Menenjit: Tanı ve Tedavi
Özet
Akut bakteriyel menenjit tıbbi acil bir durum olup; menenjit şüphesi olan hastanın klinisyenler tarafından ilk bir saat içindeki yönetiminde önceliklerin iyi anlaşılmasını gerektirir.Kan kültürlerinin alınması, lomber ponksiyon yapılması ve uygun tedavinin başlatılması bu öncelikler arasında yer alırken; nörogörüntüleme yapılana kadar tedavinin başlatılmasında gecikmelere sebep olmayacak şekilde bir yönetim uygulanmalıdır. Birçok tanı tekniği bulunmasının yanında beyin omurilik sıvısı parametrelerinin yorumlanması klinisyenler için kritik öneme sahip olmaya devam etmektedir. Bakteriyel menenjite en sık neden olan yaygın organizmalar Streptococcus pneumoniae ve Neisseria meningitidis iken; 50 yaş üstü hastalarda ve immün sistemi baskılanmış olan hastalarda Listeria monositogenes menenjitine sık rastlanır. Tedavide antibiyotiğin mümkün oldukça erken başlatılması hayati önem arz eder. Deksametazonun ilk antibiyotikle beraber veya hemen öncesinde kullanıldığı hastalarda; serebral inflamasyon, ödem ve kafa içi basınç artışının azaldığı tespit edilmiştir.
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