Bacterial Meningitis

Question 1

MCC of Bac Meningitis in Newborn

Answer 1

SEL-
Strep agalactiae- GBS
E.Coli
Listeria

Question 2

MCC of Bac Meningitis in 1mo- 2yo

Answer 2

HENS
Strep Pneumo
N. Meningitidis
E. Coli
HiB in non vaccinated children

Question 3

MCC of Bac Meningitis in teens and young adults

Answer 3

Strep Penuno

Nisseria Meningitidis

Question 4

MCC of Bac Meningitis in the elderly

Answer 4

Strep Penuno
N. Meningitidis
Listeria

Question 5

MCC of Bac Meningitis related to instrumentation

Answer 5

Staph Epidermidis

Question 6

MCC of bac meningitis in immuncompromised/ those with HIV

Answer 6

Syphyillis

Question 7

Bioterror agent of Meningitis

Answer 7

Anthrax

Question 8

N. Meningitidis- microscopic characteristics

Answer 8

Gram - diplococci
intracellular
capsule- 13 serogroups- used for typing, and capsular polysacharides determine virulence
pilli

Question 9

Major types of N.Meningitidis

Answer 9

A, B, C, Y, W135

Question 10

What types of N. Meningitidis are there vaccines for?

Answer 10

A

There is not one for B

Question 11

What is the pathology of Meningitis caused by N. Meningitidis

Answer 11

1) Previous ENT infection ie pneumonia
2) N. Menigitidis is transfered to the body via respiratory droplets or by hands
3) Pilli helps it bind to the nasopharyngeal epithelium
4) Nasopharyngeal colonization
5) Crosses BBB and releases an endotoxin (like all gram negatives)
6) immune response causing release of cytokines and complement
7) Cerebral edema –> ICP increase –> CBF decrease –> stupor –> death

Question 12

What is systemic spread called

Answer 12

This is called Meningococcemia

Question 13

What is Waterhouse Friderichson Syndrome

Answer 13

Infection of the adrenal glands by N. Meningitidis. Hemmorhages caused by the N. Meningitidis infection leading to adrenal gland failure.
Doesn’t mean that there is meningitis

Question 14

Is there exudate on the brain during meningitis

Answer 14

Yes and boy is it purulent

Question 15

Sx/ Symptoms of bacterial meningitis

Answer 15

Prolonged fever w/o response to antipyretics
petechial rash
Nuchal rigidity
vomiting, lethargy, change in mental status, irritability

Question 16

What are the two signs to look for in meningitis

Answer 16

Kernig and Brudzinski

Question 17

What symptom would you find in infants with bacterial meningitis

Answer 17

bulging fontanelles

Question 18

Early complications of meningitis

Answer 18

hypovolemia
cerebral edema
seizures
cranial nerve palsies

Question 19

Late complications of meningitis

Answer 19

hearing loss
epilepsy
MR and Learning disabilities
hydrocephalous

Question 20

Non neuro complications

Answer 20

Shock
Multi Organ dysfunction
Pupura

Question 21

Treatment for Bacterial Meningitis

Answer 21

Steroids to decrease the inflammation and prevent damage
Then antibiotics to deal with the specific etiologic agent
Prophylaxis for those that they have been in contact with

Question 22

CSF findings in bac meningitis
pressure
lymphs
neutrophils
glucose
protein

Answer 22

Pressure- inc
Lymphs- normal
Neutrophils- inc (b/c bacterial)
glucose- dec
Protein- inc

Question 23

CSF findings in Viral meningitis
Pressure
lymphs
Neutrophils
Glucose
Protein

Answer 23

Pressure- normal/ inc
lymphs- inc b/c viral
PMNs- normal
glucose- normal
protein- normal/ inc

Question 24

CSF findings Fungal meningitis
Pressure
lymphs
Neutrophils
Glucose
Protein

Answer 24

Pressure- inc
lymphs- inc
PMN's- normal
Glucose- dec
Protein- inc

Question 25

Differential for bac meningitis

Answer 25

TBF, fungal, or viral
abscess
tumor
encephalopathy

Question 26

Prevention of Tb

Answer 26

7 valent strep penumo vaccine
HiB
N. Meningitidis vaccine
Pneumovax- 23 valent