Meningitis%20-%20acute,%20bacterial Signs and Symptoms

Signs and Symptoms

Definition

Meningitis is the infection of the meninges and subarachnoid space that is usually caused by bacteria [eg Haemophilus influenzae type B (Hib), Neisseria meningitidis, Streptococcus pneumoniae, Listeria monocytogenes] and results in high mortality and morbidity throughout the world

Etiology

The introduction of conjugated vaccines against H influenzae type B, N meningitidis and S pneumoniae caused decline in the incidence of bacterial meningitis in children thus, majority of cases are now present in the adult population
Causative agents depend on the age of the patient and predisposing factors (eg compromised immune system, liver disease, alcoholism, uncontrolled diabetes, pregnancy, living in dormitories/military barracks, jail)

Alternative Causes of Meningitis

Spirochetes eg Treponema pallidum
Mycobacteria eg Mycobacterium tuberculosis
Fungi eg Cryptococcus, Coccidioides, Sporothrix
Viruses eg herpes simplex virus (HSV), varicella zoster (VZV), cytomegalovirus (CMV), enterovirus
Protozoa and helminths
Malignancy eg leukemia, lymphoma

Signs and Symptoms

Classic triad: Fever, neck stiffness and an altered level of consciousness is present in <50% of cases and some may have severe headache (especially in children) or any of the other symptoms:
- Chills
- Myalgia
- Photophobia
- Focal neurologic symptoms [eg cranial nerve palsies, ataxia, dilated/unequal and poorly reacting pupils (late sign)]
- Nausea/vomiting
- Seizures (late sign)
- Some patients may present with petechial rash

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Isavuconazole 100 mg hard cap and 200 mg infusion conc

The role of oral antivirals in COVID-19 treatment: Who, when, and how?

Dr. Roger Paredes, Dr. Nicola Petrosillo, Dr. Petrick Periyasamy, 30 Jan 2023

Though most countries have eased pandemic restrictions, there is no room for complacency in managing COVID-19, which continues to cause significant morbidity and mortality.

At a recent symposium, esteemed experts Dr Roger Paredes, Head of Department of Infectious Diseases at the Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain, and Dr Nicola Petrosillo, Head of the Infection Prevention and Control and Infectious Disease Service at University Hospital Campus Bio-Medico, Rome, Italy, gave global perspectives on the continuing unmet needs in the COVID-19 outpatient landscape and discussed the role of antiviral treatment options in patients at risk of progressing to severe COVID-19. Dr Petrick Periyasamy, Head of Infectious Diseases Unit, Medical Department, UKM Medical Centre, Kuala Lumpur, Malaysia, chaired the session.

Rapid antigen test: Don’t let perfect be the enemy of good

Pearl Toh, 23 Oct 2021

While rapid antigen test is less sensitive than conventional nucleic acid amplification test (NAAT) such as RT-PCR* in detecting SARS-CoV-2 virus, “a test does not have to be perfect to be clinically useful,” said Professor Angela Caliendo during a session in IDWeek 2021 — echoing the maxim that perfect should not be the enemy of good in the pandemic era.