[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?

 

[khanar]

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

 

[indian]

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.

 

[khanar]

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]

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]

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.

 

[indian]

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

 

[indian]

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]

Most common cause of meningitis

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.)..."

 

[dr.muhamad]

S.pneumoniae or N.meningitidis

hi every body
i got a question on UW and it says that S.pneumoniae is the most common cause of meningitis in adults but in the FA 2010 its say that it is N.meningitidis between age 6 - 60 years..
so anyone can explain,,,is there anything wrong

thx

 

[pass7]

i remember Dr. goljan saying b/w 1 month to 18 months, its N.meningitidis
>18years, its St. pnemoniae. and to complete the list, in infants Group B hemolytic streptococcus.

 

[NGaleas]

Act.

Streptococcus pneumoniae is the most common cause of meningitis in patients older than 20 years, accounting for almost 50% of the cases. N.Meningitidis is the second cause, with 25% of cases. This is due to the widespread vaccination against both H.Influenze(which had a great decline, before it was one of the most common causes) and N.Meningitidis (which had a smaller decline). N.Meningitidis accounts for up to 60% of cases in children and young adults between the ages of 2 to 20 years.This information was taken from Harrisons Internal Medicine, 17th edition. I guess First Aid has to fix that issue, the other issue I saw wasn't actualized was the most common cause of adult nephrotic syndrome, which I got to know by doing the kaplan qbank, so it is important to do the online version to get the newest information.
Since the exam is most likely to ask you a cause depending on case scenario, just look for the difference that will guide you, gram positive versus gram negative, and the characteristic petechial or pupuric skin lesions that is only seen with N. Meningitidis.

 

[drdivz]

according to harrison's text book of internal medicine and nelson'n text book of pediatrics - Neisseria is the mcc of meningitis in 6m - 6y old .

 

[earthpole]

yup..it is the same problem i faced:toosad:

 

[jahn77]

Neisseria vs Strepto ...->>FA vs UW....