Meningitis definition

See Table 67-1 for empirical treatment recommendations. cSee text for specific recommendations for use of adjunctive dexamethasone in adults with bacterial meningitis. dSee Table 67-3 for pathogen-based definitive treatment recommendations. (Adapted, with permission, ref. 14.)... 

CDC Case Definition Arboviral infections may be asymptomatic or may result in illnesses of variable severity sometimes associated with central nervous system (CNS) involvement. When the CNS is affected, clinical syndromes ranging from febrile headache to aseptic meningitis to encephalitis may occur, and these are usually indistinguishable from similar syndromes caused by other viruses. Arboviral meningitis is characterized by fever, headache, stiff neck, and pleocytosis. Arboviral encephalitis is characterized by fever, headache, and altered mental status ranging... 

SSIs are classified as either incisional (such as cellulitis of the incision site) or involving an organ or space (such as with meningitis). Incisional SSIs may be superficial (skin or subcutaneous tissue) or deep (fascial and muscle layers). Both types, by definition, occur by postoperative day 30. This period extends to 1 year in the case of deep infection associated with prosthesis implantation. 

One definition of post-operative paralytic ileus is the failure of the patient to pass faeces or flatus within 60 hr. of the termination of a surgical abdominal operation . A somewhat similar condition may arise in cases of gross mechanical obstruction of the gut. It is well known also that operations involving handling of the gut or the peritoneum are especially liable to cause paralytic ileus. Peritonitis and post-operative pain, inadequately treated with morphia, also precipitate paralytic ileus. Pneumonia, meningitis and typhoid predispose to paralytic ileus, whilst severe hypothyroidism can also be complicated by a paralytic ileus. 

In the hospital or other health care setting, patient care requires standard precautions. Botulism patients do not require isolation, although before definitive diagnosis, those with flaccid paralysis suspected as having meningitis require droplet precautions (36). 

The skull and vertebrae protect the CNS from blunt or penetrating trauma (Fig. 105-1). The brain is suspended in these structures by cerebrospinal fluid (CSF) and is surroimded by the meninges. The meninges are made up of three separate membranes dura mater, arachnoid, and pia mater. Dura mater, or pachymeninges, lies directly beneath and is adherent to the skuU. The other two membranes are referred to collectively as leptomeninges. Pia mater lies directly over brain tissue. Arachnoid, the middle layer, lies between the dura mater and the pia mater. The subarachnoid space, located between the arachnoid and the pia mater, is the conduit for CSF. By definition, meningitis refers to inflammation of the subarachnoid space or spinal fluid, whereas encephalitis is an inflammation of the brain... 

The importance of supportive care, particularly early in the course of treatment, cannot be emphasized enough. Administration of fluids, electrolytes, antipyretics, analgesics, and other supportive measures is indicated for patients presenting with acute bacterial meningitis. Although supportive care is important initially, appropriate antibiotic therapy (empirical or definitive) should be started as soon as possible. 

This was a definitive ( between-the-eyes ) adverse reaction of type 4 [41 ]. In addition to a few other reports, the report of vrrologically confirmed parotitis and meningitis in a fully immunocompetent family member provides further strong evidence that horizontal transmission after mumps immunization with the Leningrad-Zagreb strain can occur. 

The ophthalmic artery arises originally from the supraorbital branch of the stapedial artery which later becomes the middle meningeal artery. In addition, the orbital artery will also anastomose with the primitive (and later definitive) ophthalmic artery, from the supracavernous internal carotid artery. Because of the different variants in the involution of the proximal segment of the orbital or ophthalmic arteries, the supply to the orbit will finally arise exclusively from the ICA, the stapedial system (EGA) or both. 

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