Clinical Case Database / Category: Patient Management
Bacterial menengitis
Publication details
Dr Nancy TH Colchester, Dr Ashwin A Pinto
Foundation Years Journal, volume 8, issue 3, p.14 (123Doc Education, London, March 2014)
Abstract
We describe a case of an elderly lady found poorly responsive at home, in whom the final diagnosis was pneumococcal meningitis. She later developed a cerebral abscess: an uncommon complication but one that all doctors should be aware of given its implications for treatment. We discuss learning points key to assessment of such patients by junior doctors: (1) neurological assessment of a confused or drowsy patient with emphasis on localising the cause of their poor conscious level; (2) initial differential diagnosis in terms of aetiology, including whether their poor conscious level is due to a primary neurological condition or secondary to a systemic illness; (3) understanding the CSF results; (4) specific points regarding risk factors and complications of pneumococcal meningitis, the commonest cause of bacterial meningitis in adults.
Access the Clinical Cases Database
A subscription is required to read the full article. Please subscribe using one of the options below.
| Product | Price | Subscription | |
|---|---|---|---|
| Foundation Years Clinical Cases Database | £29.00 | 6 months | |
| Foundation Years Clinical Cases Database | £39.00 | 12 months |
Authors
Dr Nancy TH Colchester
Specialist Registrar in Neurology
Wessex Neurological Centre
University Hospital Southampton
Tremona Road
Southampton, SO16 6YD
ncolchester@yahoo.com
Dr Ashwin A Pinto
Consultant Neurologist
Wessex Neurological Centre
University Hospital Southampton
Tremona Road
Southampton, SO16 6YD
ashwin.pinto@uhs.nhs.uk
References
1. Weisfelt M, van de Beek D, Spanjaard L, et al. Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series. Lancet Neurol 2006, 5:123-9.
2. Ropper AH, Brown RH. Adams and Victor’s Principles of Neurology, 8th edn. New York: McGraw-Hill 2005.
3. Falcone S, Post M. Encephalitis, cerebritis, and brain abscess: pathophysiology and imaging findings. Neuroimaging Clin N Am 2000,
10:333–53.
4. De Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Eng J Med 2002, 347:1549-56.
5. Van de Beek D, Farrar JJ, de Gans J, et al. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol 2010, 9(3):254-63.
6. British Infection Society. Early management of suspected bacterial meningitis and meningococcal septicaemia in immunocompetant adults. Journal of Infection 2003; 46:75-7. www.britishinfection.org
Disclaimers
Conflict Of Interest
The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).
Financial Statement
The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.
Patient Consent statement
All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
Animal & Human Rights
When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.