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  • Meningitis
  • Bacterial Meningitis

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  • 320.0 Hemophilus meningitis

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  • G00.9 Bacterial meningitis, unspecified
  • A48.8 Other specified bacterial diseases
  • G00.8 Other bacterial meningitis

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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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General Considerations

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  • Generally, bacterial meningitis is rare; secondary to vaccine
  • Individual may not know they have the bacteria

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Demographics

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  • Usually seen in children under 5 years old

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Signs and Symptoms

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  • Severity and extent causes a wide range of neurologic signs and symptoms, generally non-focal in nature
  • Flu-like symptoms
  • Pneumonia
  • Swollen throat, difficulty breathing
  • Headache
  • Stiff neck
  • Skin rash
  • Change in mental status (confusion, delirium)
  • Fever or hypothermia
  • Malaise
  • Impaired heart, lung, liver, kidney function
  • Seizure, generalized convulsions
  • Sensory deficit/change
  • Motor deficit/change
  • With increased intracranial pressure, papilledema may develop
  • With prolonged infection, cranial nerves may become affected

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Functional Implications

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  • Loss of mobility temporarily with permanent loss possible
  • Loss of hearing/vestibular function in some cases
  • Loss of coordination, fine and gross motor temporarily with permanent loss possible
  • Loss of independence with activities of daily living
  • Reduced cognitive function, particularly executive functions

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Possible Contributing Causes

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  • Severe sinus infection
  • HIV/AIDS, immunosuppressive
  • Removal of spleen
  • Sickle cell disease
  • Bone marrow transplant
  • Cranial or spinal surgery
  • Shunt placement
  • Open head injury
  • Dural tears from remote trauma
  • Ruptured brain abscess

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Differential Diagnosis

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  • Extrapyramidal rigidity
  • Hydrocephalus
  • Alcohol intoxication or withdrawal
  • Hepatic encephalopathy
  • Subarachnoid hemorrhage
  • Meningoencephalitis
  • Epstein-Barr virus (EBV)
  • Behçet’s disease

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Laboratory Tests

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  • Lab tests for complete blood count, general chemistry panel, ...

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