Bacterial causes - medical emergency:
IM Benpen in GP
When in hospital - if <3 months or >50 years = IV cefotaxine + amox
Otherwise in hospital IV cefotaxine
Contact trace all close contacts within 7 days and offer oral Ciprofloxacin
- Neisseria meningitidis
- Streptococcus pneumoniae (pneumococcus)
- Haemophilus influenzae
- Group B streptococcus (GBS) (particularly in neonates as GBS may colonise the vagina)
- Listeria monocytogenes (particularly in neonates)
Viral causes:
- Enteroviruses (e.g., coxsackievirus)
- Herpes simplex virus (HSV)
- Varicella zoster virus (VZV)
Typical symptoms of meningitis are:
- Fever
- Neck stiffness
- Vomiting
- Headache
- Photophobia
- Altered consciousness
- Seizures
There are two special tests you can perform to look for meningeal irritation:
- Kernig’s test- slowly straighten knee while on back keeping hip flexed - +ve spinal pain and resistance to movement
- Brudzinski’s test- lift Head and Neck off bed - causes +ve patient to flex hips and knees