A child with a stiff neck

Anatomy
1. skull
2. meninges
3. ventricular system
  1. is a set of four interconnected cavities known as cerebral ventricles in the brain
    1. Within each ventricle is a region of choroid plexus
      1. which produces the circulating
        cerebrospinal fluid (CSF).
        CSF INTERPRETATION
        WBC LEVELS
        Increased
        polymorphs (nuetrophils)
        lymphocytes
meningitis
1. is an inflammation (swelling) of the protective membranes covering the brain and spinal cord
2. infectious
  1. bacterial
    1. Streptococcus pneumoniae
    2. Neisseria meningitidis
    3. Haemophilus influenzae
    4. Listeria monocytogenes
  2. viral
    1. Enterovirus
    2. Echovirus
  3. fungal
    1. mostly affects people with immune deficiencies
3. non-infectious
  1. due to injury \cancer\drugs
4. signs & symptoms
  1. headache
  2. fever
  3. neck stiffness
  4. photophobia
  5. vomiting
    1. physiology of vomiting
    2. Types
      1. projectile
        gastric outlet obstruction
      2. non-projectile
5. Investigation
  1. physical examination
    1. Kernig's sign
    2. brudzinski sign
  2. lumbar puncture
    1. Is where a thin needle is inserted between the bones in the lower spine.
      1. in infants : L4-L5 interspace
      2. on adult : L3-L4 interspace
    2. indications
      1. diagnostic
      2. therapeutic
      3. anesthetic
    3. contraindication
      1. increased intercranial pressure
      2. skin infections at the level of insertion
    4. complications
      1. back pain
      2. hemorrhage
6. Management
  1. Newborn
    1. Ampicillin + 3ed generation cephalosporin + aminoglycoside
  2. Adult
    1. Vancomycin + 3ed generation cephalosporin
  3. Elderly
    1. Ampicillin + Vancomycin + 3ed generation cephalosporin
isolation methods
1. there are three categories of Transmission-Based Precautions
  1. Airborne Precautions
  2. Droplet Precautions
  3. Contact Precautions

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A child with a stiff neck

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	Created by Rahaf Fouad almost 3 years ago