1. CSF CIRCULATION Joerelle V. Mojica Junior Intern, UERM

4. PEDIATRIC MENINGITIS Joerelle V. Mojica Junior Intern, UERM

5. BACTERIAL MENINGITIS Neonatal: grp B Streptococci. E.coli, Proteus, Klebsiella 3mos-18yo: Strep pneumoniae, Neisseria meningitidis, H. influenza CSF Analysis, C/S Fluid restriction, elevate head, hyperventilation, mannitol E. coli: cefotaxime Group B strep: ampicillin + gentamycin Staph pneumonia: Penicillin G

6. TB Meningitis Primary complex spreads hematogenously Stage 1: nonspecific, ~1 week Stage 2: changes in sensorium & cognition Stage 3: coma Gold standard: CSF C/S CT scan: basal meningeal enhancement, hydrocephalus, arteritis, infarct Chest AP Xray, PPD, Contact tracing Mannitol, Quadruple therapy, steroids VP Shunting

7. FUNGAL MENINGITIS Most common: Cryptoccocus Neoformans SSx similar to TB Meningitis (+) on India ink and Saboraud’s medium Amphoterecin B

8. VIRAL MENINGITIS Viremia, along nerve Japanese B encephalitis, dengue encephalitis, herpes encephalitis Supportive Acyclovir