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Acute Bacterial Meningitis In Children

Signs & Symptoms

 Toxic appearance at admission
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis]
Stiff neck Gr. children
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2940] Nelson Essentials [ 342]
Nuchal rigidity Gr. children
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2940] Nelson Essentials [ 342]
Lethargy
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2940]

Physical Examination

 Toxic appearance at admission
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis]
Toxic appearance
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis]
Stiff neck Gr. children
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2940] Nelson Essentials [ 342]

Lab / Serology

 Positive blood culture
Note: Confirms diagnosis.
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications] Nelson Textbook [ 2940] Nelson Essentials [ 343]
Positive CSF culture
Note: Absence of pleocytosis Early in the disease course.
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications]
Positive CSF Gram stain #Pneumococcal_meningitis
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications] Nelson Textbook [ 2490]

Imagin Study

 Pachymeningitis
Ref: Nelson Textbook [ 2942-243]
Increased ICP
Note: May present as bulging fontanelles, shift of intracranial structures, increased ICP. Especially common in infants
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications] Nelson Textbook [ 2945] Nelson Essentials [ 344]
Shift of intracranial structures
Note: May present as bulging fontanelles, shift of intracranial structures, increased ICP. Especially common in infants
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications] Nelson Textbook [ 2945] Nelson Essentials [ 344]

Complication

 Permanent neurologic sequelae
Ref: Uptodate [ Bacterial meningitis in children: Neurologic complications] Nelson Essentials [ 344]
Coma
Ref: Nelson Textbook [ 2940]
SIADH
Ref: Nelson Textbook [ 2940] Nelson Essentials [ 343]

Risk Factors

Cause

 Streptococcus pneumoniae
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2938]
Neisseria meningitidis
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis] Nelson Textbook [ 2938]
Haemophilus influenzae
Ref: Uptodate [ Bacterial meningitis in children older than one month: Clinical features and diagnosis]

Other