Bact Meningitis (lec 16)

Question 1

Meningitis is?

Answer 1

Inflamm of brain from CNS infection of subarachnoid space

Question 2

Meningitis etiology:

Community Acquired

Hospital Acquired

Answer 2

bacteria, fungus, parasitic

s. pneumo, h. flu, n. meningitidis

G- rods, s. aureus, other strep/staph

Question 3

Meningitis action?

Answer 3

Mucosal colonization -> blood stream ->
BBB -> inflammation/WBC -> CSF ->
exudation of serum ->
edema/cranial pressure/∆ blood flow

Question 4

Meningitis alternate pathways into CSF?

Answer 4

retro neuronal

direct spread

Question 5

Meningitis presentation?

Answer 5

Triad: Fever/HA/Stiff neck

N/V, confusion

Question 6

Meningitis diagnostics?

Answer 6

CBC
Serum electro
Serum glucose
Liver profile

Question 7

Meningitis tx?

Answer 7

empiric

steroids

Question 8

Purulent Meningitis is?

Answer 8

intense acute congestion of meningeal bv/purulent exudates

Question 9

Neonatal Meningitis predisposing factors?

Answer 9

immature body/defenses
premature membrane rupture
mother uterine infection or UTI

Question 10

Neonatal Meningitis presentation?

Answer 10

hyperthermia
bulging fontanelle
high-pitched cry
hypotonia
paradoxic irritability (stationary = quite, held = cry)
N/V/D
respiratory ↓

Question 11

Neonatal Meningitis etiology?

Answer 11

strep agalactiae (group B Strep)
e. coli
listeria monocytogenes

Question 12

strep agalactiae microbe characteristics?

Answer 12

(U) acquired before/during delivery
G+ coccus
Gray-white colonies
Narrow β-hemo zone

Question 13

s. agalactiae Virulence Factor?

Answer 13

Capsule
Hyaluronidase
Collagenase
Hemolysin

Question 14

s. agalactiae early onset?

Answer 14

maternal complications
sxs w/i 5 days
bacteremia, pneumo, meningitis

Question 15

s. agalactiae late onset?

Answer 15

No maternal complications
sxs onset 7 days to 3 mo
bone/joint infect, meningitis

Question 16

s. agalactiae diagnostics?

Answer 16

Sample from blood, CSF

CAMP factor

Question 17

e. coli microbe characteristics?

Answer 17

G- enteric bacillus
Encapsulated (K1) strains

Rectal colonization of mother’s vagina

Question 18

s. pneumo epidemiology?

Answer 18

Most common cause bact mening
Most C recurrent meningitis
(C) elderly
multiple myeloma
Sickle cell
Cardio/Resp dz
Congenital defects

Question 19

h. flu epidemiology?

Presentation?

Answer 19

(U) prior URI, otitis media

days of mild initial condition ->
deterioration, mening sxs

Question 20

l. monocytogenes microbe characteristics?

Answer 20

G+ coccobacillus
Motile
Low O2 for in vitro growth
Facultative in epith, macroph, monocytes

Question 21

l. monocy epidemiology?

Virulence Factors?

Answer 21

living and nonliving sources

Lipopolysacc: antiphago

Listeriolysin O: kills phagos, Ø antigen, aptosis

Question 22

Listeriosis presentation?

Answer 22

Sepsis or Meningitis

In Utero: death, pneumo, seizures
Birthcanal: meningitis

Adult: brainstem encephalitis in CA/renal transplant

Question 23

Listeriosis diagnostics?

Answer 23

Gram stain
Cx
Tumbling motility

Question 24

Meningiococcal Meningitis caused by?

Answer 24

n. meningitidis

Question 25

n. meningitidis microbe characteristics?

Answer 25

G- kidney-shaped diplo
Encapsulated
A/B/C/Y/W135 dz causing

Question 26

Meningococcus epidemiology?

Answer 26

Reservoir: humans (nasopharynx)

Close contact spread

Question 27

Meningiococcal infection characteristics?

Answer 27

meningitis
vascular collapse
rash
shock

Question 28

Meningiococcal Meningitis diagnostics?

Answer 28

petechial lesions

Gram stain from CSF

Question 29

Meningiococcal Meningitis tx?

Answer 29

PCN G or chloramphenicol

vaccine

Question 30

Encephalitis is?

Answer 30

Inflamm of parenchyma