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CONDITION/DISORDER SYNONYMS

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  • Meningitis

  • Bacterial meningitis

  • Haemophilus meningitis (HIB)

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ICD-9-CM CODE

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  • 320.0 Haemophilus meningitis

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ICD-10-CM CODES

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  • A48.8 Other specified bacterial diseases

  • G00.8 Other bacterial meningitis

  • G00.9 Bacterial meningitis, unspecified

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PREFERRED PRACTICE PATTERNS1

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  • 5A: Primary Prevention/Risk Reduction for Loss of Balance and Falling

  • 5C: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Central Nervous System—congenital origin or acquired in infancy or childhood

  • 5D: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Central Nervous System—acquired in adolescence or adulthood

  • 5I: Impaired Arousal, Range of Motion and Motor Control Associated With Coma, Near Coma, or Vegetative State

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PATIENT PRESENTATION

An “as-needed” (PRN) physical therapist called in sick to work with reports of flu-like symptoms, particularly sinus congestion, and increasing stiffness in her neck. She also noticed a skin rash and unusual sensations in her hands and feet, and she felt clumsy. She treated patients at the acute care hospital a couple of weeks ago and, because she had not had a flu shot yet, wore a mask while working with most of the patients. She reported to employee health and was sent immediately to the emergency department with suspicion of meningitis. Cerebrospinal fluid testing revealed high leukocyte count, high protein volume, and low glucose.

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KEY FEATURES

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Description
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  • A type of bacterial meningitis found in the nose and throat

  • Infection of the meninges of the brain and spinal cord caused by a spread of bacteria

  • Caused by the haemophilus influenza bacteria (Hib)

    • Most common form of meningitis

    • Acquired following an upper respiratory infection

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Essentials of Diagnosis
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  • Bacteria contracted by exhaled droplets from an infected adult or child or by the following:

    • Head injury

    • Severe local infection

    • Ear infection (otitis media)

    • Nasal sinus infection

  • Hib can enter the bloodstream and cause infection in the meninges or lungs.

  • No physical test distinguishes a bacterial from a viral infection; must rely on body fluid cultures.

  • If a central nervous system infection is suspected, the therapist should seek information regarding a potential source of infection or a condition that predisposed the patient to infection.

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FIGURE 94-1

The decline in Haemophilus influenzae type b (Hib) meningitis in association with the introduction of new vaccines is shown. Note also the steady state of the other major causes of childhood meningitis. They did not increase to “fill in the gap” nor did H. influenzae invasive disease caused by other serotypes. (From Ryan KJ, Ray CG. Sherris Medical Microbiology. 5th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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FIGURE 94-2

Haemophilus influenzae disease, cellular view. Organisms attach to epithelial cells using pili ...

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