[8] CNS Infections and Autoimmune Postinfectious Disorders in Children Flashcards
Most common Etiologic Organism causing Bacterial Meningitis in the 0-2 month age group
Streptococcus
Most common Etiologic Organism causing Bacterial Meningitis in the 3 months - 6 years age group
H. influenza
Streptococcus pneumoniae
Most common Etiologic Organism causing Bacterial Meningitis in the early to late childhood
Streptococcus pneumonia
Neisseria meningitides
Absolute contraindication to doing a lumbar puncture
Infection at the LP Site
Meningococcemia presents with this characteristic lesion
Violaceous purpura on skin, highly infectious (Isolate the patient)
Empiric Antibiotics for Neonatal Meningitis
Ampicillin / Ceftriaxone / Cefotaxime
+
Aminoglycoside
Empiric Antibiotics for 2 months - 5 years
Ceftriaxone / Cefotaxime
Empiric Antibiotics for >5-18 years
Penicillin
Specific Therapy for E. Coli
Cefotaxime
Specific Therapy for Group B Streptococcus
Cefotaxime
Specific Therapy for H. influenza
Ceftriaxone
Specific Therapy for S. pneumonia
Penicillin
Specific Therapy for N. meningitides
Penicillin
When is Dexamethasone used for meningitis
In children less than 5 years of age wherein Hib meningitis is suspected
(Dexamethasone has NO role in treating neonatal meningitis)
What stage of TBM is a patient that is posturing?
Stage III
What stage of TBM is a patient with increased ICP?
Stage II
Clinical Triad of TB Meningitis
Basal exudates
Hydrocephalus
Cerebral Infarction
Describe each Category of Smith’s Outcome Category (After Discharge)
1: Completely Recovered
2: Mild Neurologic Defect
3: Severe Neurologic Defect
4: Death
Most common fungal infection causing meningitis
Cryptococcus neoformans
Diagnostic test for Cryptococcal Meningitis
India Ink Stain
Treatment for Cryptococcal Meningitis
Amphotericin B IV for 4-6 weeks
Common Triad of Brain Abscess
Fever
Headache
Focal Neurologic Deficit
More Common Type of HSV Encephalitis
Type 1
Which type of HSV Encephalitis is associated with genital herpes? Which one is associated with orofacial herpes?
Type 1: Orofacial
Type 2: Genital
Treatment for HSV Encephalitis
Acyclovir
This is commonly seen in patients from the provinces working in rice fields
Japanese Encephalitis
Clinical Features of Anti-NMDAR Encephalitis
Psychiatric symptoms are more evident than systemic ones
Patients present with abnormal movements, seizures, autonomic instability
Treatment for Anti-NMDAR Encephalitis
Methylprednisone and other steroids
Corticosteroids
(Make sure there are no other kinds of CNS Infections before giving steroids)
Most Common Presentation of Subacute Sclerosing Panencephalitis
Initially myoclonic jerks, falls very quickly due to myoclonic seizures
EEG of a patient with Subacute Sclerosing Panencephalitis would show?
Burst Suppression Pattern
MRI Diagnostic Criteria for Pediatric Multiple Sclerosis
- =>9 hyperintense white matter lesions or one gadolinium enhancing lesion
- =>3 Periventricular Lesions
- 1 Juxtacortical Lesion
- 1 Infratentorial Lesion
MRI must show 3 or more of these features
Diagnostic Criteria for Pediatric Multiple Sclerosis
MRI Criteria
More than 1 attack located in the CNS
Treatment for Multiple Sclerosis
Corticosteroids (Methylprednisone)
Interferon Beta
Treatment for Guillan-Barre Syndrome
IV Ig
Plasmapharesis
When performing a lumbar puncture, it is best to obtain CSF from which intervertebral interspace?
L3 - L4
