pox shing rubeo rubel
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Definition
Acute infectious disease of sudden onset with slight fever,
mild constitutional sx & eruptions which are maculo-papular
for a few hours, vesicular for 3-4 days & leaves granular
scabs.
mild, self-limiting viral illness with occasional complications
common & highly contagious
affects nearly all susceptible children before adolescence
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Chicken Pox
One of the most readily communicable
diseases, especially in the early stages of
eruption
Ranks 7th - Top Ten Morbidity Causes By
Sex / 100,000 population(2004 Phil Health Statistics Last Updated February 2008)
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Chicken Pox
Other name: Varicella
C. Agent: Human(alpha) herpesvirus 3
varicella-zoster virusMOT:
Direct contact or droplet spread
Indirect through articles freshly soiled bydischarges of infected person
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Contagious 5 days before & 5 days after
blister appearance
Incubation Period: 2-3weeks, commonly
13-17 days
daiy07
Chicken Pox
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Susceptibility, Resistance &
Occurrence
Universal among those not previously
attacked. Severe in adults. An attack confers
long immunity. Second attacks are rare. Probably 70% have
the disease by the time they are 15y/o.
Not common in early infancy
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Chicken Pox
S/S:
Reddish, itchy skin rash (abdomen, back, face
then everywhere else on the body)
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Chicken Pox
S/S:
Weakness
Muscle & joint pains Sudden onset of fever
http://www.lib.uiowa.edu/haRDIN/MD/dermnet/chickenpox.html -
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Note:
Chickenpox rashes will disappear in 1-2weeks time even without treatment
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Chicken Pox
Immediate Treatment:
cut nails short (children)
do not scratch (older children)
For babies : light mittens or
socks on the hands
http://www.google.com.ph/imgres?imgurl=http://author.whebsite.com/media/images/baby-gloves-and-mittens-16.jpg&imgrefurl=http://pregnancy.whebsite.com/baby-gloves-and-mittens.html&usg=__45_7UL553-cxAoKoEotU2MD1kNI=&h=225&w=300&sz=18&hl=tl&start=2&zoom=1&itbs=1&tbnid=6kpW0ga7GEGjYM:&tbnh=87&tbnw=116&prev=/search%3Fq%3Dmittens%2Bfor%2Bbabies%26hl%3Dtl%26biw%3D1280%26bih%3D734%26gbv%3D2%26tbm%3Disch&ei=6rNATtWYG8SAmQXRscWoCQ -
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Chicken Pox
Immediate Treatment:
Antipyretics / acetaminophens
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Chicken Pox
Nursing Care Treatment:
Reducing discomfort & fever
Applying wet compresses
Bathing with cool orlukewarm water once a day Adding 4-8 ounces ofbaking soda or one or two
cups ofoatmeal to the bath
Only mild soap should be used in the bath. Patting, not rubbing
Calamine lotion also reduces itchiness
http://www.answers.com/topic/lukewarmhttp://www.answers.com/topic/ouncehttp://www.answers.com/topic/baking-sodahttp://www.answers.com/topic/oatmealhttp://www.answers.com/topic/rubbinghttp://www.answers.com/topic/rubbinghttp://www.answers.com/topic/oatmealhttp://www.answers.com/topic/baking-sodahttp://www.answers.com/topic/ouncehttp://www.answers.com/topic/lukewarm -
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Prevention & Control:
Avoid crowded areas during epidemics
Isolate known cases
Concurrent disinfection of throat & nosedischarges
Vaccine is available as precautionary
measure & as per doctors advice.
Report to local authority
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Chicken Pox
Note:
Varicella Vaccine Combination : MMRV
Those who had the disease before mayhave lifelong protection
Children younger than 13 yrs -1st dose starts
at 12-15 mos, 2nd
dose at age 4-6 years For 13 years & older who has never had
chicken pox - 2 doses, given 4-8weeks
apart!
