Primary viremia is followed by viral replication in blood and spread to CSF Patient is infectious from 3 days after infection to 10 days after symptoms develop Incubation period 3 ‐ 7 days
Data assessment: neurologic exam Milder than bacterial Resembles influenza Headache, fever, photophobia, malaise, and nausea Viral Meningitis: Patient problems 1. Infection of meninges 2. Elevated body temperature r/t CNS inflammation 3. Acute pain r/t CNS inflammation 4. Hydrocephalus r/t meningitis 5. GI complications r/t Meningitis 6. Impaired mobility r/t CNS infection 7. Psychosocial anxiety r/t CNS infection Viral Meningitis: Infection of meninges Characteristics Headache, Neck pain, Back pain Medical interventions Empiric ABX therapy initiated until bacterial cultures negative Acyclovir (Zorivax) used to treat herpes virus types 1+3 and varicella-zoster virus Supportive therapy Nursing team interventions same as bacterial meningitis Expected outcomes Patient recovers without neurological sequealae Potential complications Encephalitis Hydrocephalus Cerebral edema with increased ICP Fungal Meningitis Very difficult to treat All major fungal agents can produce meningitis Cryptococcus neoformans most common High-risk groups include immunocompromised especially HIV Medical: C neoformans meningitis is treated with amphotericin B and flucytosine Pathophysiology same as bacterial meningitis Clinical Manifestations Often nonspecific but include; Headache, fever, photophobia, malaise, nausea (flu-like) Different symptoms in patients with/without HIV infection Diagnostics CSF studies Serology (Antigen tests) India ink exam Latex agglutination test ELISA to isolate fungi in CSF CT or MRI Identify focal lesions, especially in C Neoformans Fungal Meningitis: Patient problems 1. Infection of meninges 2. Elevated body temperature r/t CNS inflammation 3. Acute pain r/t CNS inflammation 4. Hydrocephalus r/t meningitis 5. GI complications r/t Meningitis 6. Impaired mobility r/t CNS infection 7. Psychosocial anxiety r/t CNS infection
Fungal Meningitis: Infection of Meninges Characteristics Pain: headache, neck, and back Fever, malaise, nausea Lethargy, personality changes Cranial nerve palsies, papilledema Meningismus: headache, nuchal rigidity, photophobia, Kernig’s and Brudzinski’s signs Medical interventions Antifungal therapy C neoformans treated with amphotericin B and flucytosine Supportive therapy Nursing interventions same as bacterial meningitis Expected outcomes Infectious source is identified and infection successfully treated Returns to prior baseline status Patient does not experience any permanent neurological deficits Patient remains seizure ‐ free Patient complications Encephalitis Hydrocephalus Cerebral edema with increased ICP Encephalitis Inflammation of the brain parenchyma caused by virus, bacterium, fungus, or parasite Etiology Virus is most common cause Respiratory system: mumps, measles, varicella virus Oral: enteroviruses/polio Oral or genital: herpes simplex Bites Animal: rabies
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- Spring '10
- Intracranial pressure, Traumatic brain injury , Shadowhealth Neurological