A few take home points about meningitis

By Brad Sobolewski, MD, MEd|2015-09-18T12:06:12-04:00September 17th, 2015|Infectious Diseases|

Some great stuff as usual from Taming the SRU from the University of Cincinnati Emergency Medicine program about the diagnosis of meningitis. Especially pertinent during enterovirus season:

In one study, 95% of people with meningitis had 2/3 of fever, headache and meningismus – But only 44% had all 3
CT prior to LP? The American College of Radiology says do it for papilledema, altered mental status, focal neuro deficit, immunocompromised stated, history of CNS disease.
The diagnosis and distinction of viral and bacterial meningitis via CSF studies is not always clear and there can be a lot of overlap, with a significant number of cases of bacterial meningitis with the following specific, yet not sensitive findings:
- WBC2,000
- Glucose<34
- Blood:csf ratio<0.23
- protein >220mg/dL

About the Author: Brad Sobolewski, MD, MEd

Brad Sobolewski, MD, MEd is a Professor of Pediatric Emergency Medicine and an Associate Director for the Pediatric Residency Training Program at Cincinnati Children's Hospital Medical Center. He is on Twitter/X @PEMTweets, on Instagram @BradSobolewski, authors the Pediatric Emergency Medicine site PEMBlog and is the host and creator of PEM Currents: The Pediatric Emergency Medicine Podcast. All views are strictly my own and not official medical advice.