Clinical Approach to Meningitis, Encephalitis (Hon) Flashcards
What is the most common cause of bacterial meningitis?
What is a highly contagious cause in teenagers and young adults?
What is a potential cause in the elderly?
1) Streptococcus pneumoniae
2) Neisseria meningitidis
3) Listeria monocytogenes
What are common causes of viral meningitis?
1) Enteroviruses
2) HSV
3) HIV
4) West Nile
Which form of meningitis causes serious complications and could even result in death?
Bacterial meningitis
What is the most common causes of fungal meningitis especially in diabetic or immunocompromised patients?
Cryptococcal
What are signs/symptoms of meningitis in patients over age 2?
1) Sudden high fever
2) Stiff neck
3) Severe headache
What signs/symptoms of meningitis are seen in newborns?
1) A bulge in the soft spot on top of a baby’s head (fontanel)
2) Stiffness in the whole body
What is the general antimicrobial therapy given for meningitis?
1) Vancomycin
2) Ceftriaxone
When examining the CSF in meningitis, what is the WBC if the cause is bacterial?
If the cause is viral?
1) Greater than 1,000 per mm^3
2) Less than 100 per m^3
When examining the CSF in meningitis, what is the cell differential if the cause is bacterial?
If the cause is viral?
1) Predominance of PMNs
2) Predominance of Lymphocytes
When examining the CSF in meningitis, what is the protein level if the cause is bacterial?
If the cause is viral?
1) Mild to marked elevation
2) Normal to elevated
When examining the CSF in meningitis, what is the glucose level if the cause is bacterial?
If the cause is viral?
1) Normal to marked decrease
2) Normal
Of the pathogens reported to cause encephalitis, the majority are?
Viruses
What are common causes of infectious encephalitis in an adult?
1) HSV 1 or 2
2) HIV
3) West Nile
4) Varicella Zoster
5) Treponema pallidum
Herpes Simplex 1 encephalitis typically presents as a rapidly progressive neurologically devastating illness with combination of?
1) Fever
2) Headache
3) Impaired consciousness
4) Seizures
MRI and EEG of a patient with Herpes Simplex 1 encephalitis often demonstrates focal abnormalities in what area?
Temporal lobes
What is the treatment for Herpes Simplex 1 encephalitis?
Acyclovir
What should be considered in patients with rapidly progressive (usually < 6weeks) encephalopathy or psychiatric disturbance, especially if seizures also present?
Autoimmune encephalitis
What are the two most common etiologies of autoimmune encephalitis?
1) NMDA Encephalitis
2) LGI1 Encephalitis
NMDA Encephalitis most commonly affects what population?
Young or middle-aged women
NMDA Encephalitis typically presents with rapid onset (less than 3 months) of what symptoms?
At least four of the six:
1) Cognitive dysfunction
2) Speech dysfunction
3) Seizures
4) Movement disorder
5) Decreased level of consciousness
6) Autonomic dysfunction
What EEG finding is associated with NMDA Encephalitis?
Extreme delta brush
NMDA Encephalitis is commonly associated with presence of?
Teratoma
LGI1 Encephalitis occurs more commonly in what population?
Men
LGI1 Encephalitis typically involves what type of seizures?
Faciobrachial dystonic seizures
What complication is seen in 50% of LGI1 Encephalitis patients?
Sleep disturbance
Abnormality of what area of the brain is seen in LGI1 Encephalitis patients?
Temporal lobe, especially hippocampus
