CA - CNS infections (CKL) Wk 2 Flashcards
Whats encephalitis & what are its symptoms?
Infection/inflammation of the cerebral cortex
-> infection directly damages neurons & brain tissue -> disrupts normal brain function
- Altered mental state (disorientation, memory loss), Hallucinations
- Loss of sensation or coordination
- Difficulty speaking or understanding language (aphasia)
- Personality / behavioural changes
Whats the management of bacterial meningitis?
If there are no signs of raised ICP:
1. perform lumbar puncture (LP) ASAP to obtain CSF specimen
2. take blood culture (especially if fever)
How is the CSF sample of bacterial meningitis processed by the lab?
- CSF - processed urgently by Microbiology lab
- CSF white cell count & Gram stain results - conveyed to medical team ASAP to guide treatment
What are the signs & symptoms of bacterial meningitis?
inflammation in the meninges -> increased ICP -> impaired blood flow -> affects pain-sensitive structures
- Classic symptom: Stiff neck
- Sensitivity to light (photophobia)
What are the bacteria causing bacterial meningitis for the normal population, neonates, pregnant women & immunocompromised pts?
Normal population
1. Neisseria meningitidis
2. Strep pneumonia
3. Haemophilus influenzae
Neonates:
1. Group B Streptococcus
2. E coli
Neonates, pregnant women, immunocompromised:
1. Uncommon: Listeria monocytogenes
- foodborne
How to prevent bacterial meningitis?
Vaccination against :
1. Strep pneumoniae
2. Haemophilus influenzae
3. Neiserria meningitidis
Household & close contacts -> give chemoprophylaxis (meds to prevent disease or infection) if meningitis caused by :
1. Haemophilus influenzae
2. Neiserria meningitidis
Who does CRYPTOCOCCUS NEOFORMANS (fungal) MENINGITIS tend to infect?
immunocompromised host, especially HIV
What are the symptoms of TB (bacteria) meningitis?
- Can mimic acute bacterial meningitis in its presentation
- Fatal within 5-8 wks of onset if untreated
How to diagnose TB meningitis?
- Microscopy: AFB smear -> AFB culture
AFB -> for TB - TB PCR of CSF
Whats the treatment of viral meningitis?
- supportive, self-limiting
- low fatality rates compared to bacterial meningitis: acute & severe, rapid progression -> can die :((
What are the viruses that can cause viral encephalitis?
- HSV-1
- HSV-2
- Mumps
- Measles
- HHV6 (Human Herpes virus)
- CMV
- EBV
- Enterovirus
What are the symptoms of viral encephalitis?
- hallucinations, seizures, severe headache
- repetitive higher motor activity eg dressing & undressing
- unsteady gait (ataxia)
Whats the treatment for viral encephalitis?
Only treatment for: Herpes Simplex Virus HSV
- early detection of HSV and treatment with Aciclovir (antiviral) reduces mortality
- treatment is more challenging + must give higher dose -> hard to cross BBB
