Meningitis, hemophilus (Hib)

• Meningitis
• Bacterial Meningitis

• 320.0 Hemophilus meningitis

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

• 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

• 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

Essentials of Diagnosis

• 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

General Considerations

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

Demographics

• Usually seen in children under 5 years old

Signs and Symptoms

• 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

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
• 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

Differential Diagnosis

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

Laboratory Tests

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