20-21 Infection Flashcards
What is Waterhouse-Friderichsen syndrome?
Complication of meningococcal infection, occurs in 10-20% of children with acute meningitis. Petechial haemorrhages and haemorrhage into adrenals and DIC.
Increased ICP may occur
What are the commonest pathogens causing meningitis in immunocompetent patients?
Neisseria Meningitidis
Strep Pneumoniae
H. Influenza Type B
Which form of meningitis is likely to present with hydrocephalus?
Cryptococcal meningitis
Usual organisms in post-neurosurgical procedure meningitis?
coag -ve staph
staph aureus
enterobacter
pseudomonas
What pathogens to consider in immunocompromised with infection?
Cryptococcus
TB
Listeria Monocytogenes
HIV aseptic meningitis
How do you treat a post traumatic meningitis?
broad spectrum ABx with good CNS penetration e.g. Vanc and Mero.
Pneumococcal vaccine as most commonly associated with a CSF leak.
Consider exploration or insertion with lumbar drain. May stop spontaneously but this may be due to obscuration by encarcerated brain and high potential for CSF leak later.
Causes of recurrent meningitis?
dermal sinus,
CSF fistula,
neurenteric cyst
Causes of chronic meningitis?
TB
fungal infections
neurocystericosis
Borrelia burgdorferi causes what neurological deficit?
BB -> Lyme disease. Can cause facial nerve weakness. May appear weeks after the initial rash
WHat is the treatment for Listeria monocytogenes?
Ampicillin and gentamicin. (Cephalosporins are inactive against listeria) treat for 21 days
Commonest pathogen causing cerebral abscesses?
streptococcus
What stage does necrosis begin in abscess formation?
Stage 2 - late cerebritis (day 4-9)
What are the stages of abscess formation?
Stage 1 - early cerebritis Day 1-3
Stage 2 - late cerebritis Day 4-9
Stage 3 - early capsule Day 10-14
Stage 4 - late capsule >14days
What stage of abscess formation do you get neovascularisation?
Stage 3 - early capsule - Day 10-14
What is different about the scarring left by an abscess?
Collagen scar as opposed to glial scar