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http://www.healthline.com/blogs/outdoor_health/uploaded_images/139_3925-778811.JPGhttp://z.about.com/d/dermatology/1/0/J/5/HerpLip.jpghttp://z.about.com/d/dermatology/1/0/7/5/Herp_init.jpg -
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Shingles
An extremely painful viral infection of the nerve
roots resulting in a skin rash caused by the same
virus that causes chickenpox.
C. agent: reactivated virus Varicella zoster virus(VZV)
Dormant VZV can cause shingles!
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Shingles
At risk:
http://www.google.com.ph/imgres?imgurl=http://snappyworld.com/wp-content/uploads/2010/07/chemo1.jpg&imgrefurl=http://snappyworld.com/tag/cancer-suppress-treatment-chemotherapy&usg=__e1WINT7FDp0PKVQf_LlRVLTwPkk=&h=279&w=423&sz=115&hl=tl&start=4&zoom=1&itbs=1&tbnid=vGn3pYDW_8s10M:&tbnh=83&tbnw=126&prev=/search%3Fq%3Dchemotherapy%2Bpatient%26hl%3Dtl%26sa%3DG%26biw%3D1280%26bih%3D773%26gbv%3D2%26tbm%3Disch&ei=77ZATtaIMsH1mAX4kvDZCQhttp://images.google.com.ph/imgres?imgurl=http://blogs.fayobserver.com/faytoz/files/2009/05/old-people-crossing.gif&imgrefurl=http://blogs.fayobserver.com/faytoz/category/hot-topics/&usg=__Ee8m1mHYziLyB43Gu4XuKvWdsJ0=&h=400&w=453&sz=9&hl=en&start=50&um=1&tbnid=mz3iuZYCcuCcZM:&tbnh=112&tbnw=127&prev=/images?q=old+people+photos&ndsp=20&hl=en&rlz=1R2HPAA_enPH331&sa=N&start=40&um=1 -
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Shingles
S/S:
Pain, itching, tingling, or burning of the skin
Small blisters on a red base w/ new blister
continuing to form for 3-5days
Painful rash resembles the lesions of chickenpox
usually localized to a concentrated area
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Shingles
Complications:
Infection
Postherpetic neuralgia
Loss of vision
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Treatment: Bathing permitted
Cool compress Anti-itching lotions
Steroids, antiviral
meds,pain relievers
Vaccine:
Zostavax cointains
booster dose of
chicken pox
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CHICKEN POX HERPES ZOSTER
SYNONYM VARICELLA SHINGLES
CAUSATIVE AGENT VARICELLA ZOSTER
VIRUS
DORMANT VZV OR HZV
MOT DROPLET. DIRECT
CONTACT
DROPLET
AGE OF
SUSCEPTIBILITY
CHILDHOOD YEARS 35 YEARS OLD AND
ABOVE
PERIOD OF
COMMUNICABILIT
Y
UNTIL THE LAST
CRUST
UNTIL THE LAST CRUST
ENANTHEM NONE NONE
EXANTHEM VESICO-PUSTULAR
RASH
VESICO-PUSTULAR
RASH
DIRECTION OF
SPREAD OF RASHES
CENTRIFUGAL FOLLOWS PERIPHERAL
NERVE PATHWAY
ICHY, GEN.
DISTRIBUTION
PAINFUL, LIMITED
DISTRIBUTION,UNILATERAL
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Measles
An acute highlycommunicable infection
caused by a virus
A type of maculopapular rash
disease
Other Names:Rubeola
Morbilli
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Mostly affects children
Ranks 1
st
Mortality amongimmunizable disease ages under
1-14 years
Ranks 4th
Top 10 Causes ofMortality ages 1-4 years
Philippine cases 2008: 341
Measles
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Measles
Causative Agent:Rubeola virus or
Paramyxo virus
Mode of Transmission:
Direct and indirect
contact withnasopharyngeal
secretions /droplet
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MeaslesIncubation Period:10 days from exposure to appearance of
fever and about 14 days until rashappears
Susceptibility, Resistance & Occurrence
All persons are
susceptible.
