| | | | | - | - | | | |   
                     
| | - | | - | ' '   |     /

  -
  ? 
  ,  
  , ,
  , ,
    ......
   
 
  -.
 
  ...
  
    - 
 
   
  .   
  
  • -
  • BMI
  • , Meningitis `.
       
     
    ,

    , Meningitis `.

    ,       Meningitis  `.
    . , -3 .

    ' - , , , -;

      , -

                                                                                .

    '

     

    :

    -80 Haemophilus influenzae type B, .

    mumps , , -15% .

    A, C, W135 -Y , . 11 18 , -, .

     

    Type B . , , .

    23 - ,  (asplenia), , .   

     

    - , .

     

    : 

     

    -8 , , -rifampin ( 600 , 10 " , 5 " .

    -ciprofloxacin ( Cipro) 500 , - - 250 ceftriaxone ( Rocephin).

    -4 , Haemophilus influenzae -rifampin , 20 " , 600 , 4 .

     

    , , -Streptococcus agalactiae ( B), -35-37 , , , , -18 , -37 , G 5 2.5-3.0 .

    , -cefazolin (2 1 8 ) -clindamycin ( Cleocin) 900 8 , -vancomycin (15 20 " 12 .  

     

    :

    , , , CRP - , .

    .

    (CSF) : -CSF , , " 300 (PMN , ).

    -CSF , , (-) -300 ".

    , -CSF , , ( -PMN) -300 ". -CSF , ( ) -300 ". , , . 

     

    (LP lumbar puncture) , ( -abscess), .

    , CT MRI, . CT, MRI LP , .

     

    , " " , 6-18 " , .

    , : , בּ, .

    Gram -CSF , , -CFF  -60% , . -CSF 48 .

     

    40% , : -CSF -0.4 .

    -CSF -CSF -0.6, . () -CSF .

     

    , PCR DNA, .  

     

    :

    , , . .

    - ( G) .

    , .

    - , . ( shunt) .  

     

    , -CSF.

    . -Stept. pneumoniae,     -0.1 ", 10 14 4 4 .
     meropenem  ( Merrem), moxifloxacin ( Avelox) .

    ceftriaxonet ( Rocephin) 2 -12 , vancomycin (15 22 " ) ceftriaxonet (2 ) -12 . Neisseria meningitides, ceftriaxonet ( 2 -12 ) 5-7 . meropenem, moxifloxacin.

     

    Hemophilus influenzae, ceftriaxonet 2 -12 7 10 , moxifloxacin. -Streptococcus agalactiae ( B), 14 21 ampicillin gentamycin 2 -12 ( ), -vancomycin -cefotaxime ( Claforan).

    Listeria monocytogenes, 21 -ampicillin ( 2 -4 ) gentamycin ( 1-2 "   -8 ) . -trimethoprim/sulfamethoxazole ( Bactrim, Septra).

     

    (Enterobacteriaceae) ceftriaxone, ceftrazidime ( Fortaz) cefepime ( Maxipime) gentamycin.

    (MRSA), 7-10 nafcillin ( 2 -4 ) vancomycin ( 15 22 " 12 ). -daptomycin  ( Cubicin) -linezolid ( Zyvox), rifampin.

     

    - , .

    .   , 4 . , .

    , . 2010 Lancet Neurology - -, , .   

     

    , , . , herpes simplex varicella zoster, - acyclovir ( Zovirax) 10 " -8 , .

    , , .

     

    cryptococcal meningitidis, B  amphotericin (.70 1.0 " ), flucytosin ( Ancobon, 25 " -6 ).

    , , .

     

      .

    .   isoniazid (5 " , 10 " 300 ); -rifampin (10 " , 10 20 " 600 ); pyrazinamide (15-30 " ).

    (20 40 " , 1 ), . 14 . 

     

    :

    , .

    , .

    , 2-3%, 21% .

    . 

    , -14% , (-10% ) -4%.

    , , ( ), -1,000 - " .

    . ( ), , , -15% .    

     

        , , -
    19/03/2011

     
       


    , , " , "
    , " " .

    / , , , / / . .
    / , , , / , / . .

    ,
    / " .




    | |
    | | | | | | |
    | | | |
    | | | |