1. Adult Meningitis Bacterial & Viral Faith Vaughn RN, BSN, MSN
2. Learning Objectives: At the end of the presentation, the audience will be able to:
Describe causes of meningitis
Identify causes and symptoms of meningitis
State nursing interventions for meningitis
3. What is Meningitis
Meningitis: is an inflammation of the meninges (lining of the brain and spinal cord), which is caused by various organisms such as bacterial, viral, or fungi
The disease is contagious, and can spread from person to person by nasal or oral droplets (kissing, sneezing, coughing) and direct close contact with the discharges from the nose or throat of an infected person. CDC data: 10-14% of cases are fatal.
4. Inflammation of the Meninges
5. Cause of Meningitis
Can develop when the bacteria travel via the blood from another infection (sinusitis, mastoiditis, otitis media, neurosurgical procedures)
Often severe and is a medical emergency. It progresses rapidly, and if left untreated, can cause permanent damage, example (hearing loss, loss of limb)
CDC data: 10% will die despite early diagnosis and treatment.
(bacteria can live only seconds outside. It cannot
survive in air or on household objects such as
clothes, furniture etc)
6. Common Bacterial Organisms
1. Streptococcus Pneumoniae (Pneumococcal)
More common and serious in children <5yrs of age.
CDC data: It has the highest mortality rate at 21%. Vaccine is available.
2. Neisseria Meningitidis (meningococcus)
Leading cause of bacterial meningitis and is highly contagious.
Crowded living conditions increase the risk (such as daycare centers, nursing homes, dorms
Immunosuppressive pts, passive smoking, very young & very old are affected.
Prognosis: 5-10% mortality rate.
7. Viral meningitis:
Viral ("aseptic") is serious but rarely fatal in persons with a normal immune system
Symptoms are similar to bacterial
Viruses, such as varicella zoster, mumps, HIV, herpes simplex virus (HSV) type 2, cause about 90% of cases.
Decrease in locations where immunizations have become routine (vaccines)
Hx: depends on type of illness (URI, post-exposure, recent travel)
Focus is on neurological status: deterioration can progress rapidly
Diagnostic tests: Ct scan & EEG. *Lumbar puncture: most important lab test.
An increase in protein concentration and WBCs indicates bacterial.
Alert: knowing whether the organism is viral or bacterial is imperative to early, effective TX
Classical symptoms include:
Nuchal rigidity: stiff neck that creates pain when flexed toward chest
High fever (viral: never goes >104)
Altered mental status
Headache (severe, consistent)
Alert: If fever, neck stiffness, and altered mental status are all absent, bacterial meningitis is eliminated. (Visit MD if 2 or more symptoms)
Often mistaken for the cold or flu-like illness
Need for hospitalization depends on severity of illness (Immediate IV antibiotic is crucial, if suspected, and can be adjusted after CSF results).
Prophylaxis for exposure is Rifampin
Alert: (urine-orange reddish color)
Viral is mostly supportive care based on symptoms. MD recommends bed-rest, fluids, Tylenol /aspirin for aches/pain. Symptoms usually resolved in 7-10 dys.
Isolation: droplet precautions for bacterial (Mask on entering room).
11. Teaching & Prevention
Good hygiene practices (hand washing, no sharing of items, utensils)
Vaccines/Post exposure antibiotics/traveling
12. Post-test .
! Ms Jones has been admitted for meningitis. The lab analysis for CSF was reviewed by the primary nurse. The nurse would expect to note:
A. an increase in protein
B. clear color
C. decrease in WBCs
2. Meningitis is contagious. From your knowledge of the disease, you would know the organism could spread by:
A. poor hand hygiene
B. contact with infected nasal secretions
D. all of the above
3. All are symptoms of meningitis except:
B. altered mental status
4. Which classification of medications is essential in the treatment of meningitis?
D. none of the above .
5. Meningitis is define as:
A. a bacterial or non-bacterial infection that causes inflammation of the membranes covering the brain and spinal cord
B. inflammation of the spinal cord and pericardium
C. inflammation of the meninges that results in swelling of the brain and spinal tissue
D. A and C only