioning as the coordinating center of sensation
and intellectual and nervous activity
Spinal cord - the cylindrical bundle of nerve fibers and
associated tissue that is enclosed in the spine and connects
nearly all parts of the body to the brain
Meninges - the three membranes that line the skull and vertebral
canal and enclose the brain and spinal cord.
 Pia mater - the delicate innermost membrane enveloping the
brain and spinal cord
Arachnoid mater - a fine, delicate membrane, the middle one
of the three membranes or meninges that surround the brain
and spinal cord,
Dura mater - the tough outermost membrane
enveloping the brain and spinal cord
Viral meningitis
- most common type
- often less severe than bacterial meningitis
- Non-polio enteroviruses

Bacterial meningitis
- very serious and can be deadly(as little as few hours)
- Strep. pneumoniae, Group B Streptococcus, Neisseria
meningitides, Haemophilus influenza, Listeria monocytogenes
Fungal meningitis
- rare and caused by fungus spreading through blood to the
spinal cord
- weak immune system(HIV infection
or cancer) are at increased risk
- Cryptococcus

Parasitic meningitis
- much less common than viral and bacterial meningitis
- can often increase eosinophils which can cause a rare form
of Eosinophilic meningitis (EM)
 Sudden high fever
Stiff neck (positive Brudzinskis and Kernigs sign)
Severe headache that seems different than normal
Headache with nausea or vomiting
Confusion or difficulty concentrating
Seizures
Sleepiness or difficulty waking
Sensitivity to light (photophobia)
No appetite or thirst
Skin rash (sometimes, such as in meningococcal meningitis)
Newborn:

High fever
Constant crying
Excessive sleepiness or irritability
Inactivity or sluggishness
Poor feeding
A bulge in the soft spot on top of a baby's head
(fontanel)
Stiffness in a baby's body and neck
 Blood culture

Spinal tap (Lumbar puncture)

CBC

Chest X-ray

Imaging tests
 The most critical treatment is the rapid initiation of antibiotic
therapy (penicillin).
Assessment and maintenance of airway, breathing, and
circulation (ABCs) are essential. Treatment with intubation,
mechanical ventilation, and hyperventilation may occur if the
patients airway and breathing are threatened.
Supportive measures such as bedrest and temperature control
with antipyretics. Gradual treatment of hyperthermia is
required to prevent shivering.
 Other strategies to manage increased ICP include osmotic diuretics,
such as mannitol, or intraventricular CSF drainage and ICP pressure
monitoring.
Fluids are often restricted if signs of cerebral edema or excessive
secretion of antidiuretic hormone are present.
If the patient experiences seizures, the physician prescribes
anticonvulsant medications.
Surgical interventions or CSF drainage may be required to prevent
permanent neurological deficits as a result of complications such as
hydrocephalus or abscesses.
 Monitor vital signs and neurological signs.
Assess for signs of increasing ICP.
Initiate seizure precautions.
Monitor for seizure activity.
Monitor for signs of meningeal irritation. (Brudzinskis sign,
Kernigs sign, Spinal rigidity, Nuchal rigidity)
Perform cranial nerve assessment.
Assess peripheral vascular status.
 Maintain isolation precautions as necessary with bacterial
meningitis.
Maintain urine and stool precautions with viral meningitis to
avoid contaminations.
Maintain respiratory isolation for the client with pneumococcal
meningitis.
Elevate the head of the bed 30 degrees, and avoid neck
flexion and extreme hip flexion.
Administer analgesics as prescribed.
Administer antibiotics as prescribed.