Mandatory medical device diagnostics. Computed tomography of the skull (cranial CT, cranial CT or cCT); native (ie. without contrast medium), with bone window – for focus search (focal diagnosis); obligatory on admission day Note: In case of neurological deficit, decrease in vigilance or epileptic seizure, cranial computed tomography (cCT) is performed within 30 min after … Bacterial Meningitis: Diagnostic Tests
Vaccinations against Haemophilus-influenzae-b (Hib), meningococci (serogroups A, B, C), and pneumococci are important and effective preventive measures.Furthermore, to prevent bacterial meningitis (bacterial meningitis), attention must be paid to reducing risk factors. Behavioral risk factors Listeria meningitis – consumption of contaminated food such as milk or raw meat. Post-exposure prophylaxis (PEP) Post-exposure prophylaxis (here because of … Bacterial Meningitis: Prevention
The following symptoms and complaints may indicate bacterial meningitis (bacterial meningitis): Leading symptoms Severe headache (> 5 on the visual analog scale (VAS); approximately 90% of cases). Septic fever (> 38.5 °C; 50-90% of cases) Meningismus (painful neck stiffness) (about 80% of cases; need not occur in children, unlike adults) [late symptom]. Impaired consciousness ranging … Bacterial Meningitis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Bacterial meningitis is usually transmitted by droplet infection. Approximately 2.5 cases of the disease occur per 100,000 population annually. Most are infections caused by the bacteria Streptococcus pneumoniae (so-called pneumococci), Neisseria meningitidis (so-called meningococci; a good two-thirds of all cases by serogroup B, about a quarter of all cases by serogroup … Bacterial Meningitis: Causes
General measures Patients with meningococcal meningitis must be isolated until 25 hours after initiation of therapy. Observance of general hygiene measures! Review of permanent medication due topossible effect on the existing disease. Intensive care monitoring Individuals with bacterial meningitis must be monitored in an intensive care unit to control and, if necessary, immediately regulate all … Bacterial Meningitis: Therapy
Disorders of consciousness (synonyms: Drowsiness; Unconsciousness; Clouding of consciousness; Coma; Coma cardiale; Coma cerebrale; Coma hypercapnicum; Coma prolonge; Irritable syndrome of the mesodiencephalon; Coma; Coma-like disorder; Comatose state; Precoma; Drowsiness; Somnolence; Sopor; Stupor; Cerebral coma; ICD-10 R40.-: Somnolence, Sopor and Coma) refer to changes in ordinary everyday or normal consciousness. One can distinguish quantitative from … Disorders of Consciousness: Somnolence, Sopor and Coma
Medical history (history of illness) represents an important component in the diagnosis of disorders of consciousness* . Family History Are there any disorders in your family that are common? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints) [third-party history, … Disorders of Consciousness: Somnolence, Sopor and Coma: Medical History
Conditions that may cause disorders of consciousness: Respiratory System (J00-J99) Coma hypercapnium – coma caused by a marked increase in the level of carbon dioxide in the blood. Endocrine, nutritional and metabolic diseases (E00-E90). Addison’s crisis – decompensated Addison’s disease; this describes primary adrenocortical insufficiency resulting in, among other things, failure of cortisol production. Coma … Disorders of Consciousness: Somnolence, Sopor and Coma: Or something else? Differential Diagnosis
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin). Fasting glucose (fasting blood glucose). Coagulation parameters – PTT, Quick Blood cultures (two) – collection of blood into special collection systems (blood culture bottles), in which the bacteria that may … Bacterial Meningitis: Test and Diagnosis
Therapeutic targets Elimination of the pathogens Avoidance of complications Therapy recommendations In case of suspicion, immediate hospitalization (emergency) → Collection of two blood cultures. Bacterial meningitis: antibiosis (antibiotic therapy) after pathogen determination and resistogram (test for sensitivity to antibiotics)Before final diagnosis, immediate calculated or empirical antibiotic therapy + dexamethasone 10 mg i.v. must be started! … Bacterial Meningitis: Drug Therapy
Medical history (history of illness) represents an important component in the diagnosis of delirium. Family history What is the general health of your family members? Are there any diseases in your family that are common? Isolation, change of location, losses or grief? Social history What is your profession? Current medical history/systemic history (somatic and psychological … Delirium: Medical History
Respiratory System (J00-J99) Pulmonary insufficiency with hypoxemia (decreased blood oxygen content) and hypercapnia (increased blood carbon dioxide content). Pneumonia (inflammation of the lungs) Blood, blood-forming organs – immune system (D50-D90). Anemia (anemia) Autoimmune diseases such as vasculitis (inflammation of blood vessels) of the central nervous system (CNS) and cerebral lupus. Endocrine, nutritional and metabolic diseases … Delirium: Or something else? Differential Diagnosis
