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91: MENINGITIS

Mollie Venglar, DSc, MSPT, NCS

CONDITION/DISORDER SYNONYMS

  • Leptomeningitis

  • Bacterial meningitis

  • Cryptococcal meningitis

  • Haemophilus meningitis

ICD-9-CM CODES1

  • 320 Bacterial meningitis

  • 320.0 Haemophilus meningitis

  • 320.1 Pneumococcal meningitis

  • 320.2 Streptococcal meningitis

  • 320.3 Staphylococcal meningitis

  • 320.7 Meningitis in other bacterial diseases classified elsewhere

  • 320.89 Meningitis due to other specified bacteria

  • 321 Meningitis due to other organisms

  • 321.0 Cryptococcal meningitis

ICD-10-CM CODES2

  • B45.1 Cerebral cryptococcosis

  • G00.0 Haemophilus meningitis

  • G00.1 Pneumococcal meningitis

  • G00.2 Streptococcal meningitis

  • G00.3 Staphylococcal meningitis

  • G00.8 Other bacterial meningitis

  • G00.9 Bacterial meningitis, unspecified

  • G01 Meningitis in other bacterial diseases classified elsewhere

PREFERRED PRACTICE PATTERNS3

  • 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

PATIENT PRESENTATION

A 27-year-old woman is seen in the in-patient rehabilitation center for physical rehabilitation following meningitis. The woman suffered heart and lung failure and generalized convulsions before responding to the medications provided in the ICU. Presently, the woman presents with poor postural control and reduced muscle tone in her trunk and extremities. She tolerates very little time in a fully upright position. Her cognition is impaired and her attention to task is limited to approximately 10 seconds.

FIGURE 91-1

Pyogenic meningitis, showing obliteration of the gyri of the brain surface by the purulent exudate. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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KEY FEATURES

Description

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

  • Severity and extent of the infection causes a wide range of neurologic signs and symptoms, generally nonfocal in nature

Essentials of Diagnosis

  • Headache and neck stiffness are common with all infections of the central nervous system.

  • 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.

General Considerations

  • Haemophilus meningitis is caused by the haemophilus influenzae bacteria.

    • The most common form of meningitis.

    • Acquired following an upper respiratory infection.

  • Bacterial meningitis is caused by a wide range of bacteria.

    • Onset of symptoms is very rapid and considered a medical emergency.

  • Cryptococcal meningitis is caused by the fungus ...

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