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
4) Seizure
5) Confusion
What signs/symptoms of meningitis are seen on in newborns?
1) A bulge in the soft spot on top of a baby’s head (fontanel)
2) Stiffness in the whole body
3) Constant crying/irritability
4) High Fever
What is the general antimicrobial therapy given for meningitis?
1) Vancomycin
2) Ceftriaxone
3) Dexamethasone (Bacterial meningitis)
When examining the CSF in bacterial meningitis, what is the
1) Opening Pressure
2) WBC count
3) Cell Differential
4) Protein Level
5) Glucose Level
1) Elevated
2) Greater than 1,000 per mm^3
3) PMN mostly
4) Mild to marked elevated
5) Normal to decreased
When examining the CSF in VIRAL meningitis, what is the
1) Opening Pressure
2) WBC count
3) Cell Differential
4) Protein Level
5) Glucose Level
1) Normal
2) <100 per mm3
3) Lymphocytes predominately
4) Normal to elevated
5) Normal
Of the pathogens reported to cause encephalitis, the majority are?
Viruses
What are common causes of infection 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 occurs in autoimmune encephalitis?
Rapid Progressive (<6 weeks) Encephalopathy or Psychiatric disturbances, especially with seizures
What are the two most common etiologies of autoimmune encephalitis?
What are the treatments?
1) NMDA Encephalitis
2) LGI1 Encephalitis
-Combination of Immune therapies (Steroids, IVIG, Rituximab)
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?
What will CSF find?
Extreme delta brush
Pleocytosis or oligoclonal bands and/or NMDA receptor antibodies
NMDA Encephalitis is commonly associated with presence of?
Teratoma
LGI1 Encephalitis occurs more commonly in what population?
Men
LGI1 Encephalitis typically involved 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
