A 16-month-old boy is brought in by his parents with fever, irritability and lethargy. On examination, the neck is stiff. He hasn't received any vaccinations. CSF gram stain done and antibiotics were staed immediately. The organism seen in the above gram stain grows on chocolate agar but not blood agar. No one else in the family is ill. All of the following are true about the treatment of the above disease in this patient except: -
This is a case of Hemophilus influenzae causing meningitis in an unvaccinated child. The description of a chocolate agar-positive organism should suggest either Neisseria meningitidis or H. influenzae type b. The descriptor as a sho rod (from CSF) or pleomorphic rod (from culture) suggests H. influenzae type b. TREATMENT: - Initial therapy for meningitis due to Hib should consist of a cephalosporin such as ceftriaxone or cefotaxime. Therapy should continue for a total of 1-2 weeks. Administration of glucocoicoids to patients with Hib meningitis reduces the incidence of neurologic sequelae. Fluoroquinolones are highly active against H. influenzae and are useful in adults with exacerbations of COPD. Fluoroquinolones not recommended for the treatment of children or pregnant women because of effects on aicular cailage.
Glucocoicoids have no role in the treatment of the above disease.
1st line therapy consists of ceftriaxone or cefotaxime.
Duration of therapy to be given is 1-2 weeks.
Fluoroquinolones can be given.
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