Meningitis

Prevalence Causes Clinical features Differential Diagnosis Investigations Therapy Prevention Prognosis

Investigations blood countd clotting studiesd urea, electrolytes, creatinined glucosed blood culturesa chest X-rayd throat swabd lumbar puncture a Considering arranging a CT brain before performing the lumbar puncture a . Use a narrow gauge, non-cutting needle a through a bleb of local anaesthetic c Replace the stylet before withdrawing the needle. a Consider using an epidural blood patch. a There is no clear benefit from bedrest post-lumbar puncture. d  fluid supplementation d Send CSF for  Gram stain and cell count c culture a  glucose and protein c Consider  using reagent strips (e.g. urine dipsticks) a b to look for leucocyte esterase, glucose and protein levels blood for PCR for meningococcus b CSF for PCR for meningococcus b or viruses c Latex agglutination tests for diagnosing meningococcal, pneumococcal or H. influenzae b infections c

Expiry date: January 2003
Levels of Evidence used in grading these guides

Authors	RS   Phillips , C   Ball
Reviewer	B   Davis
CAT Writers	C   Ball , RS   Phillips , C   Wotton