| Download the amazing global Makindo app: ✅ Means NICE/National Guidelines 2026 compliant Android | Apple | |
|---|---|
| MEDICAL DISCLAIMER: Educational use only. Not for diagnosis or management. See below for full disclaimer. |
Pneumococcal meningitis ✅
👥 Contacts: Chemoprophylaxis is NOT indicated for pneumococcal meningitis ❌ (unlike meningococcal). 🌟 No characteristic purpuric rash (a key differentiator from meningococcal disease).
📖 About
- Most common cause of bacterial meningitis in adults in the UK.
- Caused by Streptococcus pneumoniae (Gram-positive encapsulated diplococcus).
⚠️ Risk Factors
- Older age, alcohol excess.
- CSF leak, skull fracture, cochlear implants.
- Immunocompromise: asplenia, HIV, immunosuppressants.
- Recent otitis media or sinusitis.
🩺 Clinical Features
- Fever, headache, photophobia, neck stiffness.
- Altered consciousness, confusion, seizures.
- No purpuric rash (unlike meningococcal disease).
- May present atypically in elderly.
🚨 Complications
- Sensorineural hearing loss (common)
- Cerebral oedema, hydrocephalus
- Seizures, focal deficits
- Sepsis and multi-organ failure
🧪 Investigations
- Blood cultures → take immediately (do not delay antibiotics)
- CT head before LP if:
- Focal neurological deficit
- New seizures
- Reduced GCS
- Papilloedema
- CSF (LP): neutrophils ↑, protein ↑, glucose ↓; Gram-positive diplococci
💊 Management
- 🚨 Medical emergency – do not delay treatment
- Immediate antibiotics:
- Ceftriaxone IV (first-line in UK practice)
- Add vancomycin ± rifampicin if resistance suspected (microbiology advice)
- Dexamethasone:
- 0.15 mg/kg IV q6h for 4 days
- Give before or with first antibiotic dose
- Supportive care: fluids, oxygen, seizure control, ICU if needed
📚 References
- NICE: Bacterial meningitis and meningococcal disease
- UKHSA guidance on meningitis
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
|
|
Categories
- A Level
- About
- Acute Medicine
- Anaesthetics and Critical Care
- Anatomy
- Anatomy and Physiology
- Biochemistry
- Book
- Cardiology
- Collections
- CompSci
- Crib Sheets
- Dental
- Dermatology
- Differentials
- Drugs
- ENT
- Education
- Electrocardiogram
- Embryology
- Emergency Medicine
- Endocrinology
- Ethics
- Foundation Doctors
- GCSE
- Gastroenterology
- General Practice
- Genetics
- Geriatric Medicine
- Guidelines
- Gynaecology
- Haematology
- Hepatology
- Immunology
- Infectious Diseases
- Infographic
- Investigations
- Lists
- Mandatory Training
- Medical Students
- Microbiology
- Nephrology
- Neu
- Neurology
- Neurosurgery
- Nutrition
- OSCE
- OSCEs
- Obstetrics
- Obstetrics Gynaecology
- Oncology
- Ophthalmology
- Oral Medicine and Dentistry
- Orthopaedics
- Paediatrics
- Palliative
- Pathology
- Pharmacology
- Physiology
- Procedures
- Psychiatry
- Public Health
- Radiology
- Renal
- Respiratory
- Resuscitation
- Revision
- Rheumatology
- Statistics and Research
- Stroke
- Surgery
- Toxicology
- Trauma and Orthopaedics
- USMLE
- Urology
- Vascular Surgery