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Microbio > Bacterial Meningitides > Flashcards

Bacterial Meningitides Flashcards

1
Q

Current m/c cause of bacterial meningitis

A

Strep pneumoniae

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2
Q

Cause of decrease in meningitis

A

Vaccines and screening for group B strep

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3
Q

Common problem w/ dx of meningitis

A

Difficulty culturing, presenting as “aseptic”

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4
Q

Community acquired meningitis causative agents

A

Strep pneumoniae, h. Flu, n. Meningitis

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5
Q

Hospital acquired meningitis causative agents

A

Gram negative rods, s. Aureus, other strep and staph

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6
Q

Cerebrospinal fluid is a perfect environment for bacterial because…

A

It’s sterile, no competition

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7
Q

Pathogenesis of meningitis

A

Mucosal colonization —> bloodstream —> BBB —> release of cytokines —> WBC into CSF —> inc. permeability of BBB —> exudation of serum —> edema, inc. intracranial pressure, altered blood flow

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8
Q

Most cases of bacterial meningitis are caused by

A

A localized infection elsewhere in the host

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9
Q

3 pathways for gaining access into the CNS

A
  1. Invasion of bloodstream and seeding of the CNS (M/c)
  2. Retrograde neuronal pathway (Naegleria)
  3. Direct contiguous spread (infections, malformations, trauma)
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10
Q

What causes swelling and decreased blood flow to brain?

A

“Leaky” blood vessels allow fluid, WBCs, and other immune components to cross the BBB

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11
Q

Classic triad of meningitis

A

Fever, HA, Neck stiffness

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12
Q

Dx of meningitis

A

Serum glucose compared to CSF glucose —> should be lower because bacteria are using the glucose for energy
CSF culture from lumbar puncture

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13
Q

Tx of meningitis

A

Prompt initiation of empiric therapy
Steroid to decrease swelling
Intrathecal abx for hospital acquired infections

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14
Q

Predisposing factors for neonatal meningitis

A

Immaturity of host defense, and organ systems
Low birth weight
Complications during birth

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15
Q

Signs of neonatal meningitis

A

Bulging Fontanelle
High pitched cry (intense amount of pain)
Hypotonia
Paradoxically irritability (quiet when stationary, crying when held)

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16
Q

Other signs and Sxs of neonatal meningitis

A

Hyperthermia —> very high fever
CNS manifestations
GI disturbances
Resp Abn

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17
Q

If hypothermia in neonate w/ meningitis

A

Advanced infection, body is unable to regulate anything

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18
Q

Predominant Agents of neonatal meningitis

A

Strep agalactiae
E. Coli
Listeria monocytogenes

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19
Q

Prevention of neonatal meningitis

A

Prenatal screening for group B strep during 35-37 weeks gestation

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20
Q

What do you do if the mother is positive for group B strep

A

If delivering vaginally, routine abx prophylaxis unless labor has begun

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21
Q

Prognosis of neonatal meningitis

A

Finish later

22
Q

S. Agalactiae

A 
AKA group B strep
Most common cause of NEONATAL meningitis
Prevention is difficult
Colonizes vagina and rectum
Infections in adults are rare if immunocompetent
23
Q

S. Agalactiae characteristics/morphology

A

Gram positive cocci

Gray-white colonies w/ narrow zone of b-hemolysis

24
Q

S. Agalactiae virulence factors

A 
Capsular polysaccharide
Hyaluronidase
Collage are
Hemolysis 
Sorta non-specific
Not well equipped to be pathogen
25
Q

Early onset neonatal group B strep

A

Maternal OB complications are common
Sxs during first 5 days
Bacteremia, pneumonia, meningitis
Better prognosis than late disease

26
Q

Late onset meningitis

A

Maternal OB complications are uncommon

Sxs 7 days —> 3 months of age

27
Q

Major clinical manifestations: bone/joint infections, bacteremia w/ meningitis

A

Late onset neonatal meningitis

28
Q

Dx of s. Agalactiae

A

Detection of CAMP factor (People LOVE asking questions about this, but it is a HORRIBLE test)
Enhanced hemolytic pattern
Nothing else will exhibit this

But definitive dx requires isolation from blood/CSF

29
Q

E.coli as a causative agent of meningitis

A

Will start as GI infection and enter blood stream —> CSF

Gram negative enteric bacillus

30
Q

most common cause of bacterial meningitis

A

S. Pneumoniae

31
Q

What might follow pneumococcal pneumonia

A

Acute purulent meningitis

32
Q

H. Influenzae morphology

A

Non-motile, gram negative coccobacillus

33
Q

Usual pattern of h. Inf infection

A

Mild antecedent infection (prior URI or otitis media) followed by deterioration, signs and Sxs of meningitis

34
Q

Seasonality of community acquired meningitis

A

All winter except L. Monocytogenes is summer

35
Q

L. Monocytogenes morphology

A

Gram positive motile coccobacillus

36
Q

Virulence of l. Monocytogenes

A

Mesophiles and can survive in the cold
Facultative intracellular pathogen
LPS-like surface component
Listeriolysin O

37
Q

LPS- like surface component of L. Mono

A

Antiphagocytic

Responsible for induction of complement dependent hemolytic antibodies

38
Q

Listeriolysin O

A

Assoc L. Mono
Disrupts the phagolysosome membrane
Inhibits antigen processing
Induces apoptosis

39
Q

Pathogenesis of listeriosis

A

Ingest raw food…FINISH LATER

40
Q

Clinical manifestations of listeriosis

A

Sepsis, meningitis

41
Q

Dx of listeriosis

A

Finish later

42
Q

Meningococcal meningitis

Causative agent

A

Neisseria meningitidis

43
Q

N. Meningitidis morphology

A

Gram negative kidney bean shaped diplococcus

Encapsulated

44
Q

Most important serogroups of n. Meningitidis

A

A, B, C, Y, W135

45
Q

Epidemiology of meningococcus

A

Humans are the only reservoir, nasopharyx colonized

Infection requires close contact

46
Q

Characteristics of meningococcemia

A

Skin rash
Petechiae and pink macules
Wide spread eruption
DIC and shock can occur

47
Q

Characteristics of meningococcal meningitis

A

Finish later, tumbler test

48
Q

Dx of meningococcal meningitis

A

Gram stain of CSF, finish later

49
Q

Tx of meningococcal meningitis

A

Penicillin G DOC

50
Q

Prevention of meningococcal meningitis

A

Quadrivalent vaccine for serogroups A, C, Y, W135

51
Q

Precaution w/ meningococcal meningitis vaccines

A

Administer serogroup B vaccine on one arm and the quadrivalent on the other

Microbio (9 decks)

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