Abstract
Discussion Forum (0)
Introduction: Bacterial meningitis is a rare, life-threatening disease with an incidence in the general population of 2.6-6 cases per 100,000 adults, and is even rarer in pregnancy [PMID 21612470, 21375656]. A study suggests that bacterial meningitis has an estimated mortality rate of >20% in adults [PMID 23164111].
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Introduction: Bacterial meningitis is a rare, life-threatening disease with an incidence in the general population of 2.6-6 cases per 100,000 adults, and is even rarer in pregnancy [PMID 21612470, 21375656]. A study suggests that bacterial meningitis has an estimated mortality rate of >20% in adults [PMID 23164111].
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Rethinking Meningitis in Pregnancy: Meningitis Presenting As Dysarthria and Otalgia at 28 Weeks Gestation
Alicia Palmieri
Affiliations:
Jersey Shore University Medical Center
Jersey Shore University Medical Center
Abstract
Discussion Forum (0)
Introduction: Bacterial meningitis is a rare, life-threatening disease with an incidence in the general population of 2.6-6 cases per 100,000 adults, and is even rarer in pregnancy [PMID 21612470, 21375656]. A study suggests that bacterial meningitis has an estimated mortality rate of >20% in adults [PMID 23164111].
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Introduction: Bacterial meningitis is a rare, life-threatening disease with an incidence in the general population of 2.6-6 cases per 100,000 adults, and is even rarer in pregnancy [PMID 21612470, 21375656]. A study suggests that bacterial meningitis has an estimated mortality rate of >20% in adults [PMID 23164111].
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
Methods: A 27-year-old G1 at 28 weeks gestation presented with complaints of headache, fever, and difficulty speaking. Patient was reporting symptoms of otitis infection. On admission, patient's mental status declined, requiring intubation and sedation. Patient was febrile and had a leukocytosis. Lumbar puncture and blood cultures grew Streptococcus pneumonia. On admission, patient was started on broad spectrum antibiotics, which were switched to meropenem based on sensitivities. Secondary to CT evidence of increased intracranial pressure, an intracranial pressure catheter was placed. Fetal status was reassuring throughout hospitalization. Patient was intubated for 9 days before self-extubating. Patient showed clinical improvement and was discharged home after 16 days of inpatient treatment. Patient went on to deliver a full-term liveborn male neonate via normal spontaneous vaginal delivery.
Results: n/a
Conclusion/Implications: An observational study, showed that bacterial meningitis in pregnancy does not typically present with the typical clinical triad of fever, neck stiffness, and headache, but rather with headache (87%), altered mental status (73%), fever (60%), and signs of otitis infection (60%) [PMID 22925078]. These symptoms tend to be vague and difficult to decipher, but prompt diagnosis and treatment is crucial in maternal survival. This case report supports the most commonly associated symptoms found in patients with bacterial meningitis in pregnancy.
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