Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- headache
- photophobia
- neck stiffness
- fever
- nausea and vomiting
Outros fatores diagnósticos
- rash
- Kernig's sign
- Brudzinski's sign
Fatores de risco
- infants and young children
- young adults
- older people
- summer and autumn
- exposure to mosquito or tick vector
- unvaccinated for mumps
- use of swimming pools and ponds
- immunosuppression
- exposure to rodents
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- blood cultures
- FBC and differential
- C-reactive protein (CRP)
- serum procalcitonin
- serum urea, creatinine, and electrolytes
- blood gases
- blood glucose
- CSF microscopy
- CSF Gram stain
- CSF bacterial culture
- CSF protein
- CSF glucose
- CSF lactate
- CSF, stool and throat swab PCR for viral pathogens
- HIV serology/HIV reverse transcriptase (RT)-PCR
Investigações a serem consideradas
- CT/MRI head scan
Novos exames
- CSF procalcitonin
Algoritmo de tratamento
suspected meningitis, unknown aetiology
confirmed viral meningitis
recurrent viral meningitis
Colaboradores
Consultores especialistas
John Williams, MRCP, DTM&H
Infectious Diseases Consultant
The James Cook University Hospital
Middlesbrough
UK
Declarações
JW declares that he has no competing interests.
Agradecimentos
Dr John Williams would like to gratefully acknowledge Dr David Chadwick, a previous contributor to this topic.
Declarações
DC is an author of a reference cited in this topic.
Revisores
Alex Alexiou, MBBS, BSc, DCH, FRCEM, Dip IMC RCSEd
Consultant in Emergency Medicine
Royal London Hospital
Consultant, Physician Response Unit
Barts Health NHS Trust/London Air Ambulance
London
UK
Declarações
AA declares that he has no competing interests.
Fiona McGill, MRCP, DTMH, DipHIVMed
Clinical Lecturer
Institute of Infection and Global Health
University of Liverpool
Liverpool
UK
Declarações
FM is on the Meningitis Research Foundation’s Medical Advisory Group, has lectured on national and international events on meningitis and has developed a review for ‘clinical medicine’ on viral meningitis and encephalitis.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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.Texto completo Resumo
McGill F, Griffiths MJ, Bonnett LJ, et al. Incidence, aetiology, and sequelae of viral meningitis in UK adults: a multicentre prospective observational cohort study. Lancet Infect Dis. 2018 Sep;18(9):992-1003.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Bacterial meningitis (adults)
- Bacterial meningitis (children)
- Encephalitis
Mais Diagnósticos diferenciaisDiretrizes
- A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology
- The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults
Mais DiretrizesFolhetos informativos para os pacientes
Lumbar puncture
Mais Folhetos informativos para os pacientes
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