BACTERIAL CNS Flashcards
What constitutes CHRONIC Meningitis?
Progressive or persistent sxs for 4+ weeks
What does “aseptic” mean?
CSF cx shows no bacteria → assume viral bc cannot positively ID any bacteria but still bacterial in reality
What two populations are most affected by Meningitis
- Children
- Elderly
What types of organisms are associated with community-acquired Meningitis, and what are the three?
Organisms that colonize the respiratory tract
- S. pneumoniae
- H. influenzae
- N. meningitidis
What three pathophysiology pathways can lead to Meningitis, and which is most common?
- Invasion of blood stream and seed in CNS = MOST COMMON
- Retrograde neuron pathway
- Direct contiguous spread
What three PE findings are seen with Meningitis, and what is the reasoning behind this?
- Edema
- Increased ICP
- Altered blood flow
Due to partially disrupted BBB → “leaky” blood vessels allow fluid/WBCs/other immune components to enter brain
What is the classic triad of Meningitis?
- Fever
- HA
- Neck stiffness
What two labs should be ordered to evaluate for Meningitis?
- CBC
- Serum glucose (COMPARE to CSF glucose)
What finding is seen on CSF glucose that is + for Meningitis?
LOW CSF glucose
- Lower than serum glucose because bacteria are using glucose as a food source
What four additional symptoms are seen in Neonatal Meningitis?
- Bulging fontanelle
- High-pitched cry (scream)
- Hypotonia
- Paradoxic irritability
What PE finding is VERY common in Neonatal Meningitis?
HIGH fever (hyperthermia)
What three organisms are primarily associated with Neonatal Meningitis? Which are G+ or G-?
- Streptococcus agalactiae (G+)
- Escherichia coli (G-)
- Listeria monocytogenes (G+)
What is another name for Streptococcus agalactiae? Is it G+ or G-?
Group B Streptococcus (GBS)
- It is G+
What is the most common cause of Neonatal Meningitis?
Streptococcus agalactiae (G+) = GBS
What organism is G+ coccus with beta-hemolysis?
Streptococcus agalactiae (G+) = GBS
What organism is transmitted during delivery (or before)?
Streptococcus agalactiae (G+) = GBS
Is EARLY or LATE Meningitis due to Streptococcus agalactiae associated with maternal obstetric complications common?
EARLY Streptococcus agalactiae (G+) = GBS