Table of contents

Meningitis Treatment/ how to treat meningitis

Introduction:

Meningitis is the meningeal inflammation around the brain &/ or spinal cord. It caused by bacterial, viral infections, protozoa, fungi, spirochetes, helminths, mycobacteria, or aseptic.

Clinical features: (Meningitis symptoms/ meningitis signs)

Fever, headache, photophobia, neck pain, vomiting, altered sensorium, etc
Neck, & back stiffness, Kernig’s, Brudzinski’s signs present.

Investigations: (meningitis test)

CSF study: protein, glucose, cells, Gram Stain, AFB stain, and Culture sensitivity.
Blood culture
Bacterial meningitis includes neutrophilic pleocytosis, increased CSF protein, & glucose level decreased.
Spirochetal, Granulomatous (fungal, mycobacterial) show lymphocytosis.
Viral, aseptic meningitis and meningoencephalitis show lymphocytosis.
CSF PCR for enteroviruses, HSV, and HIV
Cryptococcal antigen, & Arbovirus antibodies.

Meningitis Treatment Order:

Emperical therapy:

Empiric Treatment:

Inj. Ceftriaxone 2g IV Q12H ATD
Inj. Vancomycin 1g IV Q12H
Inj. Ampicillin 2g IV Q4H for Listeria monocytogenes.
Inj. Dexamethasone 4mg IV Q6H before or with antibiotics for streptococcus pneumonia.
Specific treatment to be started once organism and sensitivity confirmed. If MTB present then start ATT.