Bacterial Infections of the CNS II (meningitis and encephalitis)

Question 1

gram + cocci, grow in long chains, catalase negative, beta-hemolytic, group B,

Answer 1

Streptococcus agalactiae (GBS)

Question 2

positive CAMP test

Answer 2

GBS (streptococcus agalactiae)

Question 3

resistant to bacitracin

Answer 3

streptococcus agalactiae

Question 4

common cause of sepsis and meningitis in newborns

Answer 4

GBS

Question 5

more common in newborns and blacks

Answer 5

GBS meningitis

Question 6

carriers have colonization of the lower GI tract and genitourinary tract, and some may have vaginal colonization leading to the development of early onset disease in infants

Answer 6

GBS maternal colonization

Question 7

percentage of infants born of colonized mothers become colonized with the identical strain of GBS

Answer 7

50-60%

Question 8

antibody mediated opsonization appears to be protective-in the absence of maternal antibodies the neonate is at risk

Answer 8

GBS meningitis

Question 9

Amongst colonized newborns only 2% are symptomatic with early-onset sepsis, pneumonia, meningitis

Answer 9

GBS mother to infant transmission

Question 10

bacteremia, pneumonia, meningitis-respiratory distress, labored breathing, fever, lethargy, and irritability

Answer 10

early-onset GBS infection

Question 11

GBS surviving neonates may experience

Answer 11

permanent neurological sequela- blindness, deafness, and mental retardation

Question 12

meningitis is more common (also neurological complications) and survival rate is higher

Answer 12

late-onset GBS infection

Question 13

GBS infection dx:

Answer 13

clinical signs and identify the organisms

Question 14

GBS Tx:

Answer 14

penicillin

Question 15

leading infectious cause of neonatal morbidity and mortality

Answer 15

GBS early-onset disease

Question 16

prevention of perinatal GBS disease

Answer 16

universal screening of all pregnant women at 35-36 weeks gestation, intrapartum antibiotics (penicillin) more than 4 hours before delivery

Question 17

gram-negative rod, requires hemin (x) and NAD (V) for growth on chocolate agar, polysaccharide capsule (6 types) type B has poly-ribitol phosphat capsule (PRP)

Answer 17

Haemophilus influenzae type B

Question 18

prior to vaccination was responsible for 95% of all invasive disease (Haemophilus influenzae) was due to

Answer 18

type B

Question 19

encapsulated strains of Haemophilus influenzae cause

Answer 19

meningitis and epiglottitis

Question 20

non-encapsulated strains of Haemophilus influenzae cause

Answer 20

pinkeye, otitis media, sinusitis

Question 21

leading cause of pediatric meningitis

Answer 21

Haemophilus influenzae type B

Question 22

Haemophilus influenzae type B tx/dx

Answer 22

same as other bacterial meningitis agents

Question 23

Prevention of Haemophilus influenzae type B meningitis

Answer 23

non-conjugated vaccine (poorly immunogenic in kids and no booster response) conjugated (anti-PRP antibodies, highly immunogenic can vaccinate at 2 months)

Question 24

gram-positive rod, anaerobic, spore forming (terminal drumstick), tetanospasmin toxin

Answer 24

Clostridium tetani

Question 25

causes tetanus

Answer 25

Clostridium tetani

Question 26

spores common in soil and in feces of domestic animals

Answer 26

clostridium tetani

Question 27

How do Clostridium tetani infect humans?

Answer 27

spores enter the body through wound contamination or traumatic inoculation, also through the umbilical stump

Question 28

What type of toxin is the tetanus toxin?

Answer 28

A-B toxin, B binds to motor neurons-internalized and transported to spinal cord

Question 29

Clostridium tetani causes this type of paralysis

Answer 29

Spastic paralysis

Question 30

inactivates the release of inhibitory neurotransmitters

Answer 30

tetanospasmin

Question 31

early signs include "lock jaw" (trismus), neck stiffness, difficulty swallowing, abdominal muscle rigidity

Answer 31

Clostridium tetani-tetanus

Question 32

symptoms of tetanus progress to

Answer 32

generalized muscle spasms including severe back spasms

Question 33

death in tetanus usually occurs due to

Answer 33

respiratory failure

Question 34

Why is tetanus difficult to detect

Answer 34

the toxin is bound to neurons and the organism is difficult to grow

Question 35

Tx: tetanus

Answer 35

administer immunoglobulin, vaccinate with tetanus toxoid (REMOVE ANY UNBOUND TOXIN!)

Question 36

Is the binding of the toxin reversible (tetanus)?

Answer 36

no it is irreversible-symptoms resolve as new axonal termini are generated

Question 37

mortality rate of tetanus if untreated is roughly

Answer 37

15-60%

Question 38

Prevention of Clostridium tetani-tetanus

Answer 38

vaccination with tetanus toxid (DTaP)

Question 39

When should you begin vaccinating for tetanus?

Answer 39

at 2 months with booster every ten years

Question 40

gram-positive rod, anaerobic, spore forming-terminal, botulinum toxin

Answer 40

Clostridium botulinum

Question 41

Where are clostridium botulinum spores found?

Answer 41

soil, meat fish, veggies, improperly canned food

Question 42

typically not an infection, but an intoxication (absorbed from gut into the blood stream

Answer 42

botulism

Question 43

What kind of toxin is botulinum toxin?

Answer 43

A-B, B binds and A enters motor neuron, A blocks the release of acetylcholine, blocks stimulation of the muscle

Question 44

Clostridium botulinum causes this type of paralysis

Answer 44

flaccid paralysis

Question 45

Symptoms of Botulism (occur after 12 to 72 hrs post toxin ingestion)

Answer 45

nausea, dry mouth, blurred vision, involuntary eye movement, descending muscle paralysis

Question 46

gram-positive rod (cocccobacillus), motile, found in water, soil, and the feces/GI tract of many animals

Answer 46

Listeria monocytogenes

Question 47

infection usually a result of consumption of contaminated foods especially milk, soft cheese, poultry, and deli meats

Answer 47

Listeria monocytogenes

Question 48

commonly causes meningitis in immunosuppressed individuals and pregnant women (5-10% of meningitis in older adults, 5-10% neonatal meningitis)

Answer 48

Listeria monocytogenes

Question 49

infection in utero can result in stillbirth, premature delivery

Answer 49

Listeria monocytogenes

Question 50

primarily a disease of the lung, but may infect the CNS-meningitis, brain abscess-chronic disease develops slowly!

Answer 50

Mycobacterium tuberculosis

Question 51

most patients with meningitis caused by this agent have clinical historic evidence of pulmonary disease

Answer 51

Mycobacterium tuberculosis

Question 52

Staph aureus can cause these CNS complications

Answer 52

meningitis following bacteremia, brain abscesses from traumatic inoculation or surgery