Case 30: Partially treated meningitis Flashcards
What antimicrobial will an adult be commenced on in suspected meningitis?
Ceftriaxone
When will lumbar puncture be performed?
When there’s suspected meningitis and no contraindications
What does high leucocytes, low glucose and high protein in the CSF suggest?
Bacterial meningitis
Which symptom seen on the patient is typical of N. meningitidis?
Rash - because N. meningitidis stimulates inflammatory cells like crazy
What is the result of a Gram stain of N. meningitidis?
Gram -ve diplococci
What is the result of N. meningitidis growth on HBA when innoculated directly from CSF?
No growth
What is the result of N. meningitidis growth on CHA when innoculated directly from CSF?
No growth
Will N. meningitidis grow on CHA or HBA?
No
What does a turbid serum broth innoculated with CSF suggest?
Bacterial infection
If the pathogen is known to be N. meningitidis, yet the slide agglutination tests fail, why could this be?
Perhaps not enough organisms present
Could be because patient had been treated with Benzylpenicillin
Can latex agglutination test for N. meningitidis type B?
No - because it has a scialic acid capsule
What is the colonial morphology of N. meningitidis from serum broth on cultured on HBA?
White colonies
What is the colonial morphology of N. meningitidis from serum broth on cultured on CHA?
White colonies
What is the Gram stain of N. meningitidis?
Gram negative diplococci
Why is CSF innoculated into serum broth?
Antibiotic treatment kills many of the bacteria.
Allows numbers to rise before plating.
