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Acute Bacterial Meningitis In Neonates

Signs & Symptoms

 Neonatal intensive care unit
Ref: Nelson Essentials [ 228]
Tachypnea
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1072] Nelson Essentials [ 228]
Flaring of the nasal alae
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1072] Nelson Essentials [ 228]
Vomiting
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1072] Nelson Essentials [ 228]

Physical Examination

 Abnormal Moro reflex
Ref: Nelson Textbook [ 1072]
Tachypnea
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1072] Nelson Essentials [ 228]
Flaring of the nasal alae
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1072] Nelson Essentials [ 228]

Lab / Serology

 Positive Gram stain
Note: Approximately 20% of neonates with culture-confirmed bacterial meningitis have negative Gram-stained smears.
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1080]
Positive blood culture
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Textbook [ 1080]
Predominance of polymorphonuclear leukocytes
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Essentials [ 228]

Imagin Study

 Variably circumscribed region of decreased attenuation of the rim
Note: due to Brain abscess
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications] Nelson Textbook [ 1081]
Variably circumscribed region of contrast enhancement of the rim
Note: due to Brain abscess
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications] Nelson Textbook [ 1081]
Dilated ventricles
Note: due to Ventriculitis
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications] Nelson Textbook [ 1081]

Complication

 Variably circumscribed region of decreased attenuation of the rim
Note: due to Brain abscess
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications] Nelson Textbook [ 1081]
Variably circumscribed region of contrast enhancement of the rim
Note: due to Brain abscess
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications] Nelson Textbook [ 1081]
White matter atrophy #Chronic
Ref: Uptodate [ Bacterial meningitis in the neonate: Neurologic complications]

Risk Factors

 Male
Ref: Nelson Essentials [ 228]

Cause

 Group B Streptococcus
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Essentials [ 228]
Escherichia coli
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Essentials [ 228]
Gram-negative bacilli
Ref: Uptodate [ Bacterial meningitis in the neonate: Clinical features and diagnosis] Nelson Essentials [ 228]

Other