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Micro Exam 2 (Shelby) > Bacterial Meningitides > Flashcards

Bacterial Meningitides Flashcards

1
Q

(early onset/late onset) neonatal group b strep

major clinical manifestations are bone/joint infections, and bacteremia with concomitant.fulminant meningitis

A

late onset

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2
Q

Two agars associated with Neisseria meningitidis

A

Chocolate agar

Thayer-Martin agar

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3
Q

What is the causative agent of meningococcal meningitis

A

Neisseria meningitidis

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4
Q

What are the two virulence factors of Listeria monocytogenes

A
  1. lipopolysaccharide-like surface component

2. Listeriolysin O

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5
Q

3 microbes that most commonly cause community acquired meningitis

A

s. pneumoniae
h. influenzae
n. meningitidis

(organisms able to colonize the respiratory tract)

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6
Q

neonatal meningitis predisposing factors *neonatal factors:

A

immature immune system
immature organs
low birth weight

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7
Q

Which meningitis microbe is associated with the presence of petechiae and pink macules with widespread eruption within hours

A

Neisseria meningitidis

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8
Q

What is the most common cause of bacterial meningitis (NOT NEONATAL!)

A

Strep pneumoniae

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9
Q

What is the most common cause of transmission of Listeria monocytogenes

A

food

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10
Q

What does streptococcus agalatiae (group B strep) look like on agar?

A

gray-white colonies with a narrow zone of b-hemolysis

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11
Q

(early onset/late onset) neonatal group b strep

symptoms develop from 7 days to 3 months of age

A

late onset

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12
Q

What is the cause of systemic toxicity of CNS infections

A

exotoxin activity

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13
Q

What is the leading cause of meningitis in cancer and renal transplant patients

A

listeriosis

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14
Q

What is the most common agent in patients with recurrent meningeal infections

A

Strep pneumoniae

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15
Q

Neisseria meningitidis
gram (+/-)
shape?

A

negative

diplococcus

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16
Q

survivors of neonatal meningitis typically have

A

permanent defects

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17
Q

What was the most common cause of bacterial meningitis before 1986

A

Haemophilus influenzae

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18
Q

what is another name for group B strep

A

streptococcus agalatiae

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19
Q

What does Listeria monocytogenes require for growth

A

reduced oxygen tension for in vitro growth

FACULTATIVE INTRACELLULAR PATHOGEN

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20
Q

Which microbe is associated with a “tumbling” motility in hanging drop preparation

A

Listeria monocytogenes

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21
Q

streptococcus agalatiae
group B strep

gram (+/-)
shape?

A

gram +

coccus

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22
Q

What is the prognosis or neonatal meningitis

A

poor

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23
Q

What kind of cells do Listeria monocytogenes like to grow in?

A

epithelial cells

macrophages and monocytes

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24
Q

What is the most common cause of neonatal bacterial meningitis

A

streptococcus agalatiae

group B strep

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25
Q

You do the tumbler test and roll a glass on a rash of your patient and the color DOES change… whatchu got

A

not Neisseria meningitidis

probably allergies

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26
Q

(early onset/late onset) neonatal group b strep

symptoms develop during first 5 days of life

A

early onset

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27
Q

Classic triad of symptoms of meningitis

A
  1. fever
  2. headache
  3. neck stiffness
28
Q

What is a gram negative organism from the GI tract that can cause neonatal meningitis

A

E. Coli

29
Q

higher incidence of meningitis in these populations: (4)

A
  1. new borns (up to 8 months)
  2. elderly
  3. immunocompromised
  4. developing countries
30
Q

What two terrible things can happen from Meningococcemia

A

DIC

gram negative shock

31
Q

____% of colonized neonates develop neonatal bacterial meningitis

A

1-2

32
Q

You do the tumbler test and roll a glass on a rash of your patient and the color does NOT change… whatchu got

A

Neisseria meningitidis

33
Q

How is Listeriolysin O a virulence factor for Listeria monocytogenes

A

disrupts phagolysosome memebrane
inhibits antigen processing
induces apoptosis

34
Q

What causes the eventual decrease of blood flow to the brain in meningitis infections?

