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Microbiology > Bacterial Infections of the CNS I (meningitis/encephalitis) > Flashcards

Bacterial Infections of the CNS I (meningitis/encephalitis) Flashcards

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1
Q

Nearly 100% of patients with meningitis will present with two of these four symptoms

A

fever, headache, stiff neck (nuchal rigidity), and altered mental status

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2
Q

Approximately half of all patients with meningitis present with

A

Fever, Headache, and Stiff Neck

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3
Q

Labs for Dx of Meningitis

A

gram stain of CSF, cultures, latex agglutination

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4
Q

Bacterial meningitis or Viral Meningitis/encephalitis? presence of PMNs

A

bacterial

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5
Q

Bacterial meningitis or Viral Meningitis/encephalitis? presence of mono/lymphos

A

viral

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6
Q

Bacterial meningitis or Viral Meningitis/encephalitis? rare PMNs

A

Viral

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7
Q

Bacterial meningitis or Viral Meningitis/encephalitis? increased protein

A

bacterial

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8
Q

Bacterial meningitis or Viral Meningitis/encephalitis? decreased glucose

A

bacterial

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9
Q

Bacterial meningitis or Viral Meningitis/encephalitis? normal glucose

A

viral

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10
Q

Bacterial meningitis or Viral Meningitis/encephalitis? increased pressure

A

bacterial

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11
Q

Bacterial meningitis or Viral Meningitis/encephalitis? normal or slightly increased protein and pressure

A

viral

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12
Q

Tx: bacterial meningitis

A

empirical antibiotic therapy (specific after organism identified)

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13
Q

majority of bacterial meningitis cases occur in

A

infants and children

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14
Q

common agents of bacterial meningitis

A

S. pneumoniae (50%), N. meningitides (25%) Group B Strep, Listeria monocytogenes, Haemophilus influenzae

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15
Q

Group B strep meningitis is common in

A

the very young and the very old

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16
Q

incubation of 3-4 days with abrupt onset of fever, hypotension and rash, headache, neck stiffness

A

meningococcal disease

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17
Q

gram + coccus catalase -, frequently grows in chains (liquid culture), oval cells, polysaccharide capsule

A

Streptococcus pneumoniae

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18
Q

round mucoid colonies on blood agar, alpha-hemolytic

A

Streptococcus pneumoniae

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19
Q

susceptible to optochin, susceptible to bile

A

Streptococcus pneumoniae

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20
Q

most common cause of vaccine-preventable death in the US

A

pneumococcal disease-causes bacterial meningitis among infants and and young children

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21
Q

Streptococcus pneumonia clinical syndromes

A

pneumonia, bacteremia, meningitis, otitis media

22
Q

Neurological sequelae is common among survivors of bacterial meningitis caused by this bacteria

A

Streptococcus pneumonia

23
Q

Streptococcus pneumoniae causes bacterial meningitis in the

A

very old and very young

24
Q

pneumococcal bacteria bind these in the oropharynx

A

choline binding proteins of the bacterial cell wall bind carbohydrates on the surface of epithelial cells

25
Q

pneumococcal bacteria destroy ciliated epithelial cells and degrade secretory IgA using

A

pneumolysin and IgA protease (pneumolysin also interferes w/ macrophages)

26
Q

characterized by an acute onset (within hours), high mortality (30%), and neurological sequela (10-20%)

A

pneumococcal meningitis

27
Q

pneumococcal meningitis Dx

A

gram-stain CSF, latex-agglutination (presence of capsular antigens), culture, biochemical analysis, susceptibility testing

28
Q

Tx: of pneumococcal meningitis

A

vancomycin w/ a cephalosporin (modify after identification, treat for 10-14 days)

29
Q

Prevention of pneumococcal meningitis

A

PPV23 purified capsular polysaccharide antigen from 23 types of pneumococcus, PCV13

30
Q

What is one problem with the PPV23 vaccine?

A

It is not very effective in children under the age of 2

31
Q

Who is the PPV23 vaccine recommended for?

A

adults over 65, persons over 2 with chronic illness, asplenia, immunocompromised, HIV infection, environments or settings with increased risk

32
Q

What vaccine is recommended for kids under two for pneumococcal meningitis?

A

PCV7, PCV13-pneumococcal conjugate vaccine-polysaccharide conjugated to nontoxic diphtheria toxin-very effective against invasive disease (less effective against pneumonia and acute otitis media)

33
Q

What are the recommendations for the PCV13 vaccine?

A

routine vaccination of children-doses at 2, 4, 6, months, booster dose at 12-15 months

34
Q

gram-negative diplococcus, kidney bean appearance, polysaccharide capsule (12 serotypes), LOS

A

Neisseria meningitides

35
Q

Neisseria meningitides-oxidase? catalase? glucose? maltose?

A

oxidase and catalase positive, ferments both glucose and maltose

36
Q

cause of bacterial meningitis that is epidemic in sub-Saharan Africa

A

Neisseria meningitides

37
Q

Neisseria meningitides most commonly manifests as

A

bacteremia, meningitis (also as pneumonia, arthritis, otitis media, epiglottitis)

38
Q

How is neisseria meningitides transmitted?

A

aerosolized droplets

39
Q

This type of meningitis is commonly associated with people living in close quarters such as in househoulds, military barracks, schools, and dormitories

A

bacterial meningitis caused by Neisseria meningitides

40
Q

In meningitis caused by neisseria meningitides fatality rates are highest in

A

adolescents

41
Q

undergo facilitated uptake by epithelial cells

A

Neisseria meningitides

42
Q

Complications include endotoxemia-organ failure, DIC

A

meningococcal disease (neisseria meningitides)

43
Q

May occur with or without meningitis, bacteria in the blood accompanied by fever, purpuric rash hyptoension and multiorgan failure

A

Meningococcemia

44
Q

results from hematogenous dissemination-presentation includes fever, headache, stiff neck

A

Meningococcal Meningitis

45
Q

Dx: of meningococcal meningitis

A

recognize clinical signs and lab identification (gram stain of CSF/blood) culture, biochemical analysis, susceptibility testing, may also test lesion material

46
Q

Tx: meningococcal meningitis (N. meningitides)

A

penicillin (may begin with vancomycin and/or a cephalosporin before identification)

47
Q

What is recommended for family members, classmates, and co-workers of those infected with meningococcal meningitis (N. meningitides)?

A

prophylactic treatment

48
Q

What are the downfalls to the MPV4 vaccine for meningococcal meningitis?

A

only protects against A, C, Y, W-135 not B serotype, and is not effective in children under the age of 2, produces little affinity IgM, little IgG, not recommended for routine vaccination

49
Q

The meningococcal polysaccharide vaccine is not recommended for routine vaccination but is recommended for certain high-risk populations such as these

A

terminal complement deficiency, functional or anatomic asplenia, certain laboratory workers, traverls to and US citizens residing in countries in which N. meningitidis is hyperendemic or epidemic

50
Q

meningococcal conjugate vaccine (MCV4) is approved for ages 1-55 and protects against

A

A, C, Y, W-135 but not B serotype (conjugated to non-toxic diptheria toxin subunit)

51
Q

Unlike the other meningococcal vaccine this vaccine has booster response observed and a higher affinity antibody response/higher IgG response

A

MCV4

52
Q

Vaccination is recommended for students entering high school and is mandated by law in a dozen states for those entering college

A

MCV4

Microbiology (8 decks)

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