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viernes, 6 de febrero de 2015

Meningitis: perlas clínicas y escollos

emDocs - February 4, 2015
Authors: Aaron Tiffee, M. D. and Marc Zosky, D.O. (LSUHSC Baton Rouge Emergency Medicine Residency Program, Our Lady of the Lake Regional Medical Center)
Editor: Alex Koyfman, MD & Justin Bright, MD
"Summary of Pitfalls to Avoid
  • Assuming that a patient does not have meningitis because they do not have all components of the classic triad: fever, altered mental status, and neck stiffness
  • Lowering your index of suspicion in afebrile elderly patients
  • Solely relying on the physical exam, and special tests including the Kernig, Brudzinski or Jolt test to rule in or out the diagnosis
  • Delaying lumbar puncture to obtain a CT by failing to follow the IDSA criteria for CT exam prior to LP
  • Delaying the administration of appropriate IV antibiotics, antivirals, or steroids.
  • Failure to prophylactically treat close contacts of patients with Neisseria meningitidis"