Critical Care Scenarios Episode 81: Bacterial meningitis with Casey Albin
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Nov 13, 2024 
Casey Albin, a neurointensivist at Emory, shares his expertise on bacterial meningitis. He delves into essential diagnostic techniques, emphasizing the importance of distinguishing between meningitis and encephalitis. The conversation covers antimicrobial therapy choices, the role of lumbar punctures, and the necessity of tailored medical practices. Additionally, Albin discusses managing meningitis in immunocompromised patients and the critical insights gained from cerebrospinal fluid testing, underscoring the urgency of timely interventions.
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Recognizing CNS Infections
- Consider CNS infections like meningitis or encephalitis in altered septic patients, especially with additional neurological signs.
- Look for headache, photophobia, seizure activity, or unexplained vomiting.
Meningitis vs. Encephalopathy
- Septic encephalopathy is more common than meningitis, but detailed neurological assessment is crucial.
- Focus on headache, photophobia, seizure activity (even subtle ones), and unexplained vomiting.
Nuchal Rigidity's Reliability
- Nuchal rigidity, while a classic sign of meningitis, is less reliable than other symptoms.
- Prioritize headache, photophobia, possible seizures, and unexplained vomiting in your assessment.