1. INTERNAL MEDICINE

2. Meningitis Def: Meningitis is swelling and irritation (inflammation) of the membranes covering the brain and spinal cord. This inflammation causes changes in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.

3. Meningitis Types of meningitis: Pyogenic meningitis Tuberculous meningitis Viral meningitis

4. Meningitis Aetiology: A)bacterial meningitis- E.colli Group B streaptococci Neisseriameningitidis Streaptococcuspneumoniae Haemophilusinfluenzae

5. Meningitis Aetiology: B)Tuberculous meningitis- Micobacterium tuberculosis C)Viral meningitis- Enterovirus Arbovirus Herpes simplex virus Mumps virus Inflenza virus

6. Meningitis Aetiology: D)Protozoa and parasites- Toxoplasma Amoeba E)Fungi- Candida Histoplasma Cryptococcus neoformans

7. Meningitis Aetiology: F)Others- Breast cancer Leukaemia Bronchial cancer Lymphoma SLE Sarcodosis(is a multisystem granulomatousinflammatory dis.)

8. Meningitis Clinical feature in bacterial meningitis: Headache Fever Vomiting Drowsiness Restlessness Irritability Neck rigidity, kernig’s sign and brudzinski’s sign may positive Convulsion Coma

9. Meningitis Clinical feature in tuberculous meningitis: Headache Vomiting Low grade fever Depression confusion Oculomotor palsies Palilloedema

10. Meningitis Clinical features of viral meningitis: Occurs mainly in children or young adults Headache Irritability Rapid development of mental irritation There may be high pyrexia

11. Meningitis Investigation- A)Bacterial meningitis CSF study Blood for C/S B)Tuberculous meningitis CSF study Culture of CSF CT scan C)Viral meningitis CSF study

12. CSF study

13. Meningitis Management of bacterial meningitis: 1.Appropriate antibiotics- Benzylpenicillin 2.4 g i/v 6 hrly Cefotaxime 2 g i/v 6 hrly Ceftriaxone 2 g i/v 12 hrly with Vancomycin 1 g i/v 12 hrly 2.Fluid and electrolytes balance 3.Diazepam for convulsion 4.Good nursing care 5.Prevention and treatment of complication

14. Meningitis Management of tuberculous meningitis: 1.Antituberculous chemotherapy 2.Pprednisolone 10 mg 6 hrly 3.Maintin adequate hydration and nutrition Skilled nursing care

15. Meningitis Management of viral meningitis: 1.There is no specific treatment and usually benign and self-limiting 2.Symptomatic treatment in a quiet enviroment 3.Recovery usually occurs with in days