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Old 08-08-2012
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Default Meningitis

In MTB 3 page 213...it says best step in meningitis ..(vignette at top of page)...is Lumbar puncture...is this information correct?

What happened to antibiotics first?...

Pls give ur inputs...
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Old 08-08-2012
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yes , mtb 2 page 10 also says the same ....

it also says antibiotics are the best initial step only if LP is CI as in papillo edema or seizures .....

so its antibiotics first only in complicated cases .....
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Old 08-08-2012
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so basically...
meningitis no focal neurological signs.....do LP...then antibiotics

Meningitis with focal signs/papilloedema or CI to LP...give antibiotics ..then do a CT scan...
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Old 08-08-2012
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LP is first because you hage to know if its viral, bacterial or fungi
You also need to look at wbc to see if you have PMN (point to bacterial) or MN (viral, fungal)

Antibiotics will be given close after until you wait for culture results and then change accordingly.

If signs of high ICP but you are unsure then CT scan to rule out high ICP and dont risk to perform a LP and kill the patient
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