Bacterial Meningitis Flashcards
Most common organisms causing bacterial meningitis
s. pneumoniae and neisseria meningitidis
Empiric Antibiotic management of bacterial meningitis in immunocompetent host
IV Ceftriaxone or cefotaxime plux IV Vanc
Empiric Antibiotic management of bacterial meningitis in patient >50 or with altered cell mediated immunity
IV Ampicillin (Listeria) plus IV Ceftriaxone or Cfotaxime plus IV Vanc
Empiric Antibiotic management of bacterial meningitis in patient with allergy to B lactams
IV moxifloxacin instead of cephalosporin
IV Bactrim instead of ampicillin
Empiric Antibiotic management of bacterial meningitis in hospital acquired bacterial meningitis
IV Vanc plus either IV ceftazidime, Cefepime, Meropenem
Empiric Antibiotic management of bacterial meningitis in patients who had neurosurgical procedures
IV Vanc plus either IV Ceftazidime, cefepime, meropenem
In suspected or confirmed Pneumococcal meningitis, give
dexamethasone 15 min before antimicrobial agents for 4 days
Treatment for viral meningitis is
symptomatic and supportive
Brain Abscess is treated for
4-8 weeks
CSF findings in HSV Encephalitis
lymphocytic pleotosis ( increased lymphocytes in CSF), maybe erythrocytes
Testing for HSV Encephalitis
Temporal lobe abnormality on imaging, periodic lateralizing epileptiform discharges on EEG
HSV PCR of CSF
Treatment for HSV Encephalitis
High dose IV acyclovir within 24 hours of symptom onset continued for 14-21 days
West Nile may present as
asymmetric flaccid paralysis. May progress to respiratory failure
Diagnose WNV
serum IgM antibody to WNV
Treatment for WNV
Supportive care