Babies born of motherswho had the disease before
the baby is born are
immune for the first
months of life.
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Stages of Manifestation:1. Pre-eruptive Stage*symptoms appear before rashes appear
Fever 3-4 days Dry cough/colds Sore throat Headache
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Measles Lymphadenitis
Stomatitis
Kopliks spot
- pathognomonic sign
of measles
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Measles
Stimsons sign Sore-eyes like
Excessive muco-purulent lacrymal discharge
Conjunctivitis
With photophobia
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Measles2. Eruptive Stage maculopapular rashes reddish in color blotchy appearance rashes follow the hairline and cephalocaudal
distribution
appears on the 3rd day of illness upon appearance within 2-3 days the entire
body is fully covered
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Measles3. Post-eruptive Stage
fine desquamation
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Complications:
Deafness
Ear infection Pneumonia
Encephalitis
Diarrhea and dehydration Blindness
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Treatment:
Symptomatic and Supportive care
Antibiotics for bacterial complications
Vitamin A supplements
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Measles
Nursing Care: STRICT ISOLATION
Keep in a well ventilated room
Highly contagious
COOLING MEASURES
Provide sponge bath for comfort
Give PARACETAMOL medication asprescribed by physician
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MeaslesNursing Care:
EYE CARE Protect eyes from glare of strong light
VITAMIN A supplementation
Clean the eyes using cotton balls withwater (PNSS) from inner to outer
canthus
EAR CARE
Because of catarrhal symptoms to
prevent otitis media
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MeaslesNursing Care:
ORAL CARE
Because of stomatitis
May use oral antifungal as prescribed
SKIN CARE
Use of calamine lotion
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MeaslesPrevention & Control: Avoid exposure to any infected person
Isolation from diagnosis until 5-7days after the
onset of rash
Disinfection of all soiled articles Immunization: gamma Globulin or MMRV
http://www.doh.gov.ph/ -
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Mass Measles Immunization Campaign
children 9 - 48 months
http://www.doh.gov.ph/http://www.doh.gov.ph/ -
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WHO & UNICEF are collaborating to reduceglobal measles death by 90% by 2010.
Strategies:
Strong routine immunization: children by their 1st birthday
A second opportunity for measles immunization throughmass vaccination campaigns.
Effective surveillance in all countries to quickly recognize
& respond to measles outbreak.
Better treatment of measles cases: Vit A supplements,
antibiotics and supportive care.
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also known as RUBELLARubella is derived from the Latin word
meaning little red
Causes a relatively minor rash diseasewith few complications
With post auricular, post-cervical,sub-occipital lymph nodes
enlargementWill have teratogenic effect on the
fetus if acquired by a pregnant mother
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Other Names: Rubella
3-Day Disease
Little Red Disease
Generally a mild, benign
infectious disease in children
Philippines 2007 Cases - 172
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Causative Agent:
Toga virus/Pseudoparamyxo virus
Mode of Transmission:Droplets from discharge:nose & throat
Pregnant womans bloodstream
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Incubation period:
1423 days, with an average incubation
period of 1618 days
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Stages of Manifestation:
1. Pre-eruptive Stage
mild cough and colds
Forscheimers spot
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2. Eruptive Stage
rashes disappear on the 4th day of
illness
enlargement of lymph nodes(post auricular, post cervical, sub-
occipital)
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3. Post-Eruptive Stage- desquamation
Treatment: Acetaminophen or ibuprofen for fever
Monitor and provision of comfort
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Prevention and Control:
Vaccine usually given at 12-15months
Pre-natal Testing: Rubella screen
*Congenital Rubella Syndrome (CRS)-important cause of severe birth
defects!
