Meningitis, bacterial

• Meningitis
• Haemophilus meningitis

• 320 Bacterial meningitis
• 320.0 Hemophilus meningitis
• 321.0 Cryptococcal 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

• G00.9 Bacterial Meningitis
• A48.8 Meningitis in other bacterial diseases classified elsewhere
• G00.8 Meningitis due to other specified bacteria

• 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

Description

• Infection of the meninges of the brain and spinal cord caused by a spread of bacteria
• Severity and extent causes a wide range of neurologic signs and symptoms, generally non-focal in nature

Essentials of Diagnosis

• Bacterial meningitis is rare
• Infection can result due to the following
  • Head injury
  • Severe local infection
  • Ear infection (otitis media)
  • Nasal Sinsus infection
• Onset of symptoms is very rapid and considered a medical emergency
• Commonly nosocomial or iatrogenic
• 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 pre-disposed the patient to infection

General Considerations

• Bacterial meningitis is caused by a wide range of bacteria
  • Most common forms of meningitis include pneumococcal, influenza, and meningococcal worldwide; other bacteria cause meningitis but may be less common in some parts of the world
  • Hemophilus meningitis is caused by the Haemophilus influenzae bacteria (Hib)
    • Most common form of meningitis
    • Acquired most likely following an upper respiratory infection
    • Rare; mostly limited to secondary to vaccine

Demographics

• Approximately 3/100,000 in the United States; 500/100,000 in Africa2

Signs and Symptoms

• Flu-like symptoms
• 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 effected

Functional Implications

• 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

Possible Contributing Causes

• Severe sinus infection
• Cranial or spinal surgery
• Shunt placement
• Open head injury
• Diseases ...