Summary
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- cefaleia
- náuseas e vômitos
- fotofobia
- rigidez de nuca
- febre
Другие диагностические факторы
- erupção cutânea
- sinal de Kernig
- sinal de Brudzinski
Факторы риска
- lactentes e crianças pequenas
- adultos jovens
- idosos
- verão e outono
- exposição a vetores mosquito ou carrapato
- não vacinado contra caxumba
- uso de piscinas e lagoas
- imunossupressão
- exposição a roedores
Диагностические исследования
Исследования, которые показаны в первую очередь
- microscopia do LCR
- coloração de Gram do líquido cefalorraquidiano (LCR)
- cultura bacteriana do LCR
- nível de proteína no LCR
- glicose no LCR
- Reação em cadeia da polimerase para enterovírus no LCR
- Reação em cadeia da polimerase do LCR para herpesvírus
- sorologia para vírus da imunodeficiência humana (HIV)/transcriptase reversa do HIV (RT)-PCR
Исследования, проведение которых нужно рассмотреть
- tomografia computadorizada (TC)/ressonância nuclear magnética (RNM) do crânio
- eletroencefalograma (EEG)
- cultura viral do LCR
Неотложные исследования
- proteína C-reativa do LCR
- procalcitonina sérica e do LCR
- lactato no LCR
Алгоритм лечения
possível meningite bacteriana
agente viral confirmado diferente do vírus do herpes simples (HSV), varicela-zóster ou citomegalovírus (CMV)
vírus do herpes simples (HSV) ou varicela-zóster confirmados como agentes causadores
citomegalovírus (CMV) confirmado como agente causador
meningite viral recorrente
Составители
Авторы
John Williams, MRCP, DTM&H
Consultant
The James Cook University Hospital
Middlesbrough
UK
Раскрытие информации
JW declares that he has no competing interests.
Выражение благодарностей
Dr John Williams would like to gratefully acknowledge Dr David Chadwick, a previous contributor to this topic. DC is an author of a reference cited in this topic.
Рецензенты
Karen Roos, MD
John and Nancy Nelson Professor of Neurology
Indiana University School of Medicine
Indianapolis
IN
Раскрытие информации
KR declares that she has no competing interests.
Vassiliki Syriopoulou, MD
Professor of Pediatrics
University of Athens
Aghia Sophia Children's Hospital
Athens
Greece
Раскрытие информации
VS declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
McGill F, Heyderman RS, Michael BD, et al. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. J Infect. 2016 Apr;72(4):405-38.Полный текст Аннотация
Centers for Disease Control and Prevention. Viral meningitis. May 2021 [internet publication].Полный текст
Miller JM, Binnicker MJ, Campbell S, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5:ciae104.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Bacteriana, meningite
- Encefalite
- Encefalopatia (tóxica/metabólica)
Больше ОтличияРекомендации
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
- The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults
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