peds men

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Author:
Anonymous
ID:
9069
Filename:
peds men
Updated:
2010-03-04 01:27:48
Tags:
peds
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Description:
meningitis
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  1. Causative in neonates?
    • GBS
    • E Coli
  2. Causative in child less than 5
    • S. pneumoniae
    • N meningitidis
    • Hib
  3. greater than 5 yo
    • S. pneumoniae
    • N. meningitidis
  4. Viral-?
    and treatment
    • neonatal- HSV
    • Child- enterovirus, adenovirus

    acyclovir 60mg/kg/d
  5. Bacterial?
    • WBC- 400-100K
    • PMNs >90
    • glucose < .5 serum
    • protein 80-500mg/dl
    • smear +!
  6. prophylaxis of mothers dosage is GBS +
    PCN or AMP (2g iv x1 +1g iv q4h during labor)

    screen at 32-35 wks
  7. vaccination for meningitis
    • streptococcus pneumoniae- (leading cause in childhood)
    • vaccine is Prevnar (PCV7)- covers 7 serotypes
  8. Empiric treatment in neonates
    • Amp + (gentamicin of cefotaxime)
    • if GBS, L monocytogenes keep amp and 72 hours gent duration 10-21d

    if comes back gram - (E coli, Klebsiella, enterobacter) give cefotaxime
  9. Treatment in 1 month to 5 years
    empiric: ceftriaxone and vancomycin

    • if
    • S. pneumoniae cont for 10-14d
    • N. meningitidis penicillin or amp of ceftriaxone x 7d
    • Hib- ceftriaxone 10-14d
  10. treatment in children greater than 5
    empiric treatment- ceftriaxone + vancomycin

    same as 1-5 same agents

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