Most common cause of meningitis?

[lemontea88]

What exactly is the most common cause of meningitis in children 6months to 6 years old?

According to Goljan's Rapid Review : N.Meningitidis is most common cause of meningitis from 1 month to 18 years of age.
USMLE Rx : Strep Pneumo is most common cause for 6 months to 6 years old.

So if a 3 year old boy has meningitis, what is the most likely cause?

[Firas]

I faced exactly the same problem and I did not find a consistent answer
I think it's step pneumoniae is more common
N. meningitidis is more common in closed communities such as college dorms and prisons.
If you find the answer please let me know

[Easy]

I think it's Listeria

[harith]

This is clearly mentioned in First Aid and Kaplan:

Newborns:
1- GBS
2- E.coli
3- listeria
Children less than 6 years:
1- strep pneumoniae
2- neisseria
3- h influenzae
4- enteroviruses
6 years to 60 years:
1- neisseria meningitidis
2- enteroviruses
3- strep pneumoniae
4- HSV
Over 60 years:
1- strep pneumoniae
2- listeria

The story is different in HIV and immunocompramized patients where you have to think of listeria, fungi, JC virus, and toxoplasmosis.

[13monument]

Our microbiology teacher told us that there's no clear epidemiology nowadays regarding this because we started to see the effects of universal pneumococcal vaccination and therefore step pneumoniae is no longer on top of the list and n. meningitidis is becoming more and more but then again because of universal vaccination of college students even n.meningitis is becoming less and therefore perhaps right now the most common cause is viruses in young adults

[lemontea88]

Originally Posted by harith

This is clearly mentioned in First Aid and Kaplan:

Newborns:
1- GBS
2- E.coli
3- listeria
Children less than 6 years:
1- strep pneumoniae
2- neisseria
3- h influenzae
4- enteroviruses
6 years to 60 years:
1- neisseria meningitidis
2- enteroviruses
3- strep pneumoniae
4- HSV
Over 60 years:
1- strep pneumoniae
2- listeria

The story is different in HIV and immunocompramized patients where you have to think of listeria, fungi, JC virus, and toxoplasmosis.

So does this mean the First Aid listed them according to how common they are? Hmm, if so, this info tallies with USMLE Rx.

But then again, this information would contradict Goljan's Rapid Review.

[lemontea88]

Originally Posted by 13monument

Our microbiology teacher told us that there's no clear epidemiology nowadays regarding this because we started to see the effects of universal pneumococcal vaccination and therefore step pneumoniae is no longer on top of the list and n. meningitidis is becoming more and more but then again because of universal vaccination of college students even n.meningitis is becoming less and therefore perhaps right now the most common cause is viruses in young adults

Thats true.But I sure damn hope that the boards won't test any of us about this.

[harith]

Originally Posted by lemontea88

So does this mean the First Aid listed them according to how common they are? Hmm, if so, this info tallies with USMLE Rx.

But then again, this information would contradict Goljan's Rapid Review.

Of course FA and USMLERx gives the same info, same authors

[harith]

Originally Posted by lemontea88

Thats true.But I sure damn hope that the boards won't test any of us about this.

Yeah, you are right let's hope that they don't test us about it

[DrSeddik]

It's established that there's a debate about this. Ofcourse I had the same problem. Last thing I read is in UW, they said that N.meningitis is the 2nd most common cause of bacterial meningitis before the age of 60 after strept. pneumonia, and they put in their reference, this is the only question they put their reference in . While FA says N.meningitis the most common cause...

[Laurentiu]

For the purpose of USMLE Step1 , I totally agree with Harith.

I read also Goljan who clearely stated that for patients > 18 "...(some authors put N meningitidis in the first place and Strept. pneumonie on the 2-nd place.)..."