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Microbiology > Bacterial Meningitis > Flashcards

Bacterial Meningitis Flashcards

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1
Q

What is the most common causitive agent of bacterial meningitis? What is the most common cause of neonatal meningitis?

A

strep pneumo; strep agalactiae

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2
Q

What are the most common causes of community acquired meningitis?

A

s. pneumo, h. flu, n. meningitidis

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3
Q

What are the most common causes of hospital acquired meningitis?

A

gram negative rods, s. aureus, other strep or staph

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4
Q

What causes a sudden neck or head pain in meningitis? What is it followed by?

A

Huge release of inflammatory cytokines, followed by WBC diapedesis into the CSF

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5
Q

What are the three pathways for gaining access to the CNS for meningitis?

A

Invasion of blood stream and seeding of the CNS (most common), retrograde neuronal pathway (Naegleria), direct contiguous spread (infections, congenital malformations, etc)

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6
Q

What does WBC diapedesis into the brain lead to?

A

Increased permeability of BBB, increased ICP and edema, eventual decrease in BF to the brain

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7
Q

What is the classic triad of meningitis sx?

A

Fever, headache, neck stiffness! Also sleepiness, confusion, delirium

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8
Q

What will you find in a hx of meningitis pt?

A

Exposure to patients with similar illness!!!!! (onset, setting)

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9
Q

A 4 month old infant presents with a bulging fontanelle, a high pitched cry that disappates when he is left alone (paradoxic irritability), and hypotonia. What is at the top of your differential?

A

Bacterial meningitis!!!

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10
Q

What are some generalized tests to be used to diagnose meningitis?

A

CBC, serum electrolytes, SERUM GLUCOSE COMPARED WITH CSF GLUCOSE, liver profile

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11
Q

What additional tests can you order to check for meningitis?

A

Lumbar puncture, cultures, neuroimaging

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12
Q

What is the treatment for meningitis (general)?

A

empiric abx therapy, steroid (dexamethasone) for swelling, intrathecal abx for hospital acquired

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13
Q

What would you call an intense acute congestion of meningeal blood vessels and purulent exudate?

A

Purulent meningitis

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14
Q

What are maternal predisposing factors for neonatal meningitis?

A

premature rupture of membranes, urogenital infection during LATE term, intrauterine infection during EARLY term

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15
Q

What are neonatal predisposing factors for neonatal meningitis?

A

Immaturity of host defense and immaturity of organ systems (low birth weight)

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16
Q

What are signs and symptoms of neonatal meningitis?

A

Hyperthermia (usual) or hypothermia (dysregulation in general)
CNS manifestations (lethargy, irritability, seizures)
GI disturbance
Respiratory abnormalities

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17
Q

What are the predominant agents of neonatal meningitis?

A

Streptococcus agalactiae (group B strep)
E. Coli
Listeria monocytogenes

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18
Q

What are the CDC recommendations to prevent neonatal meningitis?

A

Universal prenatal screening for vaginal or rectal group B strep for all PGN women 35-37 weeks

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19
Q

What is the exception to routine antibiotic prophylaxis for group B strep positive women at the end of term?

A

undergoing planned C-section AND who have not begun labor or had rupture of membranes

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20
Q

What is the prognosis for neonatal meningitis?

A

Generally poor, survivors have permanent defects

21
Q

You are looking at a gram positive coccus with a gray-white colony and a narrow zone of B-hemolysis. What is it?

A

Strep Agalactiae

22
Q

What are the four virulence factors found in strep agalactiae?

A

capsular polysaccharide
hyaluronidase
collagenase
hemolysin

23
Q

A 15-day old neonate presents with GBS. What are some clinical manifestations and what is his prognosis?

A

bone/joint infections, bacteremia (left shift), and meningitis

24
Q

Where should you obtain a culture for GBS from?

A

A normally sterile site (blood, CSF, areas with mixed flora)

25
Q

What is one presumptive lab test for GBS? What does it look for?

A

CAMP factor; accentuation of hemolysis due to interaction with staph B-lysin

26
Q

You have a gram negative enteric bacillus. What is it and is it considered an endogenous neonatal meningitis infection?

A

E. Coli, and no, not considered endogenous

27
Q

Almost all meningitis caused by s. pneumo follows what type of infection?

A

Pneumonia!

28
Q

Gram positive, alpha hemolytic, lancet shaped diplococci

A

strep pneumo

29
Q

Why are the elderly the most commonly affected population of strep pneumo infection?

A

because youth can get the vaccine

30
Q

Non-motile, G- coccobacillus with LOS

A

H. Flu

31
Q

What is the usual pattern of meningitis caused by H. flu?

A

Several days of mild antecedent infection followed by a deterioration and signs and symptoms of meningitis

32
Q

What bacterium is the exception to community-acquired meningitis outbreaks?

A

Listeria is usually in the summer and in newborns

33
Q

What are the oxygen requirements of listeria in vitro? What about temperatures?

A

reduced O2 tension; non-fastidious so it grows and temps from 0-50* (grows well in the fridge!)

34
Q

Gram positive, motile coccobacillus that is a facultative intracellular pathogen with a worldwide distrubution

A

Listeria monocytogenes

35
Q

You just get back from a BBQ with coleslaw, raw hot dogs, undercooked chicken, what agent are you concerned about that has the ability to infect living and nonliving matter?

A

Listeria monocytogenes

36
Q

Which VF of listeria leads to its antiphagocytic ability?

A

LPS-like surface component

37
Q

What is the VF of listeria that disrupts the phagolysosome membrane? What else does it do?

A

Listeriolysin O; inhibits antigen processing and induces apoptosis

38
Q

What are the two main manifestations of listeriosis? What happens if it is acquired in utero?

A

sepsis and meningitis; stillbirth, abortion, etc.

39
Q

What is the leading cause of meningits in cancer and renal transplant patients? What is its classic feature?

A

Listeriosis; brain stem encephalitis

40
Q

What is the typical way of diagnosing listeriosis?

A

“tumbling” motility in hanging drop preparation

AccuProbe (DNA probe technology)

41
Q

Meningococcal meningitis is caused by which organism?

A

Neisseria meningitidis

42
Q

fastidious, gram negative, kidney bean shaped diplococcus

A

Neisseria meningitidis

43
Q

Which serotypes of neisseria meningitidis have conjugate and non-conjugate vaccines given to adolescents (age 11)?

A

A, C, Y, W135 (all except B)

44
Q

What is the reservoir for neisseria meningitidis?

A

HUMANS ARE THE ONLY RESERVOIR (nasopharynx)

45
Q

You live in a college dorm and your brother is in the military and lives in the barracks. What infection are you both at risk for?

A

Meningococcal meningitis (n. meningitidis)

46
Q

What is the hallmark clinical sign of meningococcemia?

A

characteristic petechial rash

47
Q

What agar is used for cultivation of Neisseria Meningitidis?

A

Thayer-Martin agar (3 abx plus nystatin)

48
Q

What is the DOC for Neisseria meningitidis? What are the alternatives?

A

PCN G; chloramphenicol or 3rd gen ceph

Microbiology (14 decks)

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