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MEASLES GERMAN MEASLES
SYNONYM RUBEOLA RUBELLA
CAUSATIVE AGENT PARAMYXOVIRUS TOGA VIRUS
MOT AIRBORNE DROPLET,
PLACENTAL
AGE OF
SUSCEPTIBILITY
CHILDHOOD YEARS 35 YEARS OLD AND
ABOVE
PERIOD OF
COMMUNICABILITY
4 DAYS BEFORE/ 5
DAYS AFTER RASHESAPPEAR
ENTIRE COURSE
ENANTHEM KOPLIKS SPOTS FORSCHEIMERS
SPOTS
EXANTHEM MACULO-PAPULAR
RASH
MACULO-PAPULAR
RASH
DIRECTION OF
SPREAD OF RASHES
CEPHALOCAUDAL CEPHALOCAUDAL
ICHY, REDDISH, HOT
DRY SKIN
MAY OR MAY NOT
PINKISH, COLD,
MOIST
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POLIOMYELITIS
A highly infectious disease caused by avirus.
An acute enteroviral infection of thespinal cord that can causeneuromuscular paralysis.
It invades the nervous system, and can
cause total paralysis in a matter of hours.
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Other Names:
Polio
Infantile Paralysis
Heine-Medins Disease
POLIOMYELITIS
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WHO 2008 world polio-endemic
countries: Afghanistan, India, Nigeria
and Pakistan
Ranks 6th Phil Mortality causes of
immunizable disease
POLIOMYELITIS
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Causative Agent:
Legio debilitans/poliovirus
3 Strains/Types of Legio debilitans: Type 1- Brunhildepermanent
immunity
Type 2- Lansing
Type 3- Leon
POLIOMYELITIS
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Mode of Transmission:
Early stage
- droplet infection/direct contact Late stage
- fecal-oral
- direct contact with infected feces
POLIOMYELITIS
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The Stage of Infection and Pathogenesis ofPoliomyelitis
First, the virus is ingested and carried to the throatand intestinal mucosa.
The virus then multiplies in the tonsils. Smallnumber escapes to the regional lymph nodes andblood.
The viruses are further amplified and cross intocertain nerve cells of the spinal column and CNS.
Last, the intestine actively sheds viruses.
POLIOMYELITIS
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Signs and symptoms:
Patterns:
1. Inapparent (subclinical) infections2. Abortive poliomyelitis
3. Major poliomyelitis
a. Nonparalytic
b. Paralytic
-Bulbar, spinal, bulbo-spinal
POLIOMYELITIS
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Signs and symptoms:
Abortive poliomyelitis (minor illness) FLU-
LIKE SYMPTOMS
fever accompanied by chills
Malaise
Sore throat
Headache
Abdominal pain Anorexia
N/V
Diarrhea or Constipation
POLIOMYELITIS
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Signs and symptoms:
Major poliomyelitis
For both types:- Resistance to neck flexion
- Hoynes sign
POLIOMYELITIS
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Signs and symptoms:
Major poliomyelitis
a. Nonparalytic
-moderate fever
-headache
-vomiting
-lethargy
-irritability
-pains in the neck, back,arms, legs and
abdomen-tenderness and
weakness
-spasms in the
extensors of theneck and back
POLIOMYELITIS
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PoliomyelitisSigns and symptoms:
Major poliomyelitis
b. Paralytic
- flaccid paralysis
- hypersensitivity to
touch
- urine retention
- constipation
Signs and symptoms:
Major poliomyelitis
b. Paralytic
- abdominal distention
- paresthesia
- loss of superficial and
deep reflexes
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- Bulbar
- Spinal
- Bulbo-Spinal
POLIOMYELITIS
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(+) Brudzinskis
signs
POLIOMYELITIS
(+) Kernigs signs
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PoliomyelitisDiagnostic Exam
1. Lumbar puncture,
cultures of throat
secretions & feces2. Muscle testing
3. EMG(electromyelography)
Treatment:
Asymptomatic
Mechanical
ventilator if withbulbar paralysis
Physical therapyor rehabilitation
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Poliomyelitis
Prevention:
No cure, but can be prevented by polio
vaccine given at multiple times
Vaccine: OPV, IPV
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POLIOMYELITIS
Causative agent Poliovirus
Most common
modes of
transmission
Fecal-oral, vehicle
Prevention Live attenuated (developing
countries/world) or inactivated
vaccine (developed world)
Treatment None, palliative, supportive
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inflammation of the meninges almost always caused by an infection,usually by a bacteria (bacterialmeningitis) or a virus (viral meningitis) can be triggered by a fungus or parasite(rare) occurs most commonly in :
young children under 5those aged 17-25people with compromised immune systems(cryptococcal meningitis)
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1. aseptic refers loosely to all cases of meningitis in which no
bacterial infection can be demonstrated
viral/acute lymphocytic meningitis ENTEROVIRUSES, ARBOVIRUSES, HSV, MUMPS VIRUS,
LYMPHOCYTIC CHO RIOMENINGITIS VIRUS2. septic/bacterial meningitis(N.meningitidis, H. influenzae, S. pneumoniae, E.coli)3. tuberculous/chronic meningitis
Mycobacterium tuberculosis
Certain CA, brain tumor
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Viral/Acute Lymphocytic Meningitis
benign "stiff neck" presents like bacterial meningitis, but usually is not soserious more prevalent than bacterial meningitis Most patients recover well after several very uncomfortabledays.MOT:
Enteroviruses1) from person to person through fecal contamination
2) through respiratory secretions (saliva, sputum, or nasal mucus
mumps and varicella-zoster virus1) through direct or indirect contact with saliva, sputum, or mucus of an
infected person
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Septic /Bacterial Meningitis
contagious, but not spread by casual contact
or by simply breathing the air where a person
with meningitis has been
MOT:
through the exchange of respiratory and
throat secretions (i.e., coughing, kissing)
/
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Tuberculous/Chronic Meningitis
lasts a month or longer
common in countries where tuberculosis is
common
also encountered in those with immune
problems, such as AIDS
Inflammatory response
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causative agentcolonizes the
nasopharynx
pathogens spread into
local tissuesand bloodstream
pathogens replicatein the bloodstream
Pathogens cross the
blood-brain barrier into
subarachnoid space
Bacterial replication
in CSF enhance local
inflammatory response
Inflammatory response
alters CSF dynamics and
cerebral blood flow
neurological complications
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Signs and Symptoms
cardinal signs1) fever, chills, malaise, headache, vomiting
nuchal rigidity whimpering and crying in a high-pitched tone
nausea &vomiting photophobia confusion, sleepiness seizures in late stage of disease
opisthotonus Brudzinskis and Kernigs sign
MENINGITIS
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MENINGITIS
SIGNS OF MENINGEAL IRRITATION
NUCHAL RIGIDITY
OPISTHOTONUS KERNIGS SIGN
BRUDZINKIS SIGN
MENINGITIS
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MENINGITIS
NUCHAL RIGIDITY
MENINGITIS
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MENINGITIS
OPISTHOTONUS
MENINGITIS
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(+) Brudzinskis
signs
MENINGITIS
(+) Kernigs signs
Diagnosis
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Diagnosis
CSF analysis through lumbar puncture
Culture of blood, urine, nose and throat
secretions
M
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Management
depends on the cause Constant VS taking Close neurological monitoring Bed rest
Protection during seizures Treating coexisting conditions Antibitiotics administration (PenG, ampicillin,
tetracycline, chloramphenicol) if bacterial Mannitol
Anticonvulsant or sedatives Isolation until 24 hours after initiation of
antibiotic Proper disposal of oral and nasal discharges
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Prevention
Keeping up to date with recommendedimmunizations
Hib
PCV 7 (Prevnar) children below 2 y/o
Pneumovax and PnuImmune 2 y/o and above
Good hygiene
Avoid sharing drinking glasses, water bottles, eating
utensils, tissues, and lip-gloss/lipsticks. Wash hands often with soap.
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