10. CSF and Other Sterile Body Fluids

Question 1

Specimen to test for empyema?

Answer 1

Pleural fluid

Question 2

Which CNS infection is this organism associated with? Treponema pallidum

Answer 2

Aseptic meningitis

Question 3

This condition may be secondary to myocarditis or endocarditis

Answer 3

Pericarditis

Question 4

Recommended media set up for CSF specimen?

Answer 4

• BAP and CHOC /CO2
• BHI/Fildes
• Gram-stained smear

Question 5

Most likely route of infection for Herpes simplex virus

Answer 5

Intraneural spread

Question 6

Which CNS infection is this organism associated with? Toxoplasma gondii

Answer 6

Meningoencephalitis

Question 7

Most likely route of infection for Actinomyces israelii

Answer 7

Direct or contiguous spread

Question 8

Which CNS infection is this organism associated with? West Nile virus

Answer 8

Encephalitis

Question 9

Term for a route of infection in CNS from an adjacent site

Answer 9

Contiguous (direct) spread

Question 10

Populations most likely affected by N. meningitidis

Answer 10

Children
Young adults
Immunocompromised

Question 11

Most likely route of infection for Neisseria meningitidis

Answer 11

Hematogenous spread

Question 12

Specimen to test for septic arthritis?

Answer 12

Synovial fluid

Question 13

Which CNS infection is this organism associated with? Mycobacterium tuberculosis

Answer 13

Chronic septic meningitis

Question 14

These strains of Cryptococcus will not be detected w/ latex agglutination.

Answer 14

Non-encapsulated

Question 15

Most likely route of infection for Staphylococcus epidermidis

Answer 15

Trauma or surgical manipulation

Question 16

2 additional testing methods that may be required for a tuberculous CSF infection

Answer 16

• Auromine-rhodamine

- PCR

Question 17

Where do brain abscesses usually originate?

Answer 17

In ear (otogenic)

Question 18

This test is performed on dialysate to check for infection and endotoxins

Answer 18

LAL test (Limulus Amoebocyte Assay)

Question 19

Sinusitis, otitis media, mastoiditis may cause this type of spread of CNS infection

Answer 19

Contiguous (direct)

Question 20

Generation(s) of cephalosporin that would NOT be unacceptable for meningitis treatment

Answer 20

1st and 2nd cephalosporins

Question 21

Pleural fluid when infected and contains many PMNs

Answer 21

Empyema

Question 22

How much CSF does an adult have?

Answer 22

150 mL

Question 23

Meningitis due to H. influenzae - which antimicrobials are appropriate?

Answer 23

• Ampicillin
• 3rd gen cephalosporins
• Chloramphenicol and/or meropenem

Question 24

Which CNS infection is this organism associated with? Haemophilus influenzae

Answer 24

Acute septic meningitis

Question 25

Why are CSF specimens not refrigerated?

Answer 25

Fastidious organisms may not remain viable

Question 26

2 scenarios where direct antigen testing would be appropriate

Answer 26

• High WBC count and no organisms in Gram stain

- Patient given abx before collection

Question 27

How much CSF is produced each day?

Answer 27

500 mL

~20mL per hour

Question 28

Symptoms of a ____________ may mimic meningitis

Answer 28

brain abscess

Question 29

Media and temperature used for quantitative culturing of dialysate?

Answer 29

TSA, 30 degC

Question 30

Why are fluoroquinones (ciprofloxacin) not used to treat meningitis?

Answer 30

They can’t cross the BBB

Question 31

This must be seen in order for India ink negative stain to be diagnostic of Cryptococcus

Answer 31

Budding yeast with halo

Question 32

What is india ink negative stain used to identify?

Answer 32

Cryptococcus neoformans

Question 33

2 reasons why a CSF specimen may be frozen

Answer 33

1. Viral studies

2. PCR studies