Central Nervous System Infections Flashcards
What are abscess
Pockets of puss
What is the most common infection of the central nervous system
Meningitis
What are the treatment objectives for central nervous system infections
Therapy will cure the infection, minimal risk of neurological damage and drug related toxicity
What is meningitis
inflammation of meninges (membranes covering the brain and spinal cord) that occurs where the cerebral spinal fluid flows through
What are common meningitis presentations between adults and young infeants
Fever and seizures
What are unique meningitis presentations for adults
Headache, Visusal disturbances, confusion, and neck stiffness
What are unique meningitis presentations for young infants
Irritability, vomiting, and decreased oral intake
How long do acute meningitis sysmptoms last, what causes them
Hours to days but are rapidly fatal, bacteria and viruses
How long do chronic meningitis symptoms last, what causes them
At least 4 weeks, M. tuberculosis and fungi
What confirms the diagnosis of meningitits, what would be present in acute bacterial meningitis
Cerebral spinal fluid/ WBC greater than 500, Major cell type is PMNs, high protien, low glucose
Because bacterial meningitis is rapidly fatal and can lead to permannent neurological damage what empiric antibiotic characteristics be present
Broad spectrum, high dose, intravenous, bactericidal
In ages 1-23 months what are the common pathogens that cause bacterial meningitis, ages 2-50
S.pneumoniae, N. meningitidis, H. influenzae/ N. meningitidis, S. pneumoniae
What is the empiric antibioitic choice to treat meningitis regardless of age
Vancomycin plus 3rd generation cephalosporin
What is the role of steroids in treating meningitis
Decrease inflammation and pressure due to Bactericidal agents causing more inflammation due to bacteria death
When are steroids given for treatment of meningitis
Before or with the first dose of antibiotics
What major pathogens are covered by the 3rd generation cephalosporin (ceftriaxone or cefotaxime)
H. Influenzae, N. meningitidis, S. pneumoniae that is penicillin susceptible
What major pathogens are covered by vancomycin
S. pneumoniae that is pencillin susceptible and non-penicillin susceptible
Why is a gram stain of CSF helpful
preliminary pathogen identification`
T/F: If the meningitis is caused by H. influenzae then vancomycin and ceftriaxone should be continued
False: The regimen should be changed to just ceftriaxone because vancomycin has no coverage for H. influenezae
What is the best prophylaxis for H. influenzae meningitis
Vaccines
What is Redman’s syndrome, what can cause it, what can prevent it
pruritis and erythema that is most prominent over the upper body, associated with rapid infusion of vancomycin dose, minimize by giving vancomycin over 1 hour
T/F: All 3rd generation cephalosporins are not interchangeable
True
What are the cephalosporins that are interchangeable for meningitis
Ceftriaxone and Cefotaxime
What is the dosing frequency of ceftriaone and cefotaxime
Ceftriaxone: every 12-24 hours, Cefotaxime: every 6 to 8 hours
