Acute Bacterial Meningitis: Predisposing Factor Age

00:01 Here's another table for you.

00:02 What do you know about these tables? Money.

00:04 What does that mean? It means you need to make sure you take these tables and get a good understanding, reminding information that in this table if you truly understand your pathology.

00:14 These tables speak volumes to you, it can use in pathology, pharmacology, microbiology, so on and so forth.

00:21 So here the topic is still acute bacterial meningitis. Okay? Strictly, bacterial.

00:28 Tell me about glucose in your cerebrospinal fluid, high or low? Low.

00:33 Protein content, high or low in the CSF? High. Your WBC's? Well, granted WBC would be elevated in any type of meningitis.

00:44 But here specifically, what kind of WBC's would you expect to see in bacterial? Good, neutrophils.

00:51 Okay. Now, based on that what are the arameters that we're looking at here? We have the predisposing factors in terms of age, then depending on the age, we'll talk about the most common bacterial pathogen and then quickly, we'll take a look at management, commonly for antimicrobial therapy.

01:08 Less than one month, what are the organisms? You come positive streptococcus agalactiae, agalactiae. Memorize that.

01:16 E. coli, gram negative organism. Listeria, at least know those three organisms causing acute bacterial meningitis in a child less than one month.

01:26 Antimicrobial therapy, this keeps changing but for the most part, you have ampicillin being a common denominator plus cefotaxime or may be perhaps aminoglycoside.

01:38 Now, what an interesting point that the boards love to asked in clinically that you need to make sure that if you're getting questioned by your attending and you wanna make sure that your well versed with a, let's say drug interactions.

01:51 1 to 23 months and now we're getting close to two years; what kind of organisms are we looking at here? Still streptococcus may be perhaps but this time it's pneumoniae; neisseria it's ringing its ugly head here and you still have agalactiae and we have a new comer and that would be our haemophilus influenza.

02:10 Keep that in mind but I wanna make sure that you're clear.

02:15 Here, if you're thinking about this age group may be perhaps a vancomycin.

02:21 And we have a little bit later. A little bit later, meaning what? The two extreme ages of life; very young and very old.

02:32 For this row; very young, very old. We have streptococcus pneumoniae and neisseria species; once again a vancomycin.

02:41 Then greater than 50, you should be thinking about streptococcus pneumoniae and maybe perhaps your listeria monocytogenes.

02:49 Alright, so now, we're getting to old once again a vancomycin plus ampicillin and then you have plus your third-generation.

02:55 So, here's a general overview as to what you can expect in terms of common pathogens, to all of these oral bacteria, okay.