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Discussion in 'Step I' started by SaturdayDwarf, Jun 1, 2008.

  1. SaturdayDwarf

    SaturdayDwarf Member 10+ Year Member

    Jan 7, 2006
    I'm a little confused about the causes of bacterial meningitis in adults. For the most part, different books seem to agree on newborns, children and the elderly. But here is what different sources say on adults.:

    First Aid (6-60 yrs):
    1. N. meningitidis
    2. S. pneumonia

    MedEssentials (adolescence / young adults):
    N. meningitidis

    UWorld (adults):
    1. S. pneumonia
    2. N. meningitidis

    I'm not including CMMRS because they do not differentiate between children and adults. But it doesn't even mentioned S. pneumonia as a major cause of bacterial meningitis.

    What's the correct answer?
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  3. Green Chimneys

    Green Chimneys Meatwad's Worst Nightmare 7+ Year Member

    Feb 2, 2006
    I don't think any of these are wrong, it's just in the way they present the time tables. In older children, teens and young adults (college kids living in dorms seems to be popular), it's Meningococcal. In older adults it's Pneumococcal. FA is listing the whole set together and saying Neisseria is overall more common where UW is separating out young adults and older adults, in which the primary etiologies are different. Of course, your inevitable USMLE question on meningitis will probably involve an AIDS patient, so whatever...:mad:
  4. agranulocytosis

    agranulocytosis 10+ Year Member

    Sep 22, 2007
    Yea I'm gonna agree with you here, in the elderly it's s. pneumo, young adult n. meningitidis. BTW, isn't it cryptococcal menigitis in AIDS?
  5. SaturdayDwarf

    SaturdayDwarf Member 10+ Year Member

    Jan 7, 2006
    They actually use the same time tables. The part in the explanation section that confused me on UWorld said that "N. meningitidis is the second most common cause of meningitis in adults under 60 years old, after S. pneumoniae". FA separates older and younger adults at 60 also (Neisseria being the number one cause in adults under 60, and Strep being the number one cause in adults over 60). I'm just concerned because it's come up twice already in UWorld, so I'm concerned that I need to know it for my test.
  6. 2cr8tive

    2cr8tive 2+ Year Member

    Mar 8, 2008
    BTW, isn't it cryptococcal menigitis in AIDS?[/quote]
  7. TerpMD

    TerpMD 2+ Year Member

    Sep 26, 2007
    UMD 2010
    RR path (pg 579) says that N men is most common btw 1 mo and 18 years of age. S pneumo in those over 18 years of age. GBS in neonates.

    I would go with s pneumo in any adult that does not have some other reason (exposure, military, colllege) to have N men but that is just me :)

    LUBDUBB Freakaholic 10+ Year Member

    Oct 7, 2002

    Don't forget the fungal meningitides and my favorites, Leukemic Meningitis and Lymphomatous meningitis :)
  9. kkc620

    kkc620 5+ Year Member

    Dec 9, 2006
    Has anyone found a clear-cut answer to this question. Generally speaking, what are the most common causes of meningitis in the different age brackets? I can't seem to find a definite answer.
  10. osli

    osli Senior Member 5+ Year Member

    Oct 13, 2005
    No clear cut answer, but the following is probably a reasonable outline:

    0-1 month:
    - GBS
    - Listeria

    1 month -18 years:
    - N. meningiditis
    - S. pneumo

    18+ years:
    - S. pneumo
  11. opb

    opb 7+ Year Member

    Jun 6, 2008
    I agree with the above poster. There are probably multiple lists from multiple sources. Here is what was given in my micro class:

    Neonates < 1 month:
    - Group B strep
    - E. coli
    - Listeria

    1 month to 18 years:
    - N. meningitidis
    - S. pneumo
    - H. influenza type B

    Over 18 years:
    - S. pneumo
    - N. meningitidis
    - Gram-negative bacilli
    - Listeria

    You'll most likely get information in the question stem that can help differentiate between the different bugs. For me, this list worked fine for the micro questions on my exam.

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