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MICRO > BACTERIAL CNS > Flashcards

BACTERIAL CNS Flashcards

1
Q

What constitutes CHRONIC Meningitis?

A

Progressive or persistent sxs for 4+ weeks

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2
Q

What does “aseptic” mean?

A

CSF cx shows no bacteria → assume viral bc cannot positively ID any bacteria but still bacterial in reality

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3
Q

What two populations are most affected by Meningitis

A
  • Children

- Elderly

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4
Q

What types of organisms are associated with community-acquired Meningitis, and what are the three?

A

Organisms that colonize the respiratory tract

  • S. pneumoniae
  • H. influenzae
  • N. meningitidis
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5
Q

What three pathophysiology pathways can lead to Meningitis, and which is most common?

A
  • Invasion of blood stream and seed in CNS = MOST COMMON
  • Retrograde neuron pathway
  • Direct contiguous spread
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6
Q

What three PE findings are seen with Meningitis, and what is the reasoning behind this?

A
  • Edema
  • Increased ICP
  • Altered blood flow

Due to partially disrupted BBB → “leaky” blood vessels allow fluid/WBCs/other immune components to enter brain

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7
Q

What is the classic triad of Meningitis?

A
  • Fever
  • HA
  • Neck stiffness
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8
Q

What two labs should be ordered to evaluate for Meningitis?

A
  • CBC

- Serum glucose (COMPARE to CSF glucose)

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9
Q

What finding is seen on CSF glucose that is + for Meningitis?

A

LOW CSF glucose

- Lower than serum glucose because bacteria are using glucose as a food source

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10
Q

What four additional symptoms are seen in Neonatal Meningitis?

A
  • Bulging fontanelle
  • High-pitched cry (scream)
  • Hypotonia
  • Paradoxic irritability
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11
Q

What PE finding is VERY common in Neonatal Meningitis?

A

HIGH fever (hyperthermia)

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12
Q

What three organisms are primarily associated with Neonatal Meningitis? Which are G+ or G-?

A
  • Streptococcus agalactiae (G+)
  • Escherichia coli (G-)
  • Listeria monocytogenes (G+)
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13
Q

What is another name for Streptococcus agalactiae? Is it G+ or G-?

A

Group B Streptococcus (GBS)

- It is G+

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14
Q

What is the most common cause of Neonatal Meningitis?

A

Streptococcus agalactiae (G+) = GBS

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15
Q

What organism is G+ coccus with beta-hemolysis?

A

Streptococcus agalactiae (G+) = GBS

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16
Q

What organism is transmitted during delivery (or before)?

A

Streptococcus agalactiae (G+) = GBS

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17
Q

Is EARLY or LATE Meningitis due to Streptococcus agalactiae associated with maternal obstetric complications common?

A

EARLY Streptococcus agalactiae (G+) = GBS

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18
Q

Is EARLY or LATE Meningitis due to Streptococcus agalactiae associated with more severe sxs?

A

LATE Streptococcus agalactiae (G+) = GBS

19
Q

What organisms is diagnosed via definitive = blood or CSF isolation?

A

Streptococcus agalactiae (G+) = GBS

20
Q

What organism shows CAMP on diagnosis?

A

Streptococcus agalactiae (G+) = GBS

21
Q

What is an important cause of NEONATAL bacterial meningitis?

A

Escherichia coli (G-)

22
Q

What organism is transmitted via rectal colonization of mother’s vagina?

A

Escherichia coli (G-)

23
Q

What organism is the most common cause of bacterial meningitis (in general)?

A

Streptococcus pneumoniae (G+)

24
Q

What organism can follow pneumococcal PNA, infection at other site, or no obvious infection?

A

Streptococcus pneumoniae (G+)

25
Q

In what two population is Meningitis due to Streptococcus pneumoniae common?

A
  • Elderly

- Recurrent meningeal infections

26
Q

What organism is G- coccobacillus, non-motile?

A

Haemophilus influenzae

27
Q

What organism of Meningitis occurs in SUMMER?

A

Listeria monocytogenes (G+)

28
Q

What organism of Meningitis is G+ motile coccobacillus?

A

Listeria monocytogenes (G+)

29
Q

What organism of Meningitis can grow at high AND low temperatures?

A

Listeria monocytogenes (G+)

30
Q

What organism of Meningitis is a facultative intracellular?

A

Listeria monocytogenes (G+)

31
Q

What organism of Meningitis is transmitted via food (animal and human carriers)?

A

Listeria monocytogenes (G+)

32
Q

What two virulence factors are associated with Meningitis and Listeria monocytogenes?

A
  • Lipopolysaccharide-like Surface Component

- Listeriolysin O

33
Q

What is the primary purpose of the Lipopolysaccharide-like Surface Component associated with Meningitis and Listeria monocytogenes?

A

Antiphagocytic

34
Q

What are the three primary purposes of the Listeriolysin O associated with Meningitis and Listeria monocytogenes?

A
  • Disrupts phagolysosome membrane
  • Inhibits antigen processing
  • Induces apoptosis
35
Q

What two clinical presentations are often seen with Listeria monocytogenes (G+)?

A
  • Sepsis

- Meningitis

36
Q

What organism of Meningitis shows “tumbling” motility in hanging drop preparation?

A

Listeria monocytogenes (G+)

37
Q

What organism of Meningitis involves homogenization required for tissue culture?

A

Listeria monocytogenes (G+)

38
Q

What causes Meningococcal Meningitis? Is it G+ or G-?

A

Neisseria meningitidis (G-)

39
Q

What organism of Meningitis is G- diplococcus?

A

Neisseria meningitidis (G-)

40
Q

What organism of Meningitis is G- diplococcus, kidney-shaped?

A

Neisseria meningitidis (G-)

41
Q

What organism of Meningitis involves chronic carriers, and where does it colonize?

A 
Neisseria meningitidis (G-)
- Colonized in nasopharynx
42
Q

What symptom is pathognomonic for Neisseria meningitidis and Meningitis?

A

Widespread, fast-spreading skin rash (petechiae)

43
Q

What three diagnostic tools can be used to evaluate for Neisseria meningitidis and Meningitis?

A
  • Tumbler Test
  • Chocolate agar
  • Thayer-Martin agar
44
Q

How can you prevent Neisseria meningitidis and Meningitis?

A

VACCINES

MICRO (11 decks)

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