A

“leaky” blood vessels allow fluid, WBCs and other immune components to enter the brain

due to BBB becoming partially disrupted

35
Q

Infections of the CNS 2 broad categories:

A
  1. meningitis

2. encephalitis

36
Q

4 signs and symptoms specific to neonatal bacterial meningitis

A
  1. bulging fontanelle
  2. high pitched cry
  3. hypotonia
  4. paradoxic irritability
37
Q

presumptive lab tests for streptococcus agalatiae (group B strep)

A

CAMP factor

accentuation of hemolysis due to interaction with staph b-lysin

38
Q

(early onset/late onset) neonatal group b strep

major clinical manifestations are bacteremia, pneumonia, and meningitis

A

early onset

39
Q

What are the two main manifestations of Listeriosis

A

sepsis

meningitis

40
Q

What are the main causes of hospital acquired meningitis

A

iatrogenic procedures

altered immune status

41
Q

What is the only reservoir of Neisseria meningitidis

A

humans

42
Q

(early onset/late onset) neonatal group b strep

maternal obstetric complications are common

A

early onset

43
Q

How is lipopolysaccharide-like surface component a virulence factor for Listeria monocytogenes

A

antiphagocytic

complement-dependent hemolytic antibodies

44
Q

Which meningitis microbe is associated with growing on a very selective agar made of Mueller Hinton supplemented with sheep RBCs and antibiotics

(vanco, colistin, nystatin, and bactrim)

A

Neisseria meningitidis

45
Q

Which microbe is associated with the tumbler test

A

Neisseria meningitidis

46
Q

What are the four virulence factors of streptococcus agalatiae (group B strep)

A
  1. capsular polysaccharide
  2. hyaluronidase
  3. collagenase
  4. hemolysin
47
Q

Encephalitis is inflammation in the:

A

parenchyma

48
Q

neonatal meningitis predisposing factors *maternal factors

A

premature rupture of membrane
urogenital infection during late term
intrauterine infection during early term
invasion of the uterine space

49
Q

definitive diagnosis for streptococcus agalatiae (group B strep)

A

isolation from blood, CSF

50
Q

Meningitis is inflammation resulting from an infection in the:

A

subarachnoid space

51
Q

what are the 5 most important serogroups of Neisseria meningitidis?

Which ones are in the quadrivalent vaccine?

A

A, B, C, Y, W35

all but B

52
Q

What are the 3 pathways for gaining access to the CNS

A
  1. invasion of the bloodstream and seeding of the CNS
  2. Retrograde neuronal pathway
  3. direct contiguous spread
53
Q

What is a classic feature of listeriosis in adults?

A

brain stem encephalitis

54
Q

What is the difference between acute and chronic meningitis

A 
acute = symptom onset of hours to several days
chronic = symptom progression for more than 4 weeks
55
Q

(early onset/late onset) neonatal group b strep

maternal obstetric complications are uncommon

A

late onset

56
Q

Listeria monocytogenes
gram (+/-)
shape?
motile?

A

gram positive
coccobacillus
motile

57
Q

What is the only microbe associated with summer seasonality for meningitis

A

Listeria monocytogenes

58
Q

What is the most common cause of bacterial meningitis now (after 1986)

A

strep pneumo

59
Q

Why do outbreaks of Neisseria meningitidis happen in college dorms and military barracks

A

because it requires close quarters for transmission

60
Q

What is the reason incidence of meningitis has declined significantly

A
  1. availability of vaccines

2. universal screening of pregnant women for Group B strep

61
Q

What is the negative result of the release of inflammatory cytokines once the bacteria crosses the blood-brain barrier

A

WBC diapedesis into CSF —>
increased permeability of blood-brain barrier —>
edema, intracranial pressure, altered blood flow

62
Q

Predominant agents of NEONATAL meningitis

A

streptococcus agalactiae
escherichia coli
listeria monocytogenes

63
Q

What is the most common pathway of an infection gaining access to the CNS

A

invasion of the bloodstream and seeding of the CNS

64
Q

What blood studies are useful in the diagnosis of meningitis

A

CBC
Serum electrolytes
Liver profile

SERUM GLUCOSE compared to CSF

65
Q

What are the main microbes associated with hospital acquired meningitis

A

gram negative rods
s. aureus
“other strep and staph”

66
Q

Which meningitis microbe is associated with being able to live at very low temps in the fridge or freezer

A

Listeria monocytogenes

Micro Exam 2 (Shelby) (9 decks